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Park S, Leon C, Zaidi A, Malik A, Rahman A, Surkan PJ. Family concerns and relationship problems in anxious pregnant women and their associations with postnatal functional disability in Pakistan. J Psychosom Res 2024; 181:111674. [PMID: 38663268 PMCID: PMC11261833 DOI: 10.1016/j.jpsychores.2024.111674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/25/2024] [Accepted: 04/13/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Expanding on existing research suggesting that strategies to reduce prenatal anxiety can decrease functional disability (e.g., difficulties in performing everyday activities and social participation), we examined if this effect varied by type of anxiety-producing problem (i.e., having family concerns and relationship problems versus other problems) reported during pregnancy. Further, we explored if perceived social support mediated this relationship. METHODS We used longitudinal data on 310 anxious Pakistani women who received any psychosocial intervention sessions as part of a program that was based on Cognitive Behavioral Therapy. The Psychological Outcome Profiles (PSYCHLOPS) was used to assess whether women had 'family concerns and relationship problems' or 'other problems.' The WHO Disability Assessment Schedule 2.0 assessed functional disability at six-weeks after delivery. Lack of support was measured using a 12-item Multi-dimensional Scale of Perceived Social Support. We employed linear regression to examine associations between types of problems reported during pregnancy and postnatal functional disability. Causal mediation analysis was used to assess whether postnatal social support mediated this relationship. RESULTS Of anxious pregnant women, 34% reported family concerns or relationship problems as primary problems in pregnancy. They were more likely to report higher functional disability at six-weeks after delivery than women who reported other problems (adjusted B = 2.40, 95% CI: 0.83-3.97). Lack of overall social support (Estimateindirect = 0.69, 95% CI: 0.04-1.38) and lack of support from friends (Estimateindirect = 0.62, 95% CI: 0.01-1.29) significantly mediated the relationship. CONCLUSIONS Findings suggest that complementing pre- and post-natal care with support programs and services that address family concerns and relationship problems, as well as enhancing social support is important to functional disability.
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Affiliation(s)
- Soim Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Carlued Leon
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan.
| | - Abid Malik
- Department of Public Mental Health, Health Services Academy, Chak Shahzad, Islamabad, Pakistan.
| | - Atif Rahman
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Alwuqaysi B, Abdul-Rahman A, Borgo R. The Impact of Social Media Use on Mental Health and Family Functioning Within Web-Based Communities in Saudi Arabia: Ethnographic Correlational Study. JMIR Form Res 2024; 8:e44923. [PMID: 38227352 PMCID: PMC10828947 DOI: 10.2196/44923] [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: 12/08/2022] [Revised: 10/02/2023] [Accepted: 11/24/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND In recent years, increasing numbers of parents, activists, and decision-makers have raised concerns about the potential adverse effects of social media use on both mental health and family functioning. Although some studies have indicated associations between social media use and negative mental health outcomes, others have found no evidence of mental health harm. OBJECTIVE This correlation study investigated the interplay between social media use, mental health, and family functioning. Analyzing data from 314 users, this study explores diverse mental health outcomes. The study places particular emphasis on the Saudi Arabian sample, providing valuable insights into the cultural context and shedding light on the specific dynamics of social media's impact on mental well-being and family dynamics in this demographic context. METHODS We collected data through a subsection of an anonymous web-based survey titled "The Effect of COVID-19 on Social Media Usage, Mental Health, and Family Functioning." The survey was distributed through diverse web-based platforms in Saudi Arabia, emphasizing the Saudi sample. The participants indicated their social media accounts and estimated their daily use. Mental health was assessed using the General Health Questionnaire and family functioning was evaluated using the Family Assessment Device Questionnaire. In addition, 6 mental health conditions (anxiety, self-esteem, depression, body dysmorphia, social media addiction, and eating disorders) were self-reported by participants. RESULTS The study demonstrates a pattern of frequent social media use, with a significant portion dedicating 3-5 hours daily for web-based activities, and most of the sample accessed platforms multiple times a day. Despite concerns about social media addiction and perceived unhealthiness, participants cited staying connected with friends and family as their primary motivation for social media use. WhatsApp was perceived as the most positively impactful, whereas TikTok was considered the most negative for our Saudi sample. YouTube, Instagram, and Snapchat users reported poorer mental health compared with nonusers of these platforms. Mental health effects encompassed anxiety and addiction, with age and gender emerging as significant factors. Associations between social media use and family functioning were evident, with higher social media quartiles correlating with a greater likelihood of mental health and unhealthy family functioning. Logistic regression identified age and gender as factors linked to affected mental health, particularly noting that female participants aged 25-34 years were found to be more susceptible to affected mental health. In addition, multivariable analysis identified age and social media use quartiles as factors associated with poor family functioning. CONCLUSIONS This study examined how social media affects mental health and family functioning in Saudi Arabia. These findings underscore the need for culturally tailored interventions to address these challenges, considering diverse demographic needs. Recognizing these nuances can guide the development of interventions to promote digital well-being, acknowledging the importance of familial connections in Saudi society.
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Affiliation(s)
| | | | - Rita Borgo
- King's College London, London, United Kingdom
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Gagné MH, Clément MÈ, Milot T, Paradis H, Voyer-Perron P. Comparative efficacy of the Triple P program on parenting practices and family violence against children. CHILD ABUSE & NEGLECT 2023; 141:106204. [PMID: 37119691 DOI: 10.1016/j.chiabu.2023.106204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 03/15/2023] [Accepted: 04/16/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND The Triple P - Positive Parenting Program was rolled-out in two communities in Quebec, Canada, in order to prevent child maltreatment. OBJECTIVES (1) Evaluate the effects of Triple P versus care as usual on positive parenting practices, dysfunctional disciplinary practices, and family violence towards the child; (2) verify whether the observed changes persisted over time. PARTICIPANTS AND SETTING A quasi-experimental protocol with an active comparison group was used. Participants were 384 parents or parental figures of at least one 0-12-year-old child, assigned to one of two groups: Triple P (n = 291) and Care as usual (n = 93). We conducted a follow-up study with 164 parents from the Triple P group. METHODS We administered questionnaires at pretest, post-test, and follow-up. Standardized instruments measured positive parenting practices, dysfunctional disciplinary practices (overreactivity, laxness, hostility), and family violence towards the child (repeated psychological aggression, minor physical violence). The intervention dose received by each parent was calculated from data provided by practitioners. RESULTS Belonging to the Triple P group was associated with increased positive practices and decreased overreactive and hostile discipline. A higher dose of intervention was associated with a decrease in laxness. All observed changes were maintained at follow-up, with medium (η2p = 0.073, hostility) to large (η2p = 0.271, overreactivity) effect sizes. Also, Triple P was more effective in reducing minor physical violence, this effect persisting over time (from 36 % to 21 %). CONCLUSIONS This study supports the sustainable efficacy of the Triple P parenting program, except for repeated psychological aggression towards children.
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Affiliation(s)
- Marie-Hélène Gagné
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada.
| | - Marie-Ève Clément
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 5 rue Saint-Joseph, Saint-Jérôme, QC J7Z 0B7, Canada.
| | - Tristan Milot
- Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, QC G8Z 4M3, Canada.
| | - Hélène Paradis
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada.
| | - Pascale Voyer-Perron
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada.
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Guyon-Harris KL, Rosas J, Dolcini-Catania L, Mendelsohn A, Morris P, Gill A, Shaw DS. Validation of Parenting Your Baby and Parenting Your Toddler and Associations with Engagement in Parenting Intervention. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:1789-1804. [PMID: 39371601 PMCID: PMC11452057 DOI: 10.1007/s10826-022-02484-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 10/08/2024]
Abstract
Infants and toddlers are dependent on supportive and nurturing parenting to promote optimal child development. Assessments of parenting can identify need for parenting intervention, however measures are needed that can predict whether parents reporting challenges will engage in intervention. We validated the Parenting Your Baby (PYB) and Parenting Your Toddler (PYT) parenting measures and examined associations with engagement in parenting intervention. Participants included 403 primary caregivers and their newborns from a multisite longitudinal randomized control trial of the Smart Beginnings (SB) parenting intervention across two urban cities. Caregivers completed the PYB (6 months) and PYT (18 and 24 months) and other self-report measures of parenting and infant and toddler temperament and social-emotional functioning for validation. Observed parenting (6, 18, and 24 months) was coded from observed caregiver-child interactions. Engagement in ongoing intervention (SB) was recorded across infancy and toddlerhood. Factor structure was adequate for the PYB and strong for the PYT. Both measures demonstrated reliability and validity across concurrent and future self-report and observed measures of parenting and caregiver-reported infant and toddler functioning. Parent-reported desire for change in parenting scores on the PYT at 18 months were associated with engagement in parenting intervention 18 through 30 months. The PYB and PYT are reliable and valid measures of the parenting of young children, though more work is needed on the factor structure of the PYB. An important direction for future research is to understand and support engagement in parenting intervention for those who report desire for change but do not engage.
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Affiliation(s)
- Katherine L. Guyon-Harris
- Department Pediatrics, University of Pittsburgh School of Medicine, 3414 5th Ave., CHOB 1st Floor, Pittsburgh, PA 15213, USA
| | - Johana Rosas
- Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor 210 South Bouquet St, Pittsburgh, PA 15260, USA
| | - Luciano Dolcini-Catania
- Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor 210 South Bouquet St, Pittsburgh, PA 15260, USA
| | - Alan Mendelsohn
- Department of Pediatrics, NYU Grossman School of Medicine, 550 1st Ave., New York, NY 10016, USA
| | - Pamela Morris
- New York University, Steinhardt School of Culture, Education, and Human Development, 82 Washington Square E, New York, NY 10003, USA
| | - Anne Gill
- Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor 210 South Bouquet St, Pittsburgh, PA 15260, USA
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor 210 South Bouquet St, Pittsburgh, PA 15260, USA
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ANDERSON NATHANIELW, HALFON NEAL, EISENBERG DANIEL, MARKOWITZ ANNAJ, MOORE KRISTINANDERSON, ZIMMERMAN FREDERICKJ. Mixed Signals in Child and Adolescent Mental Health and Well-Being Indicators in the United States: A Call for Improvements to Population Health Monitoring. Milbank Q 2023; 101:259-286. [PMID: 37052602 PMCID: PMC10262392 DOI: 10.1111/1468-0009.12634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 01/13/2023] [Accepted: 02/02/2023] [Indexed: 04/14/2023] Open
Abstract
Policy Points Social indicators of young peoples' conditions and circumstances, such as high school graduation, food insecurity, and smoking, are improving even as subjective indicators of mental health and well-being have been worsening. This divergence suggests policies targeting the social indicators may not have improved overall mental health and well-being. There are several plausible reasons for this seeming contradiction. Available data suggest the culpability of one or several common exposures poorly captured by existing social indicators. Resolving this disconnect requires significant investments in population-level data systems to support a more holistic, child-centric, and up-to-date understanding of young people's lives.
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Affiliation(s)
| | - NEAL HALFON
- University of California Los Angeles Jonathan and Karin Fielding School of Public
- University of California Los Angeles David Geffen School of Medicine
- University of California Los Angeles Meyer and Renee Luskin School of Public Affairs
| | - DANIEL EISENBERG
- University of California Los Angeles Jonathan and Karin Fielding School of Public
| | - ANNA J. MARKOWITZ
- University of CaliforniaLos Angeles Graduate School of Education and Information Studies
| | | | - FREDERICK J. ZIMMERMAN
- University of California Los Angeles Jonathan and Karin Fielding School of Public
- University of California Los Angeles Meyer and Renee Luskin School of Public Affairs
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Loyal D, Ricci L, Villegente J, Ayav C, Kivits J, Rat AC. Healthcare providers perception of therapeutic patient education efficacy according to patient and healthcare provider characteristics. Chronic Illn 2023; 19:233-249. [PMID: 34894789 DOI: 10.1177/17423953211058411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Therapeutic patient education improves numerous health and psychological outcomes in patients with chronic diseases. However, little is known about what makes a therapeutic patient education intervention more effective than another one. This study aims to identify in healthcare professionals the perceived determinants of therapeutic patient education efficacy at the individual level. METHODS Semi-structured individual interviews have been conducted with healthcare professionals (HCP, n=28, including 20 nurses) involved in therapeutic patient education programs (n=14) covering various chronic conditions (kidney and cardiovascular diseases, chronic pain, diabetes, etc.). A thematic content analysis following an inductive approach was used (Nvivo.11 software). RESULTS Five themes were retrieved for patient characteristics: understanding and education, personality, readiness and motivation, social environment, and misinformation and beliefs. Four themes were retrieved for healthcare professionals' characteristics: medical knowledge, appropriate attitude and relational skills, pedagogical skills, and training. DISCUSSION Patient personality is rarely discussed in the literature. Patients who are introverted, lack curiosity, or are not compliant might benefit from specific therapeutic patient education practices or formats. All these potential determinants regarding patients and healthcare professionals should be routinely assessed in future studies about therapeutic patient education efficacy to understand precisely what makes an intervention successful.
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Affiliation(s)
| | - Laetitia Ricci
- CIC 1433 Clinical Epidemiology, 26920CHRU-Nancy, INSERM, 137665University of Lorraine, France
| | - Julie Villegente
- CIC 1433 Clinical Epidemiology, 26920CHRU-Nancy, INSERM, 137665University of Lorraine, France.,27078University of Reims Champagne-Ardenne, France
| | - Carole Ayav
- CIC 1433 Clinical Epidemiology, 26920CHRU-Nancy, INSERM, 137665University of Lorraine, France
| | | | - Anne-Christine Rat
- 137665University of Lorraine, APEMAC EA4360, France.,27003University of Caen Normandie, UMR-S 1075 - COMETE, France.,Rheumatology Department, 26962University Hospital Center Caen, France
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McAndie E, Murray CA, Wilson P, Thompson L. Parent-infant observation for prediction of later childhood psychopathology in community-based samples: A systematic review. PLoS One 2022; 17:e0279559. [PMID: 36580478 PMCID: PMC9799315 DOI: 10.1371/journal.pone.0279559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/11/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Difficulties in parent-child interaction are easily observed and are a potential target for early intervention. This review aimed to assess the utility of current observational methods used to assess parent-child interactions-within the first year of life-and their ability to screen and identify children from low-risk samples most at risk of developing childhood psychopathology. METHODS Six bibliographic databases were searched, and reference lists screened. All peer reviewed papers studying the association between an independent observation of parent-child interaction and later childhood psychopathology in community-based samples were included. Included studies were those recruiting from population or community-based birth cohort data, which we define as 'low-risk'. Studies based on populations known to have a diagnosis of psychiatric illness or developmental disorder, or at high genetic or environmental risk of being diagnosed with such disorder, were excluded. Results were synthesised qualitatively due to high heterogeneity. RESULTS 20,051 papers were identified, nine were included in this study. Childhood psychopathology was associated with fewer positive parent-infant interactions, lower parent vocalisation frequency and lower levels of adult speech and activity. Maternal sensitivity was inversely related to separation anxiety and oppositional defiant/conduct disorders were associated with lower shared look rates. Disruptive behaviour disorders were associated with higher frequency of child vocalisation. CONCLUSION Assessment of parent-child interactions, particularly the level of maternal activity, may be an early indicator of later childhood psychopathology in low-risk samples. Further longitudinal, population-based studies are required. TRIAL REGISTRATION PROSPERO review registration: CRD42020162917 https://www.google.com/search?client=firefox-b-d&q=CRD42020162917.
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Affiliation(s)
| | | | - Philip Wilson
- Centre for Rural Health, University of Aberdeen, Inverness, Scotland
| | - Lucy Thompson
- Centre for Rural Health, University of Aberdeen, Inverness, Scotland
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Lee HY, Noh H, Choi E, Lee LH. Social determinants of willingness to discuss end-of-life care with family and doctors among Korean American immigrants: Findings from a cross-sectional survey in Alabama. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6056-e6066. [PMID: 36164279 DOI: 10.1111/hsc.14043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/22/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Prior research reported lower engagement in end-of-life discussions and planning among Korean American (KA) immigrants; however, there is a dearth of research investigating factors associated with their willingness to discuss their end-of-life care wishes. This study aimed to examine the willingness to have end-of-life discussions with family and doctors among KA immigrants and social determinants of health (SDH) associated with willingness. A self-administered, cross-sectional survey was conducted with a convenience sample of 259 KA immigrants recruited from two counties in Alabama. Demographic, health, acculturation and SDH information were collected. Logistic regression analyses were conducted to examine associations between SDH and willingness for end-of-life discussion with family and doctors, respectively. The majority of the sample was willing to discuss end-of-life care with family (94%) and doctors (82%). Those with hospice awareness were more likely to have willingness for discussion with family (OR = 27.70, p < 0.001) and doctors (OR = 5.01, p < 0.001). Those who could not see a doctor because of cost (OR = 0.03, p < 0.01) and who had higher threats to interpersonal safety (OR = 0.74, p < 0.05) were less likely to have willingness for discussion with family. Those who had more chronic conditions (OR = 0.60, p < 0.05) and higher levels of social isolation (OR = 0.77, p < 0.05) were less likely to have willingness for discussion with doctors. The SDH identified in this study should be considered in developing interventions to promote end-of-life discussions in the KA immigrant community. Future research should investigate the associations explored in this study in a larger and more representative sample.
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Affiliation(s)
- Hee Y Lee
- Research/Endowed Academic Chair on Social Work and Health, School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Hyunjin Noh
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Eunyoung Choi
- School of Global Public Health, New York University, New York, New York City, USA
| | - Lewis H Lee
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
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Ho GWK, Chan ACY, Gross DA. Measuring child-rearing goals for parents with young children: A scoping review. FAMILY PROCESS 2022; 61:1264-1286. [PMID: 34580870 DOI: 10.1111/famp.12721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
This scoping review summarizes and consolidates the parenting goals for young children captured in existing parent-report measures, and the characteristics of studies that employed them. Five electronic databases were systematically searched to identify original studies that used a self-report measure for parenting goals during the child's first 5 years. Characteristics of the parenting goals measures and the studies that employed them were extracted and synthesized. A deductive approach was used to reduce the parenting goals items across instruments into representative domains. Fourteen original parenting goals measures and their modifications (i.e., 24 unique measures in total) were identified in 44 research articles from 41 original studies. Items from these measures were synthesized into 33 representative domains. Findings will inform the direction of future research and the development of a comprehensive measure of parenting goals for parents with young children that can be applied across cultures, economic backgrounds, informants, and parenting contexts.
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Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
| | - Athena C Y Chan
- Department of Family Social Science, University of Minnesota, St. Paul, Minnesota, USA
| | - Deborah A Gross
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Blackwell CK, Lai JS, Kallen M, Bevans KB, Davis MM, Wakschlag LS, Cella D. Measuring PROMIS® Social Relationships in Early Childhood. J Pediatr Psychol 2022; 47:573-584. [PMID: 35552428 PMCID: PMC9308389 DOI: 10.1093/jpepsy/jsac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Apply the Patient-Reported Outcome Measurement Information System (PROMIS®) mixed-methods approach to develop and validate new parent-report measures of young children's (1-5 years) family and peer relationships that conceptually align to those for 5-17 year olds. METHODS Expert input, parent interviews, and reviews of theoretical and empirical literature were used to develop draft item pools, which were administered in two waves of panel surveys (N = 1,750). Psychometric evaluation was conducted using item response theory-based methods. Scores were normed to the general U.S. population. Initial validation analyses were conducted using Pearson's correlations and analysis of variance to examine known-group differences between children with various health conditions. RESULTS Experts and parents confirmed the content validity of existing PROMIS family and peer relationships domain frameworks and suggested adding child-caregiver interactions and empathic behaviors, respectively. Bi-factor model analysis supported sufficient unidimensionality where family and peer relationships were modeled as distinct subdomains of a broader concept, Social Relationships. The new measure was robust in discriminating young children with poor social relationships. Correlational and known-group analyses revealed positive associations with general health and well-being and negative associations with emotional and physical distress. CONCLUSIONS The PROMIS Early Childhood Parent-Report Social Relationships item bank enables clinicians and researchers a brief, efficient, and precise way to evaluate early relational health. Subdomain short forms also offer the ability to assess specific components (i.e., child-caregiver, family, and peer) for more targeted interventions and analyses.
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Affiliation(s)
- Courtney K Blackwell
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - Michael Kallen
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - Katherine B Bevans
- Janssen Pharmaceutical Companies of Johnson & Johnson, Global Commercial Strategy Organization, USA
| | - Matthew M Davis
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
- Lurie Children’s Hospital, Stanley Manne Children’s Research Institute, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - David Cella
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
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11
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Graven LJ, Abbott L, Boel-Studt S, Grant JS, Buck HG. Classifying Heart Failure Caregivers as Adequately or Inadequately Resourced to Care: A Latent Class Analysis. J Palliat Care 2022; 38:62-70. [PMID: 35171062 DOI: 10.1177/08258597221079244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify classes of heart failure (HF) caregivers based upon indicators of coping resources and stress, and then, to examine the relationships between the identified caregiver classes and depression, caregiver burden, and life changes. METHODS Cross-sectional data from 530 HF caregivers were analyzed in this secondary analysis using a three-step latent class mixture model to classify caregivers based on level of resources and examine the relationship between the identified classes and depression, caregiver burden, and life changes. Using an online survey, caregivers reported on social support, problem-solving, family function, depression, caregiver burden, and life changes. RESULTS Caregivers were 41.39 (± 10.38) years of age, 49.1% women, 78.3% white, 77.6% urban-dwelling, and 61.7% college/postgraduate educated. Three classes of caregivers (42.3% Adequately Resourced, 25.1% At Risk for Decompensation, 32.6% Inadequately Resourced) were identified. Inadequately Resourced caregivers had the lowest levels of social support, problem-solving, and family function and the highest levels of depression and caregiver burden. Caregivers At Risk for Decompensation had the best family function and reported the most positive perceptions of life changes despite low levels of social support and problem-solving. CONCLUSION Social support, problem-solving, and family function are modifiable coping resources which may buffer stress and influence stress indicators. Caregivers with few coping resources may experience higher degrees of depression and burden, and less positive perceptions of life changes. More research is needed to examine the influence of these coping resources on caregiver adaptation to facilitate the development of targeted interventions which support caregiver mental health.
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Affiliation(s)
- Lucinda J Graven
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Laurie Abbott
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Shamra Boel-Studt
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Joan S Grant
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harleah G Buck
- College of Nursing, University of Iowa, Iowa City, IA, USA
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Spadaro B, Martin-Key NA, Funnell E, Bahn S. mHealth Solutions for Perinatal Mental Health: Scoping Review and Appraisal Following the mHealth Index and Navigation Database Framework. JMIR Mhealth Uhealth 2022; 10:e30724. [PMID: 35037894 PMCID: PMC8804959 DOI: 10.2196/30724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/06/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
Background The ever-increasing pressure on health care systems has resulted in the underrecognition of perinatal mental disorders. Digital mental health tools such as apps could provide an option for accessible perinatal mental health screening and assessment. However, there is a lack of information regarding the availability and features of perinatal app options. Objective This study aims to evaluate the current state of diagnostic and screening apps for perinatal mental health available on the Google Play Store (Android) and Apple App Store (iOS) and to review their features following the mHealth Index and Navigation Database framework. Methods Following a scoping review approach, the Apple App Store and Google Play Store were systematically searched to identify perinatal mental health assessment apps. A total of 14 apps that met the inclusion criteria were downloaded and reviewed in a standardized manner using the mHealth Index and Navigation Database framework. The framework comprised 107 questions, allowing for a comprehensive assessment of app origin, functionality, engagement features, security, and clinical use. Results Most apps were developed by for-profit companies (n=10), followed by private individuals (n=2) and trusted health care companies (n=2). Out of the 14 apps, 3 were available only on Android devices, 4 were available only on iOS devices, and 7 were available on both platforms. Approximately one-third of the apps (n=5) had been updated within the last 180 days. A total of 12 apps offered the Edinburgh Postnatal Depression Scale in its original version or in rephrased versions. Engagement, input, and output features included reminder notifications, connections to therapists, and free writing features. A total of 6 apps offered psychoeducational information and references. Privacy policies were available for 11 of the 14 apps, with a median Flesch-Kincaid reading grade level of 12.3. One app claimed to be compliant with the Health Insurance Portability and Accountability Act standards and 2 apps claimed to be compliant with General Data Protection Regulation. Of the apps that could be accessed in full (n=10), all appeared to fulfill the claims stated in their description. Only 1 app referenced a relevant peer-reviewed study. All the apps provided a warning for use, highlighting that the mental health assessment result should not be interpreted as a diagnosis or as a substitute for medical care. Only 3 apps allowed users to export or email their mental health test results. Conclusions These results indicate that there are opportunities to improve perinatal mental health assessment apps. To this end, we recommend focusing on the development and validation of more comprehensive assessment tools, ensuring data protection and safety features are adequate for the intended app use, and improving data sharing features between users and health care professionals for timely support.
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Affiliation(s)
- Benedetta Spadaro
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom
| | - Nayra A Martin-Key
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom
| | - Erin Funnell
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom
| | - Sabine Bahn
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom
- Psyomics Ltd, Cambridge, United Kingdom
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13
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Prandstetter K, Murphy H, Foran HM. The Role of Intimate Partner Violence, Couple Dissatisfaction and Parenting Behaviors in Understanding Parental Burnout. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 32:343-355. [PMID: 35068912 PMCID: PMC8760085 DOI: 10.1007/s10826-021-02218-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/18/2021] [Indexed: 06/12/2023]
Abstract
Parental burnout (PB), a relatively new and under-studied construct, is defined as a condition resulting from chronic parenting stress. While recent research confirmed its negative associations with familial variables, such as relationship satisfaction and positive parenting practices, little is known about the role of intimate partner violence (IPV) and how it relates to parental burnout. The present study, therefore, aimed to extend existing knowledge on chronic parenting stress by 1) testing for the mediational role of couple dissatisfaction in explaining the link from IPV victimization to PB as well as the link from IPV victimization to dysfunctional parenting, and 2) investigating how specialist gender roles and parental responsibilities for child care relate to IPV victimization and PB. Data collection was part of an international collaboration on factors related to parental satisfaction and exhaustion across different countries. Self-report data from Austrian mothers (N = 121) were collected online and analyzed using structural equation modeling. Results indicated that couple dissatisfaction mediates the link from IPV victimization to PB, as well as IPV victimization to dysfunctional parenting. Furthermore, only specialist gender roles were significantly related to IPV, while parental responsibilities for child care did not significantly relate to experiences of violence. Additionally, neither specialist gender roles nor parental responsibilities were significantly associated with PB in the final model. Overall, our findings connect to family models, such as the Family System Theory and Spillover Theory, underscoring the importance of couples' relationship quality for understanding parental burnout and parenting behaviors in mothers.
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Affiliation(s)
- Katharina Prandstetter
- Institute of Psychology, Department of Health Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Hugh Murphy
- Institute of Psychology, Department of Health Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Heather M. Foran
- Institute of Psychology, Department of Health Psychology, University of Klagenfurt, Klagenfurt, Austria
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14
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López-Fernández G, Gómez-Benito J, Barrios M. The psychometric properties of the parenting scale for Spanish mothers with children aged between 2 and 7 years. J Pediatr Nurs 2022; 62:60-68. [PMID: 34799203 DOI: 10.1016/j.pedn.2021.11.002] [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: 07/23/2021] [Revised: 10/22/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This study aimed to evaluate the psychometric properties of the Spanish version of the Parenting Scale in a large sample of Spanish mothers. DESIGN AND METHODS A two-stage cross-sectional study of the adaptation and cultural validation of the Parenting Scale in a Spanish-speaking environment. In Stage I, the Parenting Scale was translated and back-translated and its semantic, linguistic and contextual equivalence was assessed. In Stage II, the Spanish-language version was validated after its application to 662 Spanish mothers with healthy children aged between 2 and 7 years. Several factor structure models of the Parenting Scale were compared by confirmatory factor analysis. Convergent validity, internal consistency and test-retest reliability were also examined. RESULTS The model of Irvine et al. (1999) presented the best fit to our data. This model demonstrated adequate reliability (internal consistency and stability). The total score and each factor of the Parenting Scale correlated positively with perceived stress in mothers, difficulties in mother-child bonding and child hyperactivity, and negatively with child prosocial behavior. CONCLUSIONS The Spanish version of the Parenting Scale is a valid and reliable measure that can be used by healthcare professionals and scientists to assess dysfunctional parenting in Spanish mothers of children aged 2 to 7 years. PRACTICE IMPLICATIONS This study will allow the use of the Parenting Scale in epidemiological and cross-cultural studies in a variety of applied contexts. Additionally, health professionals who work with families in Spain will have access to a valid and reliable instrument for the assessment of mothers' parenting styles.
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Affiliation(s)
- Gemma López-Fernández
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Department of Gynecology and Obstetrics, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain.
| | - Juana Gómez-Benito
- Department of Gynecology and Obstetrics, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Maite Barrios
- Department of Gynecology and Obstetrics, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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15
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Spitzer C, Lübke L, Göbel P, Müller S, Krogmann D, Brähler E, Reis O, Lincke L, Kölch M. [Assessment of General Family Functioning: Psychometric Evaluation of the German Version of the Brief Assessment of Family Functioning Scale]. Psychother Psychosom Med Psychol 2021; 72:292-298. [PMID: 34911106 DOI: 10.1055/a-1692-8763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The functionality of the family system is not only a central theme in developmental psychology and family research, but also plays a key role in many physical illnesses and mental disorders. Despite its high relevance, there are only a very few brief and user-friendly self-report measures assessing general family functioning. This gap is closed by the Brief Assessment of Family Functioning Scale (BAFFS), which consists of three items of the General Functioning Scale of the internationally well-established Family Assessment Device. In this study, the German version (KSAFF) of the BAFFS was psychometrically evaluated for the first time in a large and representative general population sample (n=2463). Using multigroup confirmatory factor analyses, strong measurement invariance was shown for relevant subsamples (women vs. men; participants in partnerships with vs. without children) with good model fit. Although one of the three items, which is the only negatively formulated item, yielded insufficient psychometric item characteristics, the internal consistency was Cronbach's α=0.71. As an indication of adequate construct validity, associations of family functioning with socioeconomic status as well as with current depression and anxiety were found in accordance with the hypothesis. Although application experiences and psychometric analyses of the German version of the BAFFS in relevant clinical samples are pending, this three-item self-report measure can be recommended as an economic, user-friendly assessment device for general family functioning, particularly since it yielded satisfactory to good psychometric properties in the general population.
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Affiliation(s)
- Carsten Spitzer
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock, Deutschland
| | - Laura Lübke
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock, Deutschland
| | - Philipp Göbel
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock, Deutschland
| | - Sascha Müller
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock, Deutschland.,Institut für Psychologie, Universität Kassel, Deutschland
| | - Diana Krogmann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock, Deutschland
| | - Elmar Brähler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland.,Integriertes Forschungs- und Behandlungszentrum Adipositas-Erkrankungen, Forschungsstelle Verhaltensmedizin, Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock, Deutschland
| | - Lena Lincke
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock, Deutschland
| | - Michael Kölch
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock, Deutschland
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16
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Vicente HT, Daniel F, Sequeira J, Hampson R. Rethinking the Self-Report Family Inventory-Version II (SFI-II): Factor Structure and Psychometric Properties of the Portuguese Version. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09598-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Guan Z, Wang Y, Hu X, Chen J, Qin C, Tang S, Sun M. Postpartum depression and family function in Chinese women within 1 year after childbirth: A cross-sectional study. Res Nurs Health 2021; 44:633-642. [PMID: 34101868 DOI: 10.1002/nur.22159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 05/03/2021] [Accepted: 05/15/2021] [Indexed: 01/13/2023]
Abstract
Family-related factors are reported to influence the development of postpartum depression (PPD), but limited studies have considered the role of family function in this condition. This study aimed to describe the proportion of people with probable or suspected PPD and to determine the relationships among PPD, family function, and obstetric factors. A cross-sectional study was conducted with 630 women who attended six integrated teaching and scientific research communities in Changsha, China. Instruments included the Edinburgh Postpartum Depression Scale and the Family Assessment Device (FAD). A multivariate logistic regression model was used to determine the risk factors of PPD. The prevalence of probable or suspected PPD was 37% in this sample. We found communication (odds ratio [OR] = 3.795, 95% confidence interval [CI] = 1.619-8.897), affective responsiveness (OR = 2.685, 95% CI = 1.642-4.301), role (OR = 2.483, 95% CI = 1.041-5.922), and general functioning (OR = 5.704,95% CI = 2.233-14.569) dimensions of FAD, and type of feeding (OR = 2.700, 95% CI = 1.285-5.671) influenced PPD in the context of Chinese culture. To decrease the prevalence of PPD, interventions such as health education programs and cognitive behavior therapy to strengthen family function are recommended among couples during and after pregnancy.
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Affiliation(s)
- Ziyao Guan
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuwei Wang
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Xin Hu
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiarui Chen
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Chunxiang Qin
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China.,Department of Obstetrical, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siyuan Tang
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China.,Hunan Women's Research Association, Changsha, China
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18
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Nagy M, Kleppin A, Erford BT, Anderson BM, Smith HL. Psychometric Synthesis of the Parent‐Child Relationship Inventory. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Michelle Nagy
- Department of Human and Organizational Development Vanderbilt University
| | - Alison Kleppin
- Department of Human and Organizational Development Vanderbilt University
| | - Bradley T. Erford
- Department of Human and Organizational Development Vanderbilt University
| | - Billie M. Anderson
- Department of Human and Organizational Development Vanderbilt University
| | - Heather L. Smith
- Department of Human and Organizational Development Vanderbilt University
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19
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Stuhlsatz GL, Kavanaugh SA, Taylor AB, Neppl TK, Lohman BJ. Spirituality and Religious Engagement, Community Involvement, Outness, and Family Support: Influence on LGBT+ Muslim Well-Being. JOURNAL OF HOMOSEXUALITY 2021; 68:1083-1105. [PMID: 33764281 DOI: 10.1080/00918369.2021.1888585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The current study utilized data from the Social Justice Sexuality Project to investigate influences on psychological well-being of LGBT+ Muslims (N = 75) in the United States. Specifically, path analyses were used to examine the association between spiritual and religious engagement, LGBT community involvement, outness, and family support with psychological well-being. Control variables included lifespan Islam involvement, age, income, and the age at which the participant came out to themselves. Findings illustrate spiritual and religious engagement, outness, and income were all positively related to psychological well-being. Moreover, individuals who had converted to Islam but were not raised in the faith had significantly lower psychological well-being than those who had a consistent experience with Islam from their childhood until the time of the study. The present investigation provides critical contributions to the study of gender and sexual minorities in the United States and the experiences of currently practicing LGBT+ Muslims and those who were raised Muslim. Clinical implications and future research suggestions are discussed.
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Affiliation(s)
- Greta L Stuhlsatz
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | | | - Ashley B Taylor
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia, Vancouver, Canada
| | - Tricia K Neppl
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Brenda J Lohman
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
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20
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Yee CI, Vargas T, Mittal VA, Haase CM. Adaptability and cohesion in youth at clinical high-risk for psychosis: A multi-informant approach. Schizophr Res 2021; 228:604-610. [PMID: 33277071 PMCID: PMC10471355 DOI: 10.1016/j.schres.2020.11.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 10/28/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Families can play a critical role in the development of psychosis. Adaptability (i.e., flexibility) and cohesion (i.e., emotional bonding) are important markers of family functioning, but have rarely been studied in youth at clinical high risk for developing psychosis (CHR), especially not from a multi-informant perspective. METHODS The current study examined adaptability and cohesion (using youth and mother reports) and clinical symptoms (in youth) among 75 youth at CHR and their mothers (N = 48) and 79 matched healthy controls and their mothers (N = 42). RESULTS Findings showed that (1) youth at CHR and their mothers reported lower adaptability and cohesion than their healthy control counterparts. (2) All youth reported lower adaptability than mothers, but only youth at CHR (not control youth) reported lower cohesion than their mothers. (3) There were no significant links between CHR youth and mother reports of adaptability and cohesion and clinical symptoms. CONCLUSIONS Findings support existing literature that families with a youth at CHR are at risk for poorer functioning and demonstrate pronounced youth-mother discrepancies with youth at CHR (but not controls) reporting lower emotional bonding than their mothers. Future studies may further probe multi-informant perspectives of family environment as a clinical marker in the clinical high risk state.
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Affiliation(s)
- Claire I Yee
- Department of Psychology, Northwestern University, United States of America; School of Education and Social Policy, Northwestern University, United States of America.
| | - Teresa Vargas
- Department of Psychology, Northwestern University, United States of America
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, United States of America
| | - Claudia M Haase
- School of Education and Social Policy, Northwestern University, United States of America
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21
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Liu Y, Jiang Q. Who Benefits From Being an Only Child? A Study of Parent-Child Relationship Among Chinese Junior High School Students. Front Psychol 2021; 11:608995. [PMID: 33488473 PMCID: PMC7820425 DOI: 10.3389/fpsyg.2020.608995] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
After more than three decades of implementation, China's one-child policy has generated a large number of only children. Although extensive research has documented the developmental outcomes of being an only child, research on the parent-child relational quality of the only child is somewhat limited. Using China Education Panel Survey (2014), this study examined whether the only child status was associated with parent-child relationships among Chinese junior high school students. It further explored whether children's gender moderated the association between the only child status and parent-child relationships. Two-level ordered logit models suggested that only children were more likely to report a close relationship with their mothers and fathers compared to children from multiple-child families (including two-child families). Taking birth order into consideration, we found that, only children were more likely to have close parent-child relationships than firstborns, whereas no significant differences were found between only children and lastborns. Interaction analyses further suggested that the only child advantages were gender-specific: the positive effects of the only child status were stronger for daughters than for sons, that is, daughters benefited more from being only children. Our findings highlight the importance of considering children's gender and birth order in exploring the only child effects in the Chinese context. Additional analyses about sibling-gender composition indicated female children were more likely to be disadvantaged with the presence of younger brothers, whereas male children benefited more from having older sisters. This reveals that the son preference culture is still deep-rooted in the Chinese multiple-child families.
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Affiliation(s)
- Yixiao Liu
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Quanbao Jiang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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22
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Huffman LG, Oshri A, Caughy M. An autonomic nervous system context of harsh parenting and youth aggression versus delinquency. Biol Psychol 2020; 156:107966. [PMID: 33027683 PMCID: PMC7665164 DOI: 10.1016/j.biopsycho.2020.107966] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 08/17/2020] [Accepted: 09/25/2020] [Indexed: 01/12/2023]
Abstract
Harsh parenting is a significant predictor of youth aggression and delinquency. However, not every child exposed to adverse parenting develops such problem behaviors. Recent developmental evolutionary models suggest that variability in stress response reactivity to parenting, reflected by autonomic nervous system (ANS) functioning, may affect the impact of adverse parenting on youth behavioral adjustment. The aim of the present study was to investigate whether the parasympathetic and sympathetic branches of the ANS moderate the association between parenting and aggressive and delinquent behaviors. The study sample included low-income, ethnically diverse preadolescents (M = 10.28 years old; N = 101) and their caregivers. Direct effects were found from basal RSA to delinquent behaviors. In addition, harsh parenting predicted increased youths' aggressive and delinquent behaviors in the context of high RSA withdrawal and increased youths' delinquent behaviors in the context of shortened basal PEP. Implications for prevention and intervention are discussed.
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Affiliation(s)
- Landry Goodgame Huffman
- Neuroscience Program, Biomedical & Health Sciences Institute, University of Georgia, Athens, GA, 30607, United States.
| | - Assaf Oshri
- Department of Human Development & Family Science, College of Family & Consumer Sciences, University of Georgia, Athens, GA, 30607, United States
| | - Margaret Caughy
- Department of Human Development & Family Science, College of Family & Consumer Sciences, University of Georgia, Athens, GA, 30607, United States
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23
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Wittkowski A, Vatter S, Muhinyi A, Garrett C, Henderson M. Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility. Clin Psychol Rev 2020; 82:101906. [PMID: 32977111 PMCID: PMC7695805 DOI: 10.1016/j.cpr.2020.101906] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 08/02/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Meaningful, valid and reliable self-report measures can facilitate the identification of important parent-infant-relationship factors, relevant intervention development and subsequent evaluation in community and clinical contexts. We aimed at identifying all available parent-report measures of the parent-infant-relationship or bond and to appraise their psychometric and clinimetric properties. METHOD A systematic review (PROSPERO: CRD42017078512) was conducted using the, 2018 COSMIN criteria. Eight electronic databases were searched. Papers describing the development of self-report measures of the parent-infant-bond, attachment or relationship from pregnancy until two years postpartum or the assessment of their psychometric properties were included. RESULTS Sixty-five articles evaluating 17 original measures and 13 modified versions were identified and reviewed. The studies' methodological quality (risk of bias) varied between 'very good' and 'inadequate' depending on the measurement property assessed; however, scale development studies were mostly of 'inadequate' quality. Although most measures had good clinical utility, the psychometric evaluation of their properties was largely poor. The original or modified versions of the Postpartum Bonding Questionnaire collectively received the strongest psychometric evaluation ratings with high quality of evidence. CONCLUSIONS This novel review revealed that only a few antenatal and postnatal measures demonstrated adequate psychometric properties. Further studies are needed to determine the most robust perinatal measures for researchers and clinicians.
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Affiliation(s)
- A Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Department of Clinical Psychology, Laureate House, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
| | - S Vatter
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - A Muhinyi
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - C Garrett
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - M Henderson
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow G2 3AX, UK
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24
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Montalescot L, Speyer E, Legrand K, Ayav C, Combe C, Stengel B, Untas A. Reliability and validity of the French adaptation of the Family Relationship Index-short form in patients' with chronic kidney disease. J Health Psychol 2020; 27:166-175. [PMID: 32772863 DOI: 10.1177/1359105320949921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Family Relationship Index (FRI) measures family cohesion, expressiveness and conflict. This study aimed to investigate its reliability and validity in patients with chronic kidney disease (CKD). Confirmatory factor analysis was performed on 1657 patients and on subgroups according to socio-demographics and medical variables. Two items with poor saturation were excluded. The indexes indicated an acceptable fit. Reliability was especially weak for expressiveness. Our results provide partial support for the use of the French-version of the FRI in patients with advanced CKD. The family relationship index should be used with caution, especially in certain subgroups and for the expressiveness subscale.
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Affiliation(s)
| | - Elodie Speyer
- Université Paris-Saclay, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Sud, Inserm, Équipe Epidémiologie Clinique, CESP, Villejuif, France
| | - Karine Legrand
- Epidémiologie Clinique, Inserm CIC-EC, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Carole Ayav
- Epidémiologie Clinique, Inserm CIC-EC, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Christian Combe
- Service de Néphrologie Transplantation Dialyse Aphérèses, Centre Hospitalier Universitaire de Bordeaux, and Unité INSERM U1026, Bordeaux, France
| | - Bénédicte Stengel
- Université Paris-Saclay, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Sud, Inserm, Équipe Epidémiologie Clinique, CESP, Villejuif, France
| | - Aurélie Untas
- Université de Paris, LPPS, Boulogne-Billancourt, France
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Churchman A, Mansell W, Tai S. A school-based case series to examine the feasibility and acceptability of a PCT-informed psychological intervention that combines client-led counselling (Method of levels) and a parent–child activity (Shared goals). BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2020. [DOI: 10.1080/03069885.2020.1757622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anamaria Churchman
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Mode Rehabilitation, Phoenix House, Bredbury, UK
| | - Warren Mansell
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Sara Tai
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Family Functioning and Suicide Among the Elderly in Rural China: A Case-Control Psychological Autopsy Study. J Nerv Ment Dis 2020; 208:131-137. [PMID: 31804262 DOI: 10.1097/nmd.0000000000001116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to examine the association between family functioning and suicide among the elderly in rural China. This 1:1 paired case-control psychological autopsy study included 242 suicides at age 60 or more and an equal number of controls matched on age (±3 years), gender, and residency. Family functioning was assessed by the Family Adaptation Partnership Growth Affection Resolve Index. Family dysfunction was reported more frequently in suicides than in paired controls. Severe family dysfunction denoted a significant risk factor for suicide only in women after adjusting for potential confounding factors. Suicides with family dysfunction were prone to have unstable marital status, physical illness, mental disorders, family suicide history, and more stressful life events than those with good family functioning. The findings suggest that the intervention enhancing family functioning may be effective in decreasing suicide among the elderly in rural China.
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Lachman JM, Heinrichs N, Jansen E, Brühl A, Taut D, Fang X, Gardner F, Hutchings J, Ward CL, Williams ME, Raleva M, Båban A, Lesco G, Foran HM. Preventing child mental health problems through parenting interventions in Southeastern Europe (RISE): Protocol for a multi-country cluster randomized factorial study. Contemp Clin Trials 2019; 86:105855. [PMID: 31669446 DOI: 10.1016/j.cct.2019.105855] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Child mental health problems continue to be a major global concern, especially in low- and middle-income countries (LMICs). Parenting interventions have been shown to be effective for reducing child behavior problems in high-income countries, with emerging evidence supporting similar effects in LMICs. However, there remain substantial barriers to scaling up evidence-based interventions due to limited human and financial resources in such countries. METHODS This protocol is for a multi-center cluster randomized factorial trial of an evidence-based parenting intervention, Parenting for Lifelong Health for Young Children, for families with children ages 2-9 years with subclinical levels of behavior problems in three Southeastern European countries, Republic of Moldova, North Macedonia, and Romania (8 conditions, 48 clusters, 864 families, 108 per condition). The trial will test three intervention components: length (5 vs. 10 sessions), engagement (basic vs. enhanced package), and fidelity (on-demand vs. structured supervision). Primary outcomes are child aggressive behavior, dysfunctional parenting, and positive parenting. Analyses will examine the main effect and cost-effectiveness of each component, as well as potential interaction effects between components, in order to identify the most optimal combination of program components. DISCUSSION This study is the first factorial experiment of a parenting program in LMICs. Findings will inform the subsequent testing of the optimized program in a multisite randomized controlled trial in 2021. TRIAL REGISTRATION NCT03865485 registered in ClinicalTrials.gov on March 5, 2019.
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Affiliation(s)
- Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Elena Jansen
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
| | - Antonia Brühl
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Diana Taut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Margiad Elen Williams
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice - ALTERNATIVA, Skopje, North Macedonia
| | - Adriana Båban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Heather M Foran
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
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Mohammadi R, Jafari Varjoshani N, Payami Bousari M, Ghahremani Z. On the Hemodialysis Patients’ Family Function in Zanjan Province in 2019. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.3.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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MacPherson HA, Ruggieri AL, Christensen RE, Schettini E, Kim KL, Thomas SA, Dickstein DP. Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder. J Affect Disord 2018; 235:574-582. [PMID: 29702451 PMCID: PMC5976258 DOI: 10.1016/j.jad.2018.04.078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/09/2018] [Accepted: 04/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood-onset bipolar disorder (BD) is a serious condition that affects the patient and family. While research has documented familial dysfunction in individuals with BD, no studies have compared developmental differences in family functioning in youths with BD vs. adults with prospectively verified childhood-onset BD. METHODS The Family Assessment Device (FAD) was used to examine family functioning in participants with childhood-onset BD (n = 116) vs. healthy controls (HCs) (n = 108), ages 7-30 years, using multivariate analysis of covariance and multiple linear regression. RESULTS Participants with BD had significantly worse family functioning in all domains (problem solving, communication, roles, affective responsiveness, affective involvement, behavior control, general functioning) compared to HCs, regardless of age, IQ, and socioeconomic status. Post-hoc analyses suggested no influence for mood state, global functioning, comorbidity, and most medications, despite youths with BD presenting with greater severity in these areas than adults. Post-hoc tests eliminating participants taking lithium (n = 17) showed a significant diagnosis-by-age interaction: youths with BD had worse family problem solving and communication relative to HCs. LIMITATIONS Limitations include the cross-sectional design, clinical differences in youths vs. adults with BD, ambiguity in FAD instructions, participant-only report of family functioning, and lack of data on psychosocial treatments. CONCLUSIONS Familial dysfunction is common in childhood-onset BD and endures into adulthood. Early identification and treatment of both individual and family impairments is crucial. Further investigation into multi-level, family-based mechanisms underlying childhood-onset BD may clarify the role family factors play in the disorder, and offer avenues for the development of novel, family-focused therapeutic strategies.
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Affiliation(s)
- Heather A. MacPherson
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA,Corresponding Author: Heather A. MacPherson, 1011 Veterans Memorial Parkway, East Providence, RI 02915, Phone: (401) 432-1162, Fax: (401) 432-1607,
| | - Amanda L. Ruggieri
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Rachel E. Christensen
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Elana Schettini
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Kerri L. Kim
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sarah A. Thomas
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel P. Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Shamali M, Konradsen H, Lauridsen JT, Østergaard B. Translation and validation of the Danish version of the brief family assessment measure III in a sample of acutely admitted elderly medical patients. Scand J Caring Sci 2017; 32:1247-1253. [PMID: 29131422 DOI: 10.1111/scs.12541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/17/2017] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVE Family functioning plays a pivotal role in the adaptation to illness of both individuals and families, especially among elderly patients. The Brief Family Assessment Measure Third Edition (Brief FAM-III) is among the most frequently used self-report instruments that measures family functioning. However, no Danish translation or measure of its psychometric properties in a Danish population is available. The purpose of this study was to translate the Brief FAM-III into Danish and then evaluate its psychometric properties in elderly patients. METHODS The Brief FAM-III was translated into Danish using the forward-backward translation procedure and examined its psychometric properties in 60 elderly patients (aged over 65) consecutively admitted to an acute medical ward. Internal consistency reliability was assessed by Cronbach's alpha coefficients, and confirmatory factor analysis was used to examine the construct validity of the Brief FAM-III. RESULTS Evaluation of the Danish version of the Brief FAM-III confirmed the three-factor structure (General Scale, Self-Rating Scale and Dyadic Relationships Scale) identified in the original instrument. However, goodness-of-fit indicators showed a relatively poor model fit. Cronbach's alpha for the total scales of Brief FAM-III was 0.94 suggesting good internal consistency. CONCLUSIONS The Danish version of the Brief FAM-III demonstrated satisfactory validity and reliability to assess family functioning among acutely admitted elderly Danish patients. We suggest that it may also be useful for monitoring family functioning over time or determining the effects of therapeutic interventions in elderly medical patients; however, further testing is recommended.
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Affiliation(s)
- Mahdi Shamali
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Jørgen T Lauridsen
- Centre of Health Economics Research (COHERE), Department of Business and Economics, University of Southern Denmark, Odense, Denmark
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Knafl K, Van Riper M. Tips for Developing a Successful Family Research Proposal. JOURNAL OF FAMILY NURSING 2017; 23:450-460. [PMID: 29199534 DOI: 10.1177/1074840717743248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Based on the authors' experiences conducting family research using varied methodological and conceptual approaches, the intent of this article is to offer practical advice for developing a successful research proposal that builds on existing work and makes a compelling case for the investigator's family focus, study design, and analytic approach. The article highlights key challenges unique to family research and offers suggestions and strategies for addressing the challenges.
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Macdonald G, Livingstone N, Valentine JC. Families and Schools Together (FAST) for improving outcomes for children and their families. Hippokratia 2017. [DOI: 10.1002/14651858.cd012760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Geraldine Macdonald
- University of Bristol; School for Policy Studies; Priory Road Bristol UK BS8 1TZ
| | - Nuala Livingstone
- Cochrane; Cochrane Editorial Unit; St Albans House 57-59 Haymarket London UK SW1Y 4QX
| | - Jeffrey C Valentine
- University of Louisville; Department of Educational and Counseling Psychology; Louisville Kentucky USA 40292
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Dieperink KB, Coyne E, Creedy DK, Østergaard B. Family functioning and perceived support from nurses during cancer treatment among Danish and Australian patients and their families. J Clin Nurs 2017; 27:e154-e161. [DOI: 10.1111/jocn.13894] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Karin B. Dieperink
- Department of Oncology and Danish Knowledge Centre of Rehabilitation and Palliation (REHPA); Odense University Hospital; Odense C Denmark
| | - Elisabeth Coyne
- School of Nursing and Midwifery; Menzies Health Institute; Griffith University; Meadowbrook Logan QLD Australia
| | - Debra K. Creedy
- School of Nursing and Midwifery; Menzies Health Institute; Griffith University; Meadowbrook Logan QLD Australia
| | - Birte Østergaard
- Department of Clinical Research; University of Southern Denmark; Odense C Denmark
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Frantzen KK, Lauritsen MB, Jørgensen M, Tanggaard L, Fetters MD, Aikens JE, Bjerrum M. Parental Self-perception in the Autism Spectrum Disorder Literature: a Systematic Mixed Studies Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2015. [DOI: 10.1007/s40489-015-0063-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Maternal and child psychological outcomes of HIV disclosure to young children in rural South Africa: the Amagugu intervention. AIDS 2015; 29 Suppl 1:S67-79. [PMID: 26049540 DOI: 10.1097/qad.0000000000000668] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Increasingly, HIV-infected parents are surviving to nurture their children. Parental HIV disclosure is beneficial, but disclosure rates to younger children remain low. Previously, we demonstrated that the 'Amagugu' intervention increased disclosure to young children; however, effects on psychological outcomes have not been examined in detail. This study investigates the impact of the intervention on the maternal and child psychological outcomes. METHOD This pre-post evaluation design enrolled 281 HIV-infected women and their HIV-uninfected children (6-10 years) at the Africa Centre for Health and Population Studies, in rural South Africa. The intervention included six home-based counselling sessions delivered by lay-counsellors. Psychological outcomes included maternal psychological functioning (General Health Questionnaire, GHQ12 using 0,1,2,3 scoring); parenting stress (Parenting Stress Index, PSI36); and child emotional and behavioural functioning (Child Behaviour Checklist, CBCL). RESULTS The proportions of mothers with psychological distress reduced after intervention: GHQ threshold at least 12 (from 41.3 to 24.9%, P < 0.001) and GHQ threshold at least 20 (from 17.8 to 11.7%, P = 0.040). Parenting stress scores also reduced (Pre M = 79.8; Post M = 76.2, P < 0.001): two subscales, parental distress and parent-child relationship, showed significant improvement, while mothers' perception of 'child as difficult' was not significantly improved. Reductions in scores were not moderated by disclosure level (full/partial). There was a significant reduction in child emotional and behavioural problems (CBCL Pre M = 56.1; Post M = 48.9, P < 0.001). CONCLUSION Amagugu led to improvements in mothers' and children's mental health and parenting stress, irrespective of disclosure level, suggesting general nonspecific positive effects on family relationships. Findings require validation in a randomized control trial.
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Rhee KE, Dickstein S, Jelalian E, Boutelle K, Seifer R, Wing R. Development of the General Parenting Observational Scale to assess parenting during family meals. Int J Behav Nutr Phys Act 2015; 12:49. [PMID: 25888976 PMCID: PMC4395900 DOI: 10.1186/s12966-015-0207-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 03/27/2015] [Indexed: 01/02/2023] Open
Abstract
Background There is growing interest in the relationship between general parenting and childhood obesity. However, assessing general parenting via surveys can be difficult due to issues with self-report and differences in the underlying constructs being measured. As a result, different aspects of parenting have been associated with obesity risk. We developed a more objective tool to assess general parenting by using observational methods during a mealtime interaction. Methods The General Parenting Observational Scale (GPOS) was based on prior work of Baumrind, Maccoby and Martin, Barber, and Slater and Power. Ten dimensions of parenting were included; 4 were classified in the emotional dimension of parenting (warmth and affection, support and sensitivity, negative affect, detachment), and 6 were classified in the behavioral dimension of parenting (firm discipline and structure, demands for maturity, psychological control, physical control, permissiveness, neglect). Overweight children age 8–12 years old and their parent (n = 44 dyads) entering a weight control program were videotaped eating a family meal. Parents were coded for their general parenting behaviors. The Mealtime Family Interaction Coding System (MICS) and several self-report measures of general parenting were also used to assess the parent–child interaction. Spearman’s correlations were used to assess correlation between measures. Results The emotional dimensions of warmth/affection and support/sensitivity, and the behavioral dimension of firm discipline/structure were robustly captured during the family meals. Warmth/affection and support/sensitivity were significantly correlated with affect management, interpersonal involvement, and communication from the MICS. Firm discipline/structure was inversely correlated with affect management, behavior control, and task accomplishment. Parents who were older, with higher educational status, and lower BMIs were more likely to display warmth/affection and support/sensitivity. Conclusion Several general parenting dimensions from the GPOS were highly correlated with similar family functioning constructs from the MICS. This new observational tool appears to be a valid means of assessing general parenting behaviors during mealtimes and adds to our ability to measure parent-level factors affecting child weight-related outcomes. Future evaluation of this tool in a broader range of the population and other family settings should be conducted.
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Affiliation(s)
- Kyung E Rhee
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, USA. .,Division of Academic General Pediatrics, Developmental Pediatrics, and Community Health, University of California, San Diego, School of Medicine, 9500 Gilman Drive, MC 0874, La Jolla, CA, 92093, USA.
| | - Susan Dickstein
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, USA.
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, USA.
| | - Kerri Boutelle
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, USA. .,School of Medicine, Department of Psychiatry, University of California, San Diego, La Jolla, USA.
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, USA.
| | - Rena Wing
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, USA.
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Staccini L, Tomba E, Grandi S, Keitner GI. The evaluation of family functioning by the family assessment device: a systematic review of studies in adult clinical populations. FAMILY PROCESS 2015; 54:94-115. [PMID: 25154959 DOI: 10.1111/famp.12098] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A large body of research, documenting the impact of a family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self-report questionnaire designed to assess specific dimensions of family functioning. This qualitative systematic review, which follows PRISMA guidelines, aimed to identify the FAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. The FAD has been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. The FAD also showed good test-retest and concurrent reliability, and modest sensitivity to change after treatment. FAD-dysfunctional family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop-out. The present review demonstrates that the FAD is a suitable instrument for the evaluation of family functioning both in clinical and research settings.
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Affiliation(s)
- Laura Staccini
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
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Wang B, He P, Dong B. Association between family functioning and cognitive impairment among Chinese nonagenarians/centenarians. Geriatr Gerontol Int 2014; 15:1135-42. [PMID: 25495588 DOI: 10.1111/ggi.12410] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2014] [Indexed: 02/05/2023]
Abstract
AIM We explored the association between family functioning and cognitive impairment in the very elderly aged 90-108 years. METHODS The present study comprised data from subjects included in the 2005 Project of Longevity and Aging in Dujiangyan, China. Sociodemographic and family functioning data were collected, and cognitive function was assessed in all subjects using the Mini-Mental State Examination. RESULTS Data from 699 Chinese nonagenarians and centenarians were included. The prevalence of cognitive impairment was 62.8%. The prevalence of family dysfunction was 52.2%, including 8.6% severe and 43.6% moderate dysfunction. There were significant differences among individuals with different family functioning level with regard to cognitive function scores (P = 0.005) or cognitive impairment prevalence (P = 0.012). Subjects with cognitive impairment had lower family functioning scores than those without cognitive impairment (P = 0.004). Pearson's correlation analysis showed that family functioning scores were correlated with Mini-Mental State Examination scores (r = 0.13, P = 0.001). Multiple logistic regressions showed that severe family dysfunction was a risk factor for cognitive impairment. The effect remained after adjusting for sociodemographic status, life habits and metabolic indicators. CONCLUSIONS Family functioning was related to cognitive impairment among Chinese nonagenarians and centenarians. We found that the higher the family functioning scores, the higher the Mini-Mental State Examination scores. Severe family dysfunction was associated with increased risk of cognitive impairment.
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Affiliation(s)
- Binyou Wang
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Department of Geriatrics, Second People's Hospital of Chengdu, Chengdu, China
| | - Ping He
- Department of Respiratory Diseases, Third People's Hospital of Chengdu, Chengdu, China
| | - Birong Dong
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,The Center of Coordination and Innovation for Aging Care and Health Promotion of Sichuan, Chengdu, China
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Fisher J, Tran TD, Biggs B, Tran T. Validation of the Intimate Bonds Measure for women who are pregnant or have recently given birth in Vietnam. Asia Pac Psychiatry 2014; 6:28-37. [PMID: 24591146 DOI: 10.1111/appy.12011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 09/05/2012] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Sensitive, valid measures to assess the quality of the intimate partner relationship are necessary for both clinical practice and research. The aim of this study was to examine the validity of the Intimate Bonds Measure (IBM) in women who were pregnant or had recently given birth in Vietnam. METHODS The IBM was translated and culturally verified in a step-by-step process with Vietnamese health workers, researchers and community members. The validation study was nested within two larger community-based cross-sectional investigations: the first in 2006, which recruited 199 pregnant women and 165 mothers of newborns, and the second in 2010, which recruited 419 pregnant women. Internal structure was assessed by factor analysis and Cronbach's alpha and construct validity by comparison with relevant factors. RESULTS Exploratory factor analyses revealed an identical factor structure to the one reported by the measure's developers in an Anglophone Australian population more than 20 years ago. The two factors replicate exactly the Care and Control subscales and Cronbach's alpha (from 0.68 to 0.83) indicates high internal consistency in both sub-scales. Mean scores of the Care-V and Control-V sub-scales were associated significantly and in expected directions with whether a woman could confide in, felt supported by or was frightened of her partner, or had experienced intimate partner violence and measures of mental health status. DISCUSSION The Vietnamese version of the IBM (IBM-V) is comprehensible, meaningful and appears to be a valid measure the construct of quality of relationship with an intimate partner among women in this setting.
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Affiliation(s)
- Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Melbourne School of Population Health, The University of Melbourne, Melbourne, Australia
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Young ME, Galvan T, Reidy BL, Pescosolido MF, Kim KL, Seymour K, Dickstein DP. Family functioning deficits in bipolar disorder and ADHD in youth. J Affect Disord 2013; 150:1096-102. [PMID: 23706879 PMCID: PMC3759554 DOI: 10.1016/j.jad.2013.04.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Rates of diagnosis and treatment for bipolar disorder (BD) in youth continue to rise. Researchers and clinicians experience difficulty differentiating between BD in youth and other conditions that are commonly comorbid or share similar clinical features with BD, especially attention-deficit/hyperactivity disorder (ADHD). Comparative studies of the phenomenology and psychosocial correlates of these conditions help to address this. Family functioning is an important topic for both BD and ADHD since both are associated with numerous family-related deficits. One previous study suggested that manic/hypomanic youths'family functioning differed from ADHD and typically developing control (TDC) groups. However, many family functioning studies with BD and ADHD youth have methodological limitations or fail to use comprehensive, validated measures. METHODS This investigation used adolescent report on the Family Assessment Device (FAD), based on the McMaster Model of family functioning. Youth were recruited in BD (n=30), ADHD (n=36), and TDC (n=41) groups. RESULTS Groups were similar on most demographic variables, but The TDC group scored somewhat higher than the others on IQ and socioeconomic status. FAD results indicated that BD and ADHD groups scored worse than TDC on the General Functioning and Roles scales of the FAD. In addition, the BD group showed impairment on the Problem Solving scale relative to TDC. LIMITATIONS sample size, lack of parent report, ADHD comorbidity in BD group. CONCLUSIONS Family functioning deficits distinguish both clinical groups from TDC, and problem-solving dysfunction may be specific to BD. These findings may apply to treatment models for both conditions.
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Affiliation(s)
- Matthew E. Young
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Thania Galvan
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Brooke L. Reidy
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Matthew F. Pescosolido
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Kerri L. Kim
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Karen Seymour
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel P. Dickstein
- Pediatric Mood, Imaging and Neurodevelopment Program (Pedi-MIND), Emma Pendleton Bradley Hospital, East Providence, RI, USA
,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Schlarb A, Brömer L, Brandhorst I, Wagner J, Milicevic V, Hautzinger M. Sleep problems among family members of a universal parent-training. SOMNOLOGIE 2013. [DOI: 10.1007/s11818-013-0615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Parents can play a crucial role in the development of children's behaviors associated with dietary habits, physical activity, and sedentary lifestyles. Many parenting practices and/or styles measures have been developed; however, there is little agreement as to how the influence of parenting should be measured. More importantly, our ability to relate parenting practices and/or styles to children's behaviors depends on its accurate assessment. While there is a need to standardize our assessment to further advance knowledge in this area, this article will discuss areas that may stimulate advances in the measurement of parenting constructs. Because self-report measures are important for the assessment of parenting, this article discusses whether solutions to improve self-report measures may lie in: (1) Improving the questions asked; (2) improving the methods used to correct for social desirability or measurement errors; (3) changing our measurement paradigm to assess implicit parenting behaviors; (4) changing how self-report is collected by taking advantage of ecological momentary assessment methods; (5) using better psychometric methods to validate parenting measures or alternatively using advances in psychometric methods, such as item banking and computerized adaptive testing, to solve common administration issues (i.e., response burden and comparability of results across studies); and (6) employing novel technologies to collect data such as portable technologies, gaming, and virtual reality simulation. This article will briefly discuss the potential of technologies to measure parenting constructs.
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Affiliation(s)
- Louise C. Mâsse
- Department of Pediatrics/School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Allison W. Watts
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Ngai FW, Ngu SF. Psychometric properties of a Chinese version of the medical outcomes study family and marital functioning measures in Hong Kong Chinese childbearing families. Community Ment Health J 2012; 48:634-42. [PMID: 22006069 PMCID: PMC3461203 DOI: 10.1007/s10597-011-9450-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 10/06/2011] [Indexed: 11/29/2022]
Abstract
The aim of the study was to evaluate the psychometric properties of the Chinese version of Medical Outcomes Study Family and Marital Functioning Measures (C-MOS-FMFM) in Hong Kong Chinese childbearing families. A cross-sectional survey was conducted using a convenience sample of 128 childbearing couples recruited from antenatal clinics. The C-MOS-FMFM demonstrated good internal consistency (Cronbach's alpha = 0.79) and test-retest reliability (intraclass correlation coefficient = 0.74). Significant correlations with Medical Outcomes Study-Social Support Survey (r = 0.38, P < 0.01) and Trait Anxiety Inventory (r = -0.48, P < 0.01) supported construct validity. Factor analysis identified one factor corresponding to family functioning and two factors corresponding to marital functioning. The C-MOS-FMFM has satisfactory psychometric properties. It has the potential to be used as a clinical and research instrument for measuring family and marital functioning in the Chinese population.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The University of Hong Kong, Room 417, 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
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Skelton JA, Buehler C, Irby MB, Grzywacz JG. Where are family theories in family-based obesity treatment?: conceptualizing the study of families in pediatric weight management. Int J Obes (Lond) 2012; 36:891-900. [PMID: 22531090 PMCID: PMC3977510 DOI: 10.1038/ijo.2012.56] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Family-based approaches to pediatric obesity treatment are considered the 'gold-standard,' and are recommended for facilitating behavior change to improve child weight status and health. If family-based approaches are to be truly rooted in the family, clinicians and researchers must consider family process and function in designing effective interventions. To bring a better understanding of family complexities to family-based treatment, two relevant reviews were conducted and are presented: (1) a review of prominent and established theories of the family that may provide a more comprehensive and in-depth approach for addressing pediatric obesity; and (2) a systematic review of the literature to identify the use of prominent family theories in pediatric obesity research, which found little use of theories in intervention studies. Overlapping concepts across theories include: families are a system, with interdependence of units; the idea that families are goal-directed and seek balance; and the physical and social environment imposes demands on families. Family-focused theories provide valuable insight into the complexities of families. Increased use of these theories in both research and practice may identify key leverage points in family process and function to prevent the development of or more effectively treat obesity. The field of family studies provides an innovative approach to the difficult problem of pediatric obesity, building on the long-established approach of family-based treatment.
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Affiliation(s)
- J A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27 157, USA.
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Salari R, Terreros C, Sarkadi A. Parenting Scale: Which Version Should We Use? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9281-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TV, Odoms-Young A, Wansink B, Wylie-Rosett J. Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps. Circulation 2012; 125:1186-207. [DOI: 10.1161/cir.0b013e31824607ee] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This scientific statement addresses parents and adult caregivers (PACs) as “agents of change” for obese children, evaluating the strength of evidence that particular parenting strategies can leverage behavior change and reduce positive energy balance in obese youth. The statement has 3 specific aims. The first is to review core behavior change strategies for PACs as used in family-based treatment programs and to provide a resource list. The second is to evaluate the strength of evidence that greater parental “involvement” in treatment is associated with better reductions in child overweight. The third is to identify research gaps and new opportunities for the field. This review yielded limited and inconsistent evidence from randomized controlled clinical trials that greater PAC involvement necessarily is associated with better child outcomes. For example, only 17% of the intervention studies reported differential improvements in child overweight as a function of parental involvement in treatment. On the other hand, greater parental adherence with core behavior change strategies predicted better child weight outcomes after 2 and 5 years in some studies. Thus, the literature lacks conclusive evidence that one particular parenting strategy or approach causally is superior to others in which children have a greater focus in treatment. A number of research gaps were identified, including the assessment of refined parenting phenotypes, cultural tailoring of interventions, examination of family relationships, and incorporation of new technologies. A conceptual model is proposed to stimulate research identifying the determinants of PAC feeding and physical activity parenting practices, the results of which may inform new treatments. The statement addresses the need for innovative research to advance the scope and potency of PAC treatments for childhood obesity.
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