Allison Caruthers

An ecological approach to promoting early adolescent mental health and social adaptation: family-centered intervention in public middle schools.

This study examined the impact of the Family Check-Up (FCU) and linked intervention services on reducing health-risk behaviors and promoting social adaptation among middle school youth. A total of 593 students and their families were randomly assigned to receive either the intervention or middle school services as usual. Forty-two percent of intervention families engaged in the service and received the FCU. Using complier average causal effect analyses, engagement in the intervention moderated intervention outcomes. Families who engaged in the intervention had youth who reported lower rates of antisocial behavior and substance use over time than did a matched control sample. Results extend previous research indicating that a family-centered approach to supporting youth in the public school setting reduced the growth of antisocial behavior, alcohol use, tobacco use, and marijuana use throughout the middle school years.

A Six-Year Predictive Test of Adolescent Family Relationship Quality and Effortful Control Pathways to Emerging Adult Social and Emotional Health

This longitudinal study examined how a multimethod (youth report, parent report, direct observation) assessment of family relationship quality (cohesion and conflict) in adolescence (age 16-17) predicted growth and maintenance of effortful control across ages 17, 22, and 23 years old, and, ultimately, subjective well-being, emotional distress, and aggressive behavior in emerging adulthood (23). A diverse sample of 792 youth at age 17 and their families, and youth at ages 22 and 23, were studied to examine family cohesion and conflict and the growth and maintenance of effortful control as predictors of emerging adult social and emotional health. Results indicated that family cohesion and conflict during late adolescence and mean-level effortful control at age 22 each served as unique pathways to emerging adult adjustment. These findings underscore the importance of family functioning during adolescence and the maintenance of effortful control into emerging adulthood for understanding adjustment during the emerging adulthood period.

Femininity Ideology and Sexual Health in Young Women: A focus on Sexual Knowledge, Embodiment, and Agency

ABSTRACT Traditional femininity ideology is associated with diminished sexual agency in women; yet we know little about its connection to sexual knowledge or experiences of ones body during sex. This study examined how femininity ideology related to sexual health knowledge, body comfort during sex, condom self-efficacy, and sexual assertiveness in college-age women. Femininity ideologies were related to decreased sexual-risk knowledge and lowered body esteem during sex. Femininity ideologies were also related to decreased sexual assertiveness and condom use self-efficacy. Results highlight the importance of understanding the association between femininity ideologies and sexual knowledge acquisition as an aspect of sexual agency, as well as sexual embodiment, in addition to the more commonly studied sexual self-efficacy and assertiveness.

Awkward or Amazing: Gender and Age Trends in First Intercourse Experiences.

Although research continues to highlight significant gender differences in first coital experiences, developmental approaches suggest that some of these patterns may be age-related. Therefore, this study investigated both gender and age differences in first intercourse experiences. Open-ended responses regarding reasons for, and descriptions of, first vaginal intercourse were provided by 323 sexually active undergraduate students (65.3% female; 75.7% White; M age = 19.87) and coded into a range of categories. Several gender and age differences emerged, such that women’s descriptions were generally less positive than men’s, and women’s reasons were more likely than men’s to emphasize relationships and emotions. However, there were also a number of similarities in women’s and men’s experiences. Those who first experienced coitus during early adolescence were more likely to describe it as awkward, were less likely to describe it as positive, and differed in their reasons from those whose first coitus occurred later. Importantly, gender differences were less pronounced among older versus younger initiates, suggesting that commonly-identified gender differences may be developmentally specific. Future research focusing on subjective aspects of first intercourse experiences should carefully attend both to age or developmental stage and to gender similarities.

The Impact of Family-Centered Prevention on Self-Regulation and Subsequent Long-Term Risk in Emerging Adults

Emerging adulthood is characterized by not only opportunity and transition but also a substantial increase in risk behaviors (Fosco et al. Journal of Family Psychology, 26(4), 565–575, 2012; Johnston et al. 2016). Building on prior research, we tested a mediational model hypothesizing that Family Check-Up (FCU) intervention effects on young adult risk would be mediated by increases in self-regulation, and that these changes would continue to affect risk behavior as high school youths transitioned to young adulthood. We also predicted that the intent-to-treat intervention would be associated with lower levels of risk in young adulthood and that this effect would be accounted for by intervention-induced improvements in self-regulation during early adolescence, which in turn would prevent young adult risk. Participants were 593 adolescents and their families recruited from three public middle schools and randomized either to the FCU or to a control group. Item response theory was applied to construct a measure of high-risk behavior at this age, including risk behaviors such as substance abuse, high-risk sexual behavior, and vocational risk. Results suggested that changes in children’s self-regulation that occurred early during the middle school years, and that were associated with the FCU, led to reductions in risk behaviors during young adulthood. This study builds on our prior research that has suggested that effects of the FCU during middle school lead to changes in a range of risk behaviors during the transition to high school (Fosco et al. Journal of School Psychology, 51(4), 455–468, 2013; Stormshak et al. School Mental Health, 2(2), 82–9, 2010).

The Family Check-Up Online Program for Parents of Middle School Students: Protocol for a Randomized Controlled Trial

Background Research has established that skillful family management during adolescence protects youth from a variety of mental health and behavioral problems. Interventions associated with this research have focused on parenting skills as the mediator that links early risk factors with a profile of later behavioral risk, including problem behavior, substance use, and school failure. Fortunately, positive changes in family management skills have been linked to meaningful improvements in adolescent behavior, and these improvements have been significant across a variety of cultural groups. Objective We describe the background, research design, and intervention components of an electronic health version of the Family Check-Up program that is targeting middle school children and is being evaluated in a randomized controlled trial for its usability, feasibility, and efficacy. Methods We used an iterative formative research process to develop an electronic health version of the Family Check-Up program. In our ongoing randomized controlled trial, eligible families are randomly assigned to 1 of 3 conditions: Family Check-Up Online-only (n≈100), Family Check-Up Online + Coach (n≈100), and a waitlist control condition (middle school as usual; n≈100). We are conducting assessments at baseline, 3 months following randomization (posttest), and at follow-ups scheduled for 6 months and 12 months. Results This randomized controlled trial project was funded in 2015. Participant recruitment was completed in spring 2018 and enrollment is ongoing. Follow-up assessments will be completed in 2019. Conclusions The innovative Family Check-Up Online program has the potential to help address many of the barriers that more traditional school-based behavioral mental health implementation strategies have yet to solve, including staffing and resources to implement family-centered support within schools. Trial Registration ClinicalTrials.gov NCT03060291; https://clinicaltrials.gov/ct2/show/NCT03060291 (Archived by WebCite at http://www.webcitation.org/70f8keeN4) Trial Registration RR1-10.2196/11106

Predicting sexual coercion in early adulthood: The transaction among maltreatment, gang affiliation, and adolescent socialization of coercive relationship norms.

This study tested a transactional hypothesis predicting early adult sexual coercion from family maltreatment, early adolescent gang affiliation, and socialization of adolescent friendships that support coercive relationship norms. The longitudinal study of a community sample of 998 11-year-olds was intensively assessed in early and middle adolescence and followed to 23-24 years of age. At age 16-17 youth were videotaped with a friend, and their interactions were coded for coercive relationship talk. Structural equation modeling revealed that maltreatment predicted gang affiliation during early adolescence. Both maltreatment and gang affiliation strongly predicted adolescent sexual promiscuity and coercive relationship norms with friends at age 16-17 years. Adolescent sexual promiscuity, however, did not predict sexual coercion in early adulthood. In contrast, higher levels of observed coercive relationship talk with a friend predicted sexual coercion in early adulthood for both males and females. These findings suggest that peers have a socialization function in the development of norms prognostic of sexual coercion, and the need to consider peers in the promotion of healthy relationships.