David S. DeGarmo

Parenting, Parental Mental Health, and Child Functioning in Families Residing in Supportive Housing

Long-term homelessness is associated with other psychosocial risk factors (e.g., adult mental illness, substance abuse, and exposure to violence). All of these factors are associated with impairments in parenting effectiveness and child adjustment, but there are very limited data investigating parenting among families who are homeless and highly mobile. In particular, there is no literature examining the relationships among observed parenting, parental mental health, and child adjustment in a supportive housing sample. Data are reported from a multimethod study of 200 children in 127 families residing in supportive housing agencies in a large metro area. Observed parenting and parents mental health symptoms directly affected childrens adjustment. The influence of parenting self-efficacy on childrens adjustment was mediated through its impact on observed parenting. However, observed parenting did not mediate the relationship between parental mental health and child adjustment. Implications for research and practice with homeless populations are offered.

Effects of Parents' Experiential Avoidance and PTSD on Adolescent Disaster-Related Posttraumatic Stress Symptomatology

Despite the importance of family context to adolescents reactions following disaster, little research has examined the role of parents functioning on adolescents disaster-related posttraumatic stress disorder (PTSD) symptoms. Using data from 288 adolescents (ages 12 to 19 years) and 288 parents exposed to a series of severe tornadoes in a rural Midwestern community, this study tested a conceptual model of the interrelationships between individual and parental risk factors on adolescents disaster-related PTSD symptoms using structural equation modeling. Results showed that the psychological process of experiential avoidance mediated the relationship between family disaster exposure and PTSD for both adolescents and their parents. Parents PTSD symptoms independently predicted adolescents PTSD symptoms. Further, parents postdisaster functioning amplified the effects of adolescent experiential avoidance on adolescents disaster-related PTSD symptoms. Findings highlight the importance of family context in understanding adolescents postdisaster reactions. Clinical implications are discussed.

Relationship of service members’ deployment trauma, PTSD symptoms, and experiential avoidance to postdeployment family reengagement.

This research examined whether military service members deployment-related trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and experiential avoidance are associated with their observed levels of positive social engagement, social withdrawal, reactivity-coercion, and distress avoidance during postdeployment family interaction. Self reports of deployment related trauma, postdeployment PTSD symptoms, and experiential avoidance were collected from 184 men who were deployed to the Middle East conflicts, were partnered, and had a child between 4 and 13 years of age. Video samples of parent-child and partner problem solving and conversations about deployment issues were collected, and were rated by trained observers to assess service members positive engagement, social withdrawal, reactivity-coercion, and distress avoidance, as well as spouse and child negative affect and behavior. Service members experiential avoidance was reliably associated with less observed positive engagement and more observed withdrawal and distress avoidance after controlling for spouse and child negative affect and behavior during ongoing interaction. Service members experiential avoidance also diminished significant associations between service members PTSD symptoms and their observed behavior. The results are discussed in terms of how service members psychological acceptance promotes family resilience and adaption to the multiple contextual challenges and role transitions associated with military deployment. Implications for parenting and marital interventions are described.

Treatment effectiveness of PMTO for children's behavior problems in Iceland: Assessing parenting practices in a randomized controlled trial

Findings are presented from an Icelandic randomized control trial (RCT) evaluating parent management training - Oregon model (PMTO™), a parent training intervention designed to improve parenting practices and reduce child behavior problems. In a prior report from this effectiveness study that focused on child outcomes, children in the PMTO condition showed greater reductions in reported child adjustment problems relative to the comparison group. The present report focuses on observed parenting practices as the targeted outcome, with risk by treatment moderators also tested. It was hypothesized that mothers assigned to the PMTO condition would show greater gains in pre-post parenting practices relative to controls. The sample was recruited from five municipalities throughout Iceland and included 102 participating families of children with behavior problems. Cases were referred by community professionals and randomly assigned to either PMTO (nxa0=xa051) or community services usually offered (nxa0=xa051). Child age ranged from 5 to 12xa0years; 73% were boys. Contrary to expectations, findings showed no main effects for changes in maternal parenting. However, evaluation of risk by treatment moderators showed greater gains in parenting practices for mothers who increased in depressed mood within the PMTO group relative to their counterparts in the comparison group. This finding suggests that PMTO prevented the expected damaging effects of depression on maternal parenting. Failure to find hypothesized main effects may indicate that there were some unobserved factors regarding the measurement and a need to further adapt the global observational procedures to Icelandic culture.

Two-Year Outcomes of the Early Risers Prevention Trial With Formerly Homeless Families Residing in Supportive Housing

This article reports 2-year outcomes from a cluster randomized, controlled trial of the Early Risers (ER) program implemented as a selective preventive intervention in supportive housing settings for homeless families. Based on the goals of this comprehensive prevention program, we predicted that intervention participants receiving ER services would show improvement in parenting and child outcomes relative to families in treatment-as-usual sites. The sample included 270 children in 161 families, residing in 15 supportive housing sites; multimethod, multi-informant assessments conducted at baseline and yearly thereafter included parent and teacher report of child adjustment, parent report of parenting self-efficacy, and parent-child observations that yielded scores of effective parenting practices. Data were modeled in HLM7 (4-level model accounting for nesting of children within families and families within housing sites). Two years postbaseline, intent-to-treat (ITT) analyses indicated that parents in the ER group showed significantly improved parenting self-efficacy, and parent report indicated significant reductions in ER group childrens depression. No main effects of ITT were shown for observed parenting effectiveness. However, over time, average levels of parenting self-efficacy predicted observed effective parenting practices, and observed effective parenting practices predicted improvements in both teacher- and parent-report of child adjustment. This is the first study to our knowledge to demonstrate prevention effects of a program for homeless families residing in family supportive housing.

Effects of a Military Parenting Program on Parental Distress and Suicidal Ideation: After Deployment Adaptive Parenting Tools.

Few studies have examined whether parenting prevention programs might mitigate risk for suicidality in parents, yet parent suicidality is a strong risk factor for offspring suicidality. We report results from a randomized controlled trial of a parenting program for deployed National Guard and Reserve families with a school-aged child. Intent-to-treat analyses showed that random assignment to the parenting program (ADAPT) was associated with improved parenting locus of control (LOC). Improved parenting LOC was concurrently associated with strengthened emotion regulation which predicted reductions in psychological distress and suicidal ideation at 12 months postbaseline. Results are discussed in the context of ongoing efforts to reduce suicide rates in military populations.

Associations of contextual risk and protective factors with fathers' parenting practices in the postdeployment environment

Deployment separation and reunifications are salient contexts that directly impact effective family functioning and parenting for military fathers. Yet, we know very little about determinants of postdeployed father involvement and effective parenting. The present study examined hypothesized risk and protective factors of observed parenting for 282 postdeployed fathers who served in the National Guard/Reserves. Preintervention data were employed from fathers participating in the After Deployment, Adaptive Parenting Tools randomized control trial. Parenting practices were obtained from direct observation of father-child interaction and included measures of problem solving, harsh discipline, positive involvement, encouragement, and monitoring. Risk factors included combat exposure, negative life events, months deployed, and posttraumatic stress disorder symptoms. Protective factors included education, income, dyadic adjustment, and social support. Results of a structural equation model assessing risk and protective factors for an effective parenting construct indicated that months deployed, income, and father age were most related to observed parenting, explaining 16% of the variance. We are aware of no other study using direct parent-child observations of fathers parenting skills following overseas deployment. Implications for practice and preventive intervention are discussed.

Treatment Effectiveness of PMTO for Children's Behavior Problems in Iceland: Child Outcomes in a Nationwide Randomized Controlled Trial.

Well-documented treatment methods must be tested following their implementation in community service agencies and across different cultures to ensure continuing effectiveness. This study was a randomized controlled trial (RCT) of Parent Management Training-the Oregon model (PMTO), conducted within a nationwide implementation in Iceland. Families of 102 clinically referred children with behavior problems were recruited from five municipalities throughout Iceland. Child age ranged from 5 to 12; 73% were boys. Families were randomly assigned to either PMTO or services usually offered in the communities (SAU). Child adjustment was measured with a latent construct based on parent, child, and teacher reports of externalizing and internalizing problems and social skills. Prepost intent-to-treat analyses showed that PMTO treatment led to greater reductions in child adjustment problems relative to the comparison group, obtaining a modest to medium effect size based on the construct score. Only one indicator (parent-rated Social Skills) showed significant change independently and information on amount and kind of treatment in the SAU was limited. Overall, findings indicate that PMTO is an effective method to treat childrens behavior problems in a Northern European culture and supply evidence for the methods successful implementation in community settings in Iceland. This is one of few nationwide implementation studies of PMTO outside the United States and the first RCT in Iceland to test a treatment model for childrens behavior problems.

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).

Testing a Military Family Stress Model

The current study examines a military family stress model, evaluating associations between deployment-related stressors (i.e., deployment length/number, posttraumatic stress disorder [PTSD] symptoms) and parent, child, parenting, and dyadic adjustment among families in which a parent had previously deployed to Iraq or Afghanistan in the recent conflicts. Married families (Nxa0=xa0293) with at least one child between the ages of 4 and 12 were recruited from a Midwestern state. Service members were from the Reserve Component (National Guard or Reserves); fathers (Nxa0=xa0253) and/or mothers had deployed (Nxa0=xa045) to the recent conflicts in the Middle East. Multiple-method (observations of parenting and couple interactions; questionnaires) and multiple informant measures were gathered online and in the homes of participants, from parents, children, and teachers. Findings demonstrated associations between mothers and fathers PTSD symptoms and a latent variable of child adjustment comprising teacher, parent, and child report. Mothers but not fathers PTSD symptoms were also associated with dyadic adjustment and parenting practices; parenting practices were in turn associated with child adjustment. The results are discussed in terms of their implications for military family stress research and interventions to support and strengthen parents and families after deployment.