A Recovery Capital and Stress-Buffering Model for Post-deployed Military Parents

We tested a recovery capital model for military families employing the After Deployment, Adaptive Parenting Tools (ADAPT) randomized control trial, a longitudinal preventive intervention study of 336 post-deployed military parents. Recovery resources included measures of social capital (parenting support, observed partner support behaviors), personal capital (parenting efficacy, education), and community capital (the ADAPT behavioral parent-training intervention). We hypothesized higher levels of recovery capital would buffer the negative impact of military stress on growth in post-traumatic stress disorder (PTSD) symptoms for deployed and civilian parents. Outcome data were evaluated with three waves across 2-years. Hypotheses were tested with latent growth models in a structural equation modeling framework. Military stress was assessed by reports of exposure to combat and battle aftermath. Recovery capital was measured by reported support for parenting and direct observation of behavioral interactions during problem-solving discussions of deployment-related stressors. Fathers had higher levels of military-related stress and PTSD symptoms over time compared to mothers. Growth curve models showed that fathers were characterized by individual differences in 2-year average levels of PTSD symptoms while mothers were characterized by individual differences in initial status and linear growth trajectories. Results supported a recovery capital model. Higher levels of parenting efficacy and parenting support were associated with lower PTSD symptoms, representing common pathways for both mothers and fathers. Similarly, parenting support operated as a moderating buffer for both parents. That is, effects of military trauma exposure on psychological distress were lower for mothers and fathers with higher levels of parenting support relative to parents with lower levels. Regions of significance indicated that half a standard deviation above the mean of support was beneficial for mothers, while one and half standard deviations were needed to impact the effects of trauma on fathers’ PTSD. For mothers assigned to the ADAPT parent training intervention – but not fathers – the intervention was associated with linear reductions in PTSD symptoms over 2 years. The recovery capital model explained 36% of the variance in father outcomes and 46% for mothers. The intervention obtained a medium effect size in reducing mothers’ symptoms (d = 0.41). Implications for prevention and treatment within a recovery capital model are discussed

Juvenile Justice Girls’ Depressive Symptoms and Suicidal Ideation 9 Years After Multidimensional Treatment Foster Care

OBJECTIVE: Multidimensional Treatment Foster Care (MTFC) has been found to reduce delinquency among girls in juvenile justice through 2-year follow-up. Given that such girls are at elevated risk for suicide and depression into adulthood, we tested MTFC effects on long term trajectories of suicidal ideation and depressive symptoms. METHOD: Girls [n =166; mean (SD) age = 15.3 (1.2) years; 68% Caucasian] with a recent criminal referral who were mandated to out-of-home care were enrolled in two sequential cohorts. Girls were randomized to receive MTFC (n = 81) or group care (GC) treatment as usual (TAU; n = 85); the second MTFC cohort also received modules targeting substance use and risky sexual behavior. Depressive symptoms and suicidal ideation were assessed repeatedly through early adulthood [mean (SD) follow-up = 8.8 (2.9) years]. Suicide attempt history was assessed in early adulthood. RESULTS: Girls assigned to MTFC showed significantly greater decreases in depressive symptoms across the long-term follow-up than GC girls (π = -.86, p < .05). Decreases in suicidal ideation rates were slightly stronger in MTFC than in GC as indicated by a marginal main effect [odds ratio (OR) = .92, p < .10] and a significant interaction that favored MTFC in the second cohort relative to the first [OR = .88, p < .01]. There were no significant MTFC effects on suicide attempt. CONCLUSIONS: MTFC decreased depressive symptoms and suicidal thinking beyond the decreases attributable to time and TAU. Thus, MTFC has further impact on girls’ lives than originally anticipated.This article may not exactly replicate the final version published in the APA journal. It is not the copy of record. This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by the American Psychological Association and can be found at: http://www.apa.org/pubs/journals/ccp/Keywords: Juvenile justice, MTFC, Depression, Suicide, Randomized controlled trial, RC

Young Adult Follow-up of Adolescent Girls in Juvenile Justice Using the Columbia Suicide Severity Rating Scale

We studied the reliability and validity of the Columbia Suicide Severity Scale (C-SSRS). Severely delinquent adolescent girls (n = 166) participated in a treatment trial and repeated assessments over time. Lifetime suicide attempt history was measured using the C-SSRS in early adulthood (n = 144; 7–12 years post-baseline). Nonclinician raters showed strong interrater reliability using the C-SSRS. Self-, caseworker-, and caregiver-reports of girls’ suicide attempt histories collected at baseline correlated with adult participants’ recollections of their baseline attempt histories. Suicidal ideation measured prospectively across a 7–12 year period was associated with retrospectively reported suicide attempt across the same period

Depressive Symptom Trajectories Among Girls in the Juvenile Justice System: Findings from an RCT of Multidimensional Treatment Foster Care

Youth depression is a significant and growing international public health problem. Youth who engage in high levels of delinquency are at particularly high risk for developing problems with depression. The present study examined the impact of a behavioral intervention designed to reduce delinquency (Multidimensional Treatment Foster Care; MTFC) compared to a group care intervention (GC; i.e., services as usual) on trajectories of depressive symptoms among adolescent girls in the juvenile justice system. MTFC has documented effects on preventing girls’ recidivism, but its effects on preventing the normative rise in girls’ depressive symptoms across adolescence have not been examined. This indicated prevention sample included 166 girls (13–17 years at T1) who had at least one criminal referral in the past 12 months and who were mandated to out-of-home care; girls were randomized to MTFC or GC. Intent-to-treat analyses examined the main effects of MTFC on depression symptoms and clinical cut-offs, and whether benefits were greatest for girls most at risk. Depressive symptom trajectories were specified in hierarchical linear growth models over a two year period using five waves of data at six month intervals. Depression clinical cut-off scores were specified as nonlinear probability growth models. Results showed significantly greater rates of deceleration for girls in MTFC versus GC for depressive symptoms and for clinical cut-off scores. The MTFC intervention also showed greater benefits for girls with higher levels of initial depressive symptoms. Possible mechanisms of effect are discussed, given MTFC’s effectiveness on targeted and nontargeted outcomes.This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Springer and can be found at: http://link.springer.com/journal/11121.Keywords: randomized controlled trial, juvenile justice, maltreatment, MTFC (Multidimensional Treatment Foster Care), girls, depressio

Influence of early childhood parental hostility and socioeconomic stress on children’s internalizing symptom trajectories from childhood to adolescence

IntroductionChildren and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood—parental hostility and socioeconomic stress—and children’s internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence.Materials and MethodsThe study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4–5; and sex assigned at birth on children’s internalizing symptom latent class outcomes at child ages 7–9, 10–12, 13–15, and 16–19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children’s symptom classes. Other covariates included parent depressive symptoms at child ages 4–5 and child race and ethnicity.ResultsAnalyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c’ = .57) effects of socioeconomic stress on children’s symptom class membership in the mediation analysis were significant (p &lt;.001).DiscussionStudy findings suggest that intervening on modifiable bioecological stressors—including parenting behaviors and socioeconomic stressors—may provide important protective influences on children’s internalizing symptom trajectories

Depressive symptom trajectories among girls in the juvenile justice system: 24-month outcomes of an RCT of Multidimensional Treatment Foster Care

Youth depression is a significant and growing international public health problem. Youth who engage in high levels of delinquency are at particularly high risk for developing problems with depression. The present study examined the impact of a behavioral intervention designed to reduce delinquency (Multidimensional Treatment Foster Care; MTFC) compared to a group care intervention (GC; i.e., services as usual) on trajectories of depressive symptoms among adolescent girls in the juvenile justice system. MTFC has documented effects on preventing girls' recidivism, but its effects on preventing the normative rise in girls' depressive symptoms across adolescence have not been examined. This indicated prevention sample included 166 girls (13-17 years at T1) who had at least one criminal referral in the past 12 months and who were mandated to out-of-home care; girls were randomized to MTFC or GC. Intent-to-treat analyses examined the main effects of MTFC on depression symptoms and clinical cut-offs, and whether benefits were greatest for girls most at risk. Depressive symptom trajectories were specified in hierarchical linear growth models over a 2 year period using five waves of data at 6 month intervals. Depression clinical cut-off scores were specified as nonlinear probability growth models. Results showed significantly greater rates of deceleration for girls in MTFC versus GC for depressive symptoms and for clinical cut-off scores. The MTFC intervention also showed greater benefits for girls with higher levels of initial depressive symptoms. Possible mechanisms of effect are discussed, given MTFC's effectiveness on targeted and nontargeted outcomes. © 2013 Society for Prevention Research

Improving parenting practices among fathers who misuse opioids: fathering through change intervention.

Fathers have been largely neglected in the parenting literature though there is a critical need to improve parenting practices among fathers who misuse opioids in the midst of the opioid epidemic. Urgency is critical to rapidly intervene in the lives of fathers and children to reduce misuse and interrupt intergenerational cycles of substance misuse. Thus, we provide an overview of solutions to adapt existing parenting interventions for fathers who misuse opioids to accelerate the pace of science for this population

Concerns regarding an evaluation of MTFC-A for adolescents in English care

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