Parenting and Youth Sexual Risk in South Africa: The Role of Contextual Factors

Black South African youth are disproportionately affected by the HIV epidemic, and risky sexual behaviors increase youths’ vulnerability to HIV infection. U.S.-based research has highlighted several contextual factors that impact sexual risk, but these processes have not been examined in a South African context. In a sample of Black South African parent-youth dyads, this study examined relations among parenting, neighborhood quality, maternal social support, coparenting, and youth sexual risk. Hypotheses were evaluated using structural equation modeling. Results revealed that better neighborhood quality predicted less youth sexual risk via higher levels of positive parenting. Social support was positively related to parenting quality but did not interact with neighborhood quality to impact parenting. Coparenting did not moderate the relation between parenting and sexual risk. Results highlight the importance of family- and community-level processes for youth sexual risk in an understudied and high-risk sample. HIV prevention-interventions should be informed by these contextual factors

HIV Disclosure and Family Processes Among Mothers Living with HIV and Their Children: A Mixed-Methods Longitudinal Investigation

Despite recent reductions in HIV incidence in the U.S., African American and Latina women remain significantly overrepresented in HIV prevalence rates. Many women living with HIV are primary caregivers and are now living long enough to raise their children. Mothers living with HIV (MLH) face unique stressors, including elevated parenting stress, barriers to effective parenting, decisions related to disclosing their HIV status, and risk of child adjustment difficulties. Though studies have demonstrated cross-sectional relations among these family processes for MLH and their children, none have explored these processes transactionally across time. The current study was a longitudinal, mixed-methods examination of mothers’ HIV disclosure to children and its interplay with parenting quality, parenting stress, and child psychosocial adjustment. In the context of a randomized controlled trial evaluating an HIV disclosure intervention, a sample of 174 MLH and their children were recruited from two sites. Quantitative data were collected over four waves spanning 15 months. Qualitative data were collected with a subsample of 14 families in which disclosure had occurred. Two longitudinal structural equation modeling approaches—latent change score (LCS) modeling and cross-lagged panel analysis (CLPA)—were employed to examine relations among HIV disclosure, child adjustment, parenting, and parenting stress. Qualitative interviews were conducted to enrich the quantitative findings by further exploring families’ perspectives of these processes. Results of LCS models demonstrated that HIV disclosure led to subsequent improvements in parenting stress and children’s perceptions of parent-child communication and relationship quality. Changes in parenting stress inversely predicted changes in parental involvement. In the CLPA framework, several unidirectional and bidirectional relations were observed between mean levels of parenting stress and child adjustment, between child-reported parenting quality and child adjustment, and between child- and mother-reported parenting quality and parenting stress. Qualitative themes mirrored quantitative findings and provided explanation and contextualization for these findings. Results highlight the complex and multifaceted nature of the interplay among HIV disclosure, parenting practices, parenting stress, and child functioning. Findings suggest that MLH should be supported in disclosing their serostatus to their children to minimize parenting stress, bolster parenting skills, and promote positive outcomes for youth

Harnessing innovative technologies to advance children's mental health: Behavioral parent training as an example

Disruptive behaviors of childhood are among the most common reasons for referral of children to mental health professionals. Behavioral parent training (BPT) is the most efficacious intervention for these problem behaviors, yet BPT is substantially underutilized beyond university research and clinic settings. With the aim of addressing this research-to-practice gap, this article highlights the considerable, but largely unrealized, potential for technology to overcome the two most pressing challenges hindering the diffusion of BPT: (1). The dearth of BPT training and supervision opportunities for therapists who work with families of children with disruptive behaviors and; (2). The failure to engage and retain families in BPT services when services are available. To this end, this review presents a theoretical framework to guide technological innovations in BPT and highlights examples of how technology is currently being harnessed to overcome these challenges. This review also discusses recommendations for using technology as a delivery vehicle to further advance the field of BPT and the potential implications of technological innovations in BPT for other areas of children’s mental health are discussed

Does a Latent Class Underlie Schizotypal Personality Disorder? Implications for Schizophrenia

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Despite growing enthusiasm for dimensional models of personality pathology, the taxonic versus dimensional status of schizotypal personality disorder (PD) remains a point of contention in modern psychiatry. The current study aimed to determine empirically the latent structure of schizotypal PD. We examined the latent structure of schizotypal PD in the Psychiatric Morbidity Survey in Great Britain and the second wave of the U.S.-based National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) survey. We analyzed composite indicators created from participant responses using the mean above minus mean below a cut (MAMBAC), Maximum Covariance (MAXCOV), and latent mode factor analysis (L-Mode) taxometric procedures. We also analyzed item-level responses using two latent variable mixture models—latent class analysis and latent class factor analysis. Taxometric and latent variable mixture analyses supported a dimensional, rather than taxonic, structure in both epidemiological samples. The dimensional model better predicted psychosis, intellectual functioning, disability, and treatment seeking than the categorical model based on DSM–IV diagnosis. People meeting criteria for schizotypal PD appear to exist on a spectrum of severity with the rest of the population. The possible dimensionality of schizotypal PD adds to growing support for a dimensional structure of PDs including other Cluster A disorders