Trajectories of Social Anxiety in Children: Influence of Child Cortisol Reactivity and Parental Social Anxiety

Few studies have examined the interactive effect of intra- and extra-individual vulnerability factors on the trajectory of social anxiety in children. In this study, we examined the joint influence of familial vulnerability (i.e., parental social anxiety) and child biological stress vulnerability (i.e., cortisol reactivity) on trajectories of social anxiety. Children (N?=?112 (57 males), M _age?=?8.14 years, S.D. = 2.25) were followed over three visits spanning approximately three years. Parental social anxiety was assessed using the Social Phobia and Anxiety Inventory, children’s behavior and salivary cortisol reactivity were measured in response to a speech task, and children’s social anxiety was assessed at all three visits using the Screen for Child Related Emotional Disorders (SCARED; Parent-report). A growth curve analysis was used to examine trajectories of child social anxiety as predicted by children’s cortisol reactivity and parental social anxiety, adjusting for covariates. We found a significant interaction between parental social anxiety and child cortisol reactivity in predicting child social anxiety across time. Having a socially anxious parent coupled with heightened cortisol reactivity predicted the highest levels of child social anxiety, with scores that remained above clinically significant levels for social anxiety across all visits. Children with familial risk for social anxiety and who also exhibit high stress-reactivity appear to be at risk for persistent, clinically significant social anxiety. This highlights the importance of considering the interaction between both biological and contextual factors when considering the development, maintenance, and treatment of social anxiety in children across time.     

Impaired Fear Recognition and Social Anxiety Symptoms in Adolescence

This study represents the first examination of adolescent anxiety in relation to peer emotion recognition, rather than adult emotion recognition. Additionally, we examine potential mechanisms for the development of social anxiety in females. Facial emotion recognition (FER) is important for accurate social cognition, which is impaired in individuals with various disorders, including anxiety disorders. Social anxiety often onsets during adolescence, is observed more commonly in females, and is often associated with FER difficulties. Given the importance of peer interaction during adolescence, and some evidence that FER may differ as a function of the stimuli (adolescent or adult faces), we sought to study FER in relation to social anxiety symptoms using stimuli portraying adolescent faces. Male and female adolescents (N = 64) completed an online survey in which they rated 257 child and adolescent emotional faces and completed a self-report measure of social anxiety symptoms. We examined differences in emotion recognition (e.g., fear, anger, sadness) between individuals with high and low levels of social anxiety symptoms. Adolescents with high social anxiety symptoms were more likely to have problems correctly identifying fearful expressions (90.55 % accuracy) compared to adolescents with low social anxiety symptoms (96.00 % accuracy; t = 2.375, p = .021, d = 0.594), and this effect was observed exclusively in female adolescents. The observed sex difference in accurate identification of fearful faces in relation to social anxiety could suggest a potential mechanism for social anxiety development in adolescent females.     

Parenting Behaviors of Mothers and Fathers of Preschool Age Children with Internalizing Disorders

This study investigated parenting behaviors of mothers and fathers of clinically anxious preschool children (with or without depressive comorbidity) and healthy comparison children. Studies assessing children from early school age onwards have found that parental control, rejection, and inconsistent discipline are associated with the presence of children’s internalizing symptoms/disorders. Despite the scarcity of studies investigating these associations at preschool age, we assumed that findings with older children would also apply to children in this age group. In a cross-sectional study we assessed N = 176 children of preschool age (M = 5; 2 years) and both of their parents. A diagnostic interview (Preschool Age Psychiatric Assessment) was conducted to determine children’s psychiatric diagnoses, yielding the following results: a group of n = 67 children with pure anxiety disorders (AD group), a group of n = 38 children with anxiety disorders with depressive comorbidity (AD/DC group), and a comparison group of n = 71 children without psychiatric disorders. Both parents completed the German extended version of the Alabama Parenting Questionnaire. We evaluated maternal depressive symptoms and children’s temperament as further correlates. All variables that differed significantly between groups were entered into multinomial logistic regression analyses to test which variables predict group membership. When comparing each of the two anxiety groups with the comparison group we obtained the following results: (1) Inconsistent paternal discipline and maternal depressive symptoms increased and children’s positive affectivity decreased the probability of children of being in the AD group rather than in the comparison group. (2) Maternal overinvolvement, maternal depressive symptoms and children’s negative affectivity increased and children’s positive affectivity decreased the probability of children of belonging to the AD/DC group rather than to the comparison group. When comparing the two anxiety groups with each other, we found that inconsistent paternal discipline increased and children’s negative affectivity decreased the probability of children of being in the AD group rather than in the AD/DC group. The results suggest that paternal parenting behaviors show different associations with internalizing disorders at preschool age than maternal parenting behaviors. This underlines the importance of including fathers in the prevention and treatment of internalizing disorders at preschool age.     

Factors Influencing Adolescents’ Self-control According to Family Structure

We compared factors influencing adolescents’ self-control according to their family structure. Participants were 944 adolescents in five cities in South Korea (115 from single-parent families, 65 from grandparent-led families, and 764 from two-parent families). Data were collected using self-report questionnaires containing items on self-control, stress, parenting attitude, parent–adolescent communication, and family cohesion. Data were analyzed using stepwise multiple regressions with SPSS program. The factors influencing adolescents’ self-control differed across the three family structure groups. For single-parent families, stress and parental attitudes were significantly related to adolescents’ self-control (adjusted R²?=?0.37, p?<?0.001). In contrast, for grandparent-led families, family cohesion and parental attitude were significantly related to adolescents’ self-control (adjusted R²?=?0.31, p?<?0.01), while for two-parent families, stress, parental attitude, and parent–adolescent communication were related to the outcome (adjusted R²?=?0.24, p?<?0.001). Parental attitude was thus a common factor relating to self-control, regardless of family structure. On the other hand, the main factors influencing adolescents with low self-control were gender and stress. Our results confirm that adolescents’ self-control is not only affected by personal factors but also by parental and family factors. It is important to improve individual program to improve adolescents’ self-control according to family structure. The results of study may act as a base for improving individual intervention programs aimed at promoting adolescents’ self-control by factoring in family structure.     

<Emphasis Type="Italic">DRD4</Emphasis> Variants Moderate the Impact of Parental Characteristics on Child Attention-Deficit Hyperactivity Disorder: Exploratory Evidence from a Multiplex Family Design

Parental ADHD symptomatology and related impairments have been robustly associated with youth ADHD across decades of work. Notably, these factors may impede typical development of child self-regulation capabilities through both neurobiological and interpersonal processes. High heritability of estimates for the disorder further suggest that these effects are likely genetically-mediated, at least in part. Variation within the dopamine D4 receptor gene (DRD4) has been shown to moderate parental influences on youth ADHD. Use of a multiplex family design (i.e., samples of families that included multiple affected members) may facilitate identification of additional gene variants of interest and advance understanding of gene-environment interplay in regard to parenting. Thirty multiplex families consisting of 114 individuals (66 youth, 48 parents) completed a multi-stage, multi-informant diagnostic and neurocognitive assessment, measures of parenting, and provided saliva samples for DNA analyses. Sanger sequencing of the DRD4 gene yielded 16 rare variants; a polygenic risk score was computed for both parents and youth. Generalized estimating equations (GEE) examined the predictive effects of parental ADHD symptoms, parental neurocognitive functioning, and poor parenting dimensions on youth ADHD as well as moderation of these effects by parental and youth DRD4 variants. Findings indicated that parental DRD4 variants moderated the impact of parental ADHD and neurocognitive functioning on youth ADHD symptoms. Youth DRD4 variants moderated the impact of parental inconsistent discipline on child ADHD. In all cases, stronger associations were observed for those individuals with more risk variants. These exploratory findings highlight the potential utility of a multiplex family design for examining the interplay between parent and child characteristics in predicting youth outcomes.     

Psychometric Properties of the Parenting Sense of Competence Scale in Treatment-Seeking Post-9/11 Veterans

Although evidence suggests deployment-related stress impacts parenting, few measures of parenting competency have been validated in returning post-9/11 veterans. As part of clinical care in a multidisciplinary clinic serving veterans and military families, 178 treatment-seeking OEF/OIF/OND veterans completed measures including the 16-item Parenting Sense of Competence Scale (PSOC), a widely-used measure of parental efficacy and satisfaction; the Family Assessment Device—general functioning subscale; and the depression, anxiety, and stress scale. Utilizing data from an IRB-approved de-identified data repository, we examined the psychometrics and factor structure of the PSOC. According to a proposed clinical cut-off, 10?% of our clinical sample of veterans exhibited low self-confidence in parenting. A confirmatory factor analysis of the 2-factor structure introducing correlated error terms between items 3 and 9, and between items 10 and 11, revealed to be a satisfactory fit to the data (Χ ² /df?=?1.57, RMSEA?=?0.056 [90?% CI 0.039–0.073]; CFI?=?0.928; TLI?=?0.914; SRMR?=?0.055). In addition, the PSOC exhibited good convergent validity with measures of parental distress (r?=??.22, p?<?0.01 with anxiety symptoms, and r?=??.33, p?<?.001 with depressive symptoms) and family functioning (r?=??.53, p?<?.0001), very good temporal stability (r?=?.81, p?<?.0.0001), and excellent internal consistency (α?=?.85). The PSOC exhibited satisfactory psychometric properties in treatment-seeking veterans and may be used by clinicians and researchers to assess parenting sense of competence, including satisfaction and sense of efficacy, in this population.     

Sex-Specific Effect of Recalled Parenting on Affective and Cognitive Empathy in Adulthood

Previous research has demonstrated the influence of parenting on the development of children’s empathy. However, few studies have considered the impact of parents on empathy in adulthood, specific components of empathy, or the importance of parent and child biological sex. In the present study, 226 participants (71 men) completed online versions of the Parental Bonding Instrument (Parker et al. British Journal of Medical Psychology, 52, 1–10 1979), Empathy Quotient (Baron-Cohen and Wheelwright Journal of Autism and Developmental Disorders, 34, 163–175 2004), and Interpersonal Reactivity Index (Davis JSAS Catalog of Selected Documents in Psychology, 10, 85 1980). Paternal care and overprotection influenced affective empathy in men, whilst maternal overprotection predicted affective empathy in women. Further, maternal care related to cognitive empathy in men, whilst none of the parental care variables related to cognitive empathy in women. Findings are discussed in relation to sex differences in childhood parenting experiences on adult cognitive and affective empathy.     

Strengths and Subjective Wellbeing in Adolescence: Strength-Based Parenting and the Moderating Effect of Mindset

Recent research suggests that strength-based parenting—the tendency for parents to see and encourage children to use their strengths—relates to lower stress and higher life satisfaction in adolescents. The current study tests whether strength-based parenting, in conjunction with a teenager’s strengths use, influences the teenager’s subjective wellbeing, and whether a growth mindset moderates the relationship between strength-based parenting and strengths use. Three hundred and sixty three adolescents (M _age = 13.74, 51% female) completed questionnaire measures of strength-based parenting, strengths use, subjective wellbeing (life satisfaction, positive affect, and negative affect), Extraversion, Neuroticism, and two aspects of growth mindset. A hierarchical regression using latent variables found that strengths use and strength-based parenting were both significant independent predictors of subjective wellbeing, over and above the effects of extraversion and neuroticism. A mediation analysis found that strengths use partially mediated the relationship between strength-based parenting and subjective wellbeing. Finally, a novel measure of strengths mindset significantly moderated the relationship between strength-based parenting and strengths use. These results suggest that adolescents who see their parents as strength-based report greater strengths use (especially when they have a growth mindset about their strengths) and greater subjective wellbeing.     

Child Conduct Problems Across Home and School Contexts: a Person-Centered Approach

To examine patterns of conduct problems across the home and school context, we used latent class analysis to analyze primary caregivers’ and teachers’ ratings on the conduct problems subscale of the Strengths and Difficulties Questionnaire (Goodman Journal of Child Psychology and Psychiatry, 38, 581–586, 1997) in the Family Life Project (N?=?1,292), a prospective study of child development in rural and small town contexts. We found a similar four-class solution at 5 and 7 years of age. In decreasing prevalence, the following classes were identified: (1) low symptoms reported by both informants (low cross-context); (2) high parent-reported symptoms, low teacher-reported symptoms (home context); (3) low parent-reported symptoms, moderate teacher-reported symptoms (school context); and (4) high symptoms reported by both informants (high cross-context). Classes exhibited stability from age five to age seven: children were more likely to remain in the same class than to transition to a different class, and longitudinal stability was especially high for children in the low cross-context class at age 5. A number of child and family characteristics measured in early childhood (executive function, verbal ability, poverty-related risk, sensitive parenting, and parental depressive symptoms) were associated with class membership at age five and age seven, but were generally not associated with longitudinal transitions between classes.     

Religion and Health: Anxiety,Religiosity, Meaning of Life and Mental Health

We examined the association among anxiety, religiosity, meaning of life and mental health in a nonclinical sample from a Chinese society. Four hundred fifty-one Taiwanese adults (150 males and 300 females) ranging in age from 17 to 73 years (M = 28.9, SD = 11.53) completed measures of Beck Anxiety Inventory, Medical Outcomes Study Health Survey, Perceived Stress Scale, Social Support Scale, and Personal Religiosity Scale (measuring religiosity and meaning of life). Meaning of life has a significant negative correlation with anxiety and a significant positive correlation with mental health and religiosity; however, religiosity does not correlate significantly anxiety and mental health after controlling for demographic measures, social support and physical health. Anxiety explains unique variance in mental health above meaning of life. Meaning of life was found to partially mediate the relationship between anxiety and mental health. These findings suggest that benefits of meaning of life for mental health can be at least partially accounted for by the effects of underlying anxiety.     

Effects of Parent Training on Callous-Unemotional Traits,Effortful Control,and Conduct Problems: Mediation by Parenting

Callous-unemotional (CU) traits and effortful control (EC) are personality and temperament traits implicated in early-onset antisocial trajectories. This secondary analysis of Hitkashrut’s randomized controlled trial first tested parent training’s effects on EC and CU traits while controlling for more general treatment effects on conduct problems (CP), and subsequently tested mediation by parenting. Prekindergarten teachers in three Israeli cities identified 209 3–5 year-old (163 boys; 46 girls) preschoolers with subclinical-clinical range conduct problems. All participants were Jewish ranging from ultra-orthodox to secular. They were assigned to 14-session co-parent training groups (n = 140 couples), or to minimal intervention control groups with referral to local services as necessary (n = 69 couples). We employed averaged indices of pre- and post-intervention questionnaires completed by both parents. The testing of all hypothesized models controlled for treatment effects on CP in order to strengthen the robustness of the analyses. We found significant concurrent treatment effects on CP and on either CU traits or EC. All effects were mediated by ineffective parenting (IP): a latent variable that was indicated by negative/inconsistent practices and perceived parenting inefficacy. This is the first demonstration of parenting mediated treatment effects on both EC and CU traits in a randomized controlled study conducted in everyday practice contexts. This finding supports a disruption model of change: the reduction of IP facilitates a caregiving environment that affects children’s behavior and developing personality. The changing of personality and temperament characteristics implicated in early-onset pathways suggests an innovative prevention strategy for disruptive behavior disorders.     

Family Cohesion and Adaptation in Pediatric Chronic Conditions: The Missing Link of the Family’s Condition Management

The quality of family functioning has been considered an important predictor of adaptation in children with chronic conditions and their parents. Previous research suggests that beyond general family functioning, the specific experience of the family’s condition management is paramount for understanding family members’ adaptation. This study’s first goal was to compare family functioning and parents’ and children’s adaptation outcomes across four chronic conditions: asthma, diabetes, epilepsy, and obesity. Secondly, we explored the mediating role of family life difficulties and parental mutuality, as two potential paths through which family cohesion is linked to family members’ adaptation. A total of 263 parents of children (3–19 years old) with asthma (n = 77), obesity (n = 79), epilepsy (n = 52) and diabetes (n = 55) completed self-report measures of family cohesion, family life difficulty, parental mutuality, anxiety and depressive symptoms, and their children’s health-related quality of life (HrQoL). The results showed that families of children with diabetes, obesity, and epilepsy were at higher risk of experiencing family difficulties and children’s deteriorated HrQoL when compared to families of children with asthma. With regard to the links among study variables, although family cohesion had both a direct and indirect relationship with parental depressive symptoms, its links with parental anxiety symptoms and children’s HrQoL were only indirect, through family life difficulty. These associations were consistent across the four clinical groups. These findings emphasize the relevance of family-centered interventions aimed at promoting family cohesion, parents’ mutuality, and effective coping with the demands of pediatric chronic conditions.     

The Modal Logic of Gödel Sentences

The modal logic of Gödel sentences, termed as GS, is introduced to analyze the logical properties of ‘true but unprovable’ sentences in formal arithmetic. The logic GS is, in a sense, dual to Grzegorczyk’s Logic, where modality can be interpreted as ‘true and provable’. As we show, GS and Grzegorczyk’s Logic are, in fact, mutually embeddable. We prove Kripke completeness and arithmetical completeness for GS. GS is also an extended system of the logic of ‘Essence and Accident’ proposed by Marcos (Bull Sect Log 34(1):43–56, 2005). We also clarify the relationships between GS and the provability logic GL and between GS and Intuitionistic Propositional Logic.     

A Randomized Controlled Trial of the Impact of a Family-Based Adolescent Depression Intervention on both Youth and Parent Mental Health Outcomes

This paper presents findings from a multi-centre, double-blind, randomized controlled trial that tested the hypothesis that parent and youth mental health improvements would be superior in a family-based intervention for adolescent depression (BEST MOOD) compared to a treatment-as-usual supportive parenting program (PAST). Eligible participants were families with a young person aged between 12 and 18 years who met diagnostic criteria for a depressive disorder (major, minor or dysthymic). Participating families (N = 64; 73.4% of youth were female) were recruited in Victoria, Australia and allocated to treatment condition using a block randomization procedure (parallel design) with two levels of blinding. This paper reports on the trial’s secondary outcomes on youth and parent mental health. General linear mixed models were used to examine the longitudinal effect of treatment group on outcome. Data were analyzed according to intention-to-treat; 31 families were analyzed in BEST MOOD, and 33 families in PAST. Parents in the BEST MOOD group experienced significantly greater reductions in stress and depressive symptoms than parents in the PAST group at 3-month follow-up. A greater reduction in parental anxiety was observed in the BEST MOOD group (d = 0.35) compared with PAST (d = 0.02), although the between-group difference was not significant. Both groups of youth showed similar levels of improvement in depressive symptoms at post-treatment (d = 0.83 and 0.80 respectively), which were largely sustained at a 3-month follow-up. The family-based BEST MOOD intervention appeared superior to treatment-as-usual (PAST) in demonstrating greater reductions in parental stress and depression. Both interventions produced large reductions in youth depressive symptoms.     

Parents’ Intelligence Mindsets Relate to Child Internalizing Problems: Moderation Through Child Gender

Parental belief systems can strongly influence children’s affect, behavior, and mental health. However, associations between specific kinds of parental beliefs and children’s mental health have not been thoroughly explored. One relevant belief system is parental intelligence mindset: beliefs about the malleability of intelligence. Children of parents who view intelligence as static (known as a fixed intelligence mindset), rather than malleable through effort (known as a growth intelligence mindset), experience more academic, self-regulatory, and motivational difficulty. However, associations between parental intelligence mindset and child mental health problems are unclear. Accordingly, we tested whether parents’ intelligence mindsets related to internalizing problems in their children (N?=?131, ages 5–8). Overall, parents with stronger fixed intelligence mindsets had children with greater internalizing problems, particularly social anxiety (characterized by fear of negative evaluation). Results further revealed that parents’ fixed intelligence mindsets were associated with overall internalizing problems and depressive symptoms in boys, but not girls. Results are the first to suggest and parse direct links between parents’ intelligence mindsets and youth internalizing problems.     

Do Children’s Attributions Mediate the Link Between Parental Conditional Regard and Child Depression and Emotion?

Both parental conditional regard for academics and depressogenic attributions are related to detrimental psychological outcomes for children. Here we examine associations among parental conditional negative regard, child depressogenic attributions, child depressive symptoms, and emotion reactivity in children between the ages of 8 and 12, as well as whether children’s self-reported and behavioral attributions for negative events mediate associations between parental conditional negative regard for academics with children’s depressive symptoms and emotion reactivity. In Study 1 (N?=?108, M _age ?=?9.73, 50 male), children’s self-reported attributions for hypothetical events mediated the link between parental conditional negative regard and child depressive symptoms. In Study 2 (N?=?104, M _age ?=?10.28, 54 male), children attempted an impossible puzzle task while their skin conductance level was monitored, after which they completed an interview that was coded for spontaneous attributions for failure. Children’s spontaneous attributions mediated the link between parental conditional negative regard and child emotion reactivity, but not depressive symptoms. Findings suggest that children’s attributions may be a mechanism through which parental conditional negative regard is related to children’s depressive symptoms and emotion reactivity during a performance challenge. These results have implications for developmental models of depression risk and potential areas for clinical interventions with both children and their parents.     

Parenting Styles and Suicidal Ideation in Adolescents: Mediating Effect of Attachment

The present study aims to analyze the role of parenting styles in the development of suicidal ideation in adolescents, as well as test the mediating role of attachment to parents in the association between authoritative, authoritarian and permissive parenting style and suicidal ideation. The sample was made up of 604 individuals, aged between 15 and 18. In order to gather data, the Styles & Dimensions Questionnaire: Short Version, the Father/Mother Attachment Questionnaire and the Suicidal Ideation Questionnaire were used. The results suggest that the relations with parents, which are characterized by inhibition of exploration and of individuality, contribute to an emotional maladjustment being positively associated with suicidal ideation (r?=?.26 to r?=?.28). This confirmed the mediating role of parental attachment in the association between authoritative and permissive parenting styles from father and mother to suicidal ideation. It was also verified also a partial mediation, through the attachment to parents, in the association between the parent’s authoritarian style and the mother’s permissive styles and suicidal ideation. Furthermore, it was found the presence of total mediation, by throughout to attachment to the father, in the association between the father’s permissive style and suicidal ideation. The results suggest the importance of adopting authoritative parenting styles, since they seem to facilitate the development of the quality of attachment with parents. The results were analyzed in light of the attachment theory, taking into consideration the importance of parenting styles in understanding the processes inherent to suicidal ideation in adolescence.     

Neural response to prosocial scenes relates to subsequent giving behavior in adolescents: A pilot study

Adolescence is characterized by extensive neural development and sensitivity to social context, both of which contribute to engaging in prosocial behaviors. Although it is established that prosocial behaviors are linked to positive outcomes in adulthood, little is known about the neural correlates of adolescents’ prosociality. Identifying whether the brain is differentially responsive to varying types of social input may be important for fostering prosocial behavior. We report pilot results using new stimuli and an ecologically valid donation paradigm indicating (1) brain regions typically recruited during socioemotional processing evinced differential activation when adolescents evaluated prosocial compared with social or noninteractive scenes (N = 20, ages 13–17 years, M_Age = 15.30 years), and (2) individual differences in temporoparietal junction recruitment when viewing others’ prosocial behaviors were related to adolescents’ own charitable giving. These novel findings have significant implications for understanding how the adolescent brain processes prosocial acts and for informing ways to support adolescents to engage in prosocial behaviors in their daily lives.     

Hillel and Confucius: The prescriptive formulation of the golden rule in the Jewish and Chinese Confucian ethical traditions

A prospective convert asked Hillel to teach him the entire Torahwhile standing on one foot. Hillel replied, “What is hateful to yourself, do not do to your fellow man. That isthe whole of Torah and the remainder is but commentary. Go and study it.” (Hillel:Shab. 31; emphasis added)Zigong: “Is there asingle word that can serve as a guide to conduct throughout one’s life?” Confucius said: “Perhaps the word ‘shu’, ‘reciprocity’: ‘Do not do to others what you would not want others to do to you’.” (Analects: 15.24; see alsoAnalects. 12 andZhongyong. 13.3; emphasis added)¹     

How Couple- and Parenting-Focused Programs Affect Child Behavioral Problems: A Randomized Controlled Trial

The significance of enhancing parenting skills to reduce child maladjustment is well-established and supports the important role of evidence-based parenting programs. However, the notion that parenting should be the exclusive focus for enhancing child behavior is necessarily limiting. Evidence is growing that relationship-oriented treatments may be another powerful approach to improve child adjustment, albeit the underlying effects in couple- versus parenting-focused programs have been subject to limited study. The aim of this RCT was to compare the treatment effects of (1) a couple-focused program (the Couples Coping Enhancement Training) to (2) a parenting training (Triple P) and (3) a control group on children’s behavioral problems in 150 couples. The parents’ perceptions of relationship quality, parenting behavior, and child’s behavioral problems were assessed by means of questionnaires completed prior to and 2 weeks after the end of the treatment. Multi-group path analyses revealed that in mothers’ perception the couple-focused program reduced child behavioral problems by enhancing the relationship quality whereas improved parenting mediated the benefits in the parenting training. In fathers’ evaluations the couple-focused program reduced dysfunctional parenting which largely accounted for the benefits in child adjustment. The dearth of research on child outcomes in couple-focused intervention studies is a striking gap that should be overcome. It is a promising field because of its evident potential to foster the health of many children.