The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Linking Family Functioning and Self-Discrepancies among Children with Functional Somatic Symptoms

Functional somatic symptoms (FSS), defined as physical symptoms of unknown pathology, are common among children and adolescents and are often associated with high levels of functional impairment. Self-discrepancy theory (SDT) suggests that discrepancies between one’s ideal, ought, or undesired self-states and one’s actual self-representation may lead to emotional distress. Among families with dysfunctional patterns, such emotional distress may result in FSS. The current study examined the relationship between familial patterns and children’s levels of self-discrepancies, among children with and without FSS. Twenty-three children diagnosed with FSS and 23 children with orthopedic problems (non-FSS) and their mothers participated in the study. Mothers and children completed the Child Somatization Inventory and the Integrated Self-Discrepancies Index. Mothers also completed the general scale of the Family Assessment Device. Higher levels of symptom intensity were found in the FSS group than in the non-FSS group. Dysfunctional familial patterns were significantly higher in the FSS group, and higher levels of discrepancies were reported in the FSS group, compared with the non-FSS group. No significant relationship was found in the FSS group between level of self-state discrepancies and level of family functioning. Higher levels of dysfunctional patterns are observed among families of children with FSS. Furthermore, children with FSS and their mothers hold relatively high levels of self-state discrepancies. However, these elevated discrepancies are not significantly related to familial dysfunctional patterns. Viewing self-state discrepancies together with family maladaptive patterns might help address both inter- and intrapersonal conflicts within the family and reduce children’s symptoms.     

Single Parenthood and Adolescent Sexual Outcomes

Research suggests that children of single parents are at heightened risk of precocious sexual behavior, STDs, and other risky sexual outcomes. However, few such studies have addressed the type of single-parent family (single mother or single father), or differences across other-sex parent–child dyads. While gender essentialist models assume differences among youth living only with mothers or with fathers, constructivist models propose more flexible modes of parenting that lead to more similar outcomes. Using data from the National Longitudinal Study of Adolescent to Adult Health (n?=?2570) on youth between the ages of 15 and 19, we compared sexually-related outcomes among adolescents, both boys and girls, who lived with a single mother or a single father. These outcomes include sexual intercourse and knowledge, use of contraception, attitudes toward intimacy and pregnancy, and diagnosis of sexually-transmitted diseases. The results from linear and logistic regression models indicated few differences between single-mother and single-father families, or between same-sex and opposite-sex parent–child matches, using p values of .05 or smaller. Our results called into question essentialist models that posit higher risks for adolescents living with a particular parent or with an opposite-sex parent.     

Validation of the Chinese Revision of Emotional and Behavioral Screener among Preschoolers (4–7 years old)

The study aimed to examine the psychometric properties of the Chinese revision of the Emotional and Behavioral Screener (EBS), and to extend its application to preschoolers (4–7 years old). Teachers and parents of 216 preschoolers (age M?=?5.11, SD?=?0.9) were invited to complete the EBS, and some of the teachers were also asked to complete the Preschool Behavioral and Emotional Rating Scale (PreBERS) (N?=?80) and the Strength and Difficulties Questionnaires (SDQ) (N?=?90). Results of confirmatory factor analysis suggested that the original single-factor model of the EBS didn’t fit the data well. Based on the results of a series of exploratory factor analyses, we proposed a two-factor model instead, representing externalizing and internalizing problems respectively. The Chinese revision demonstrated satisfactory internal reliability, inter-rater reliability, convergent validity and divergent validity. All these evidences supported its use among Chinese preschoolers to identify those who will be at risk of suffering from emotional and behavioral disturbances.     

Intergenerational Transfers: Associations with Adult Children’s Emotional Support of Their Parents

This study investigates how different factors in regard to intergenerational relationships are associated with emotional support given by adults to their parents. The analysis focuses on adult children and their parents in a representative German sample. Data were obtained from the second wave of the German Family Panel (pairfam) consisting of 2064 women and 1841 men. Results show that transfer of emotional support by the adult children was especially associated not only with received emotional support from parents, but also with affection, conflicts, and expectations concerning parents. A moderator analysis focuses on gender and showed differences for the association between given support by adults and conflicts between mothers and fathers. For the offspring, no gender effects were found.     

Alleviation of Side Effects and Distress in Breast Cancer Patients by Cognitive-Behavioral Interventions: A Systematic Review and Meta-analysis

Cognitive and behavioral interventions (CBI) have been used for breast cancer patients with various stages of the disease or undergoing different treatments. However, no quantitative review has summarized their efficacy on the side effects of treatment, distress, and quality of life in the acute treatment setting after diagnosis. This meta-analysis synthesizes data from 19 randomized clinical trials in order to: (a) provide an estimation of overall effect of CBI in breast cancer patients during treatment for breast cancer, i.e., neo-adjuvant and adjuvant treatment; (b) provide average effect sizes on side effects of treatment, distress, and quality of life; and (c) test possible moderators of effect size. The results show that CBI yielded a small effect size overall, specifically on general side effects of treatment, nausea, vomiting, distress, and quality of life. Individual and behavioral interventions seem to elicit better results on distress and on general side effects of treatment, respectively. While more studies are needed with regard to specific side effects (i.e., fatigue, pain, and sleep disturbance), the overall results clearly support the use of CBI in breast cancer patients during treatment.     

Ethics and Confidentiality for Psychologists in Academic Health Centers

Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care. Considerations for best practices in integrated care settings will be discussed, and the APA Ethical Standards will be referenced throughout.     

Validation Study of the Portuguese Version of the Family Problem Solving Communication (FPSC) Index

Within family stress theories, the way in which families communicate about their hardships and issues is crucial for the family’s stress management and functioning. In the current study, we sought to validate the Portuguese version of the Family Problem Solving Communication (FPSC) Index and examine its psychometric properties. Developed within the context of the resiliency model of family stress, adjustment and adaptation, the FPSC is a ten-item self-report measure that assesses the family communication patterns that are likely to play a role in the family’s coping with hardships and difficulties. The participants were 332 individuals between 18 and 76 years who completed the FPSC and self-report measures of family hardiness and family functioning. A confirmatory factor analysis supported the original FPSC bifactorial structure, indicating the presence of two dimensions, Affirmative Communication and Incendiary Communication. Correlations between the scale’s total score and its dimensions with the measures of family hardiness and family functioning attested to its convergent validity. Furthermore, the index demonstrated respectable to very good internal consistency and temporal stability. In conclusion, the Portuguese version of the FPSC is a valid and reliable instrument that can support the development of future empirical studies focused on family problem solving communication, especially with regard to family adaptation in different contexts of adversity.