Delimiting Family in Syntheses of Research on Childhood Chronic Conditions and Family Life

Synthesis of family research presents unique challenges to investigators who must delimit what will be included as a family study in the proposed review. In this paper, the authors discuss the conceptual and pragmatic challenges of conducting systematic reviews of the literature on the intersection between family life and childhood chronic conditions. A proposed framework for delimiting the family domain of interest is presented. The framework addresses both topical salience and level of relevance and provides direction to future researchers, with the goal of supporting the overall quality of family research synthesis efforts. For users of synthesis studies, knowledge of how investigators conceptualize the boundaries of family research is important contextual information for understanding the limits and applicability of the results.     

母亲消极教养、同伴侵害与FKBP5基因对青少年抑郁的影响

累积压力假说与匹配-不匹配假说均可解释远端和近端逆境对个体抑郁的影响,但鲜有研究考察遗传基因在其中的调节作用。采用问卷法和DNA分型技术,对970名青少年进行间隔3年的追踪调查。分别以母亲消极教养、同伴侵害为远端和近端压力指标, FKBP5基因多位点累加得分为遗传指标,考察三者对青少年抑郁的交互作用及性别差异。结果发现,在男青少年中, E×E×G显著。当累加得分较高、同伴侵害水平较高时,母亲消极教养显著负向预测抑郁,符合匹配-不匹配假说;累加得分较低时, E×E不显著,但倾向于以累积压力假说的方式发挥作用。女青少年中, E×E×G不显著。研究结果提示,在男青少年中,累积压力假说与匹配-不匹配假说均可阐明抑郁的发生机制,分别适用于携带不同FKBP5基因多位点累加得分的个体。     

Toward resolution of a longstanding controversy in personality disorder diagnosis: Contrasting correlates of schizoid and avoidant traits

Although the construct validity and clinical utility of separate schizoid and avoidant personality disorder (PD) categories has been controversial since avoidant PD was first introduced in DSM-III, few studies have compared individuals with schizoid versus avoidant features on variables relevant to their contrasting personality dynamics. Those few investigations that exist have yielded inconclusive results. In this study a mixed-sex sample of nonclinical participants (N = 123) completed the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) and self-report measures of attachment style, defense style, empathy, internalized shame, need to belong, rejection sensitivity, and social anhedonia. High levels of social anhedonia were uniquely predictive of schizoid features; high levels of need to belong and internalized shame were uniquely predictive of avoidance. These findings support retaining the two PD categories in future versions of the DSM. Supplementary analyses revealed that among women—but not men—schizoid and avoidant traits were positively and significantly intercorrelated; it may be that women show more of a blended schizoid–avoidant profile, whereas men display the more prototypical categorical profile where either schizoid or avoidant features predominate.     

The Experience of Prisoners’ Parents: A Meta‐Synthesis of Qualitative Studies

The parents of prisoners have long drawn the attention of researchers, due to their role in the etiology of criminality as well as the importance of their support of their offspring during and after incarceration. However, although studies have shown that the parents of prisoners experience high levels of distress, burden, and social stigma, research into their experience is only now beginning to emerge. This metasynthesis examined the limited body of qualitative research on the experience of prisoners’ parents, as an exploratory step toward advancing the understanding of their experience. Relevant terms were used to systematically search key databases. Ten small‐scale studies, which varied in focus, location, and disciplinary orientation, met the inclusion criteria. The synthesis produced four core themes, reflecting findings regarding parents’ (primarily mothers’) experience of their offspring's incarceration: parenting from a distance; the burden of care; troubled parental identity; and social reaction. Furthermore, the findings suggested a number of possible mediating factors of this experience, such as parents’ social capital and their cognitive appraisal of their offspring's criminality. These themes imply a possible experience of “imprisonment by association” among the parents of inmates and illuminate features that may be unique to them. Given the inherent limitations regarding generalizability of a metasynthesis and the heterogeneity of the experiences of the parents represented by the articles reviewed, the findings call for future large‐scale quantitative studies to explore the challenges and therapeutic needs of parents of prisoners regarding the themes identified.     

Cooperation,Conflict, or Disengagement? Coparenting Styles and Father Involvement in Fragile Families

This paper draws on information from the Fragile Families Study (N = 2,695) to examine how different coparenting styles emerge and are related to fathers' involvement with young children in a representative sample of unmarried parents. The results show that the quantity and quality of paternal involvement is significantly higher when unmarried parents establish a cooperative as opposed to a disengaged or conflicted coparenting style. Cooperative coparenting is less likely, however, when unmarried parents have separated after the birth or were never together as a couple, when fathers are unemployed or have other risk factors, when the child has a more difficult temperament, and when parents have fewer children together. This analysis also helps clarify previously equivocal findings concerning the relationship between coparenting conflict and paternal involvement. Regression results show that paternal involvement is not significantly different among parents with cooperative and mixed coparenting styles, indicating that when unmarried parents can work together and support each other's parenting efforts, even if they argue frequently while doing so, fathers remain more involved. At the same time, conflicted coparenting leads to a larger decrease in father involvement than disengaged coparenting. In the context of poorer‐quality coparenting relationships, it was conflict that mattered for fathering, not just parents' inability to cooperate. Implications of these findings for parenting education programs are discussed.     

IS REFLECTIVE SUPERVISION ENOUGH? AN EXPLORATION OF WORKFORCE PERSPECTIVES

Infant mental health practice requires the performance of intense emotional labor. Professionals comprising the infant mental health (IMH) field are largely women at seminal points in adult life‐span development. The purpose of this article is to explore the day‐to‐day challenges faced by clinical infant mental health professionals and their perspectives on the supports available for effective job performance. We review reflective supervision as a long‐cherished professional support in the IMH field designed to hold the practitioner's fears, worries, and ambivalence, so that she may return to the work fortified to remain in therapeutic alliance with families despite unsolvable problems and an unknowable future (Weatherston, D., 2009). Yet, we propose that reflective supervision alone may not be an adequate protective measure for a workforce performing intensive emotional labor for extended periods and therefore at potentially increased risk for burnout and high turnover (Hochschild, A.R. 1983 ; C. Maslach, 1982 , C.M. Brotheridge & A.A. Grandey, 2009; A.S. Wharton, 2009 ). We suggest that structural factors concerning organizational culture, flexibility in scheduling, and professional growth and versatility bear deeper examination for their merits in supporting the IMH workforce. Finally, we contend that the overrepresentation of women in practitioner positions in IMH leaves an empirical gap where little is known about the experience of male IMH practitioners and the ramifications of their performance of emotional labor.     

IMPACT OF PARENTAL BINGE EATING DISORDER: EXPLORING CHILDREN'S EMOTIONAL/BEHAVIORAL PROBLEMS AND THE QUALITY OF PARENT–CHILD FEEDING INTERACTIONS

This study examines psychopathological problems in children of parents with binge eating disorder (BED), particularly the effect of parental diagnosis on their offspring's psychopathology and the mediating power of the quality of parent–infant feeding interactions. Two hundred parents and their offspring were administered a questionnaire for the assessment of their children's psychopathology at 18 (T1) and 36 (T2) months of age. An observational measure to evaluate feeding interactions was administered at T1. Children with both parents with BED showed the highest affective, anxiety, oppositional/defiant, and autism spectrum problems, but no influence of paternal diagnosis was found on the offspring's psychopathology. Maternal BED had an influence on children's affective and autism spectrum problems, and diagnosis of BED in both parents had an effect on infants’ affective problems. Paternal BED had an effect on oppositional/defiant problems through the quality of father–infant interactions, and maternal BED had an effect on the offspring's affective and anxiety problems through the mediation of mother–infant interactions. These results suggest the importance of intervention programs focusing both on parental psychopathology and on mother–child and father–child feeding interactions in families with parents with BED.     

MEASURING REFLECTIVE SUPERVISION WITHIN HOME VISITING: CHANGES IN SUPERVISORS’ SELF‐PERCEPTION OVER TIME

Despite widespread belief in the early childhood field of the benefits of reflective supervision, there has been limited empirical evidence to support the effectiveness of reflective supervision for home visitors and the children and families they serve. The present study examined the psychometric properties of four adapted self‐report measures assessing supervisors’ reflective supervision capacities; the study also investigated whether these measures captured change in reflective capacity over time as supervisors participated in professional development activities focused on reflective supervision. Results from 33 participants (home visiting supervisors and program managers) suggested that three of the four measures demonstrated acceptable internal consistency, and these three measures were correlated with each other. Two of these measures also captured significant change over time. Finally, there was some evidence that those with less education demonstrated more substantial improvement in their reflective supervision capacities than did those with an advanced degree. Findings provide initial evidence for reliable, efficient, and cost‐effective supervisor self‐report measures that could be used in research and program evaluation to assess change in supervisor reflective capacity over time.     

MEDIATING ROLE OF MATERNAL SENSITIVITY: ENHANCING LANGUAGE DEVELOPMENT IN AT‐RISK FAMILIES

Home‐visiting programs have gained increasing importance in family‐centered prevention and intervention. However, few studies have examined the mechanisms underlying early intervention treatment effects. The goal of this study is to analyze the mediating role of maternal sensitivity in enhancing language development with the home‐visiting program Parents as Teachers (PAT). Data were collected and analyzed within the ongoing, long‐term ZEPPELIN study, a randomized controlled trial with 251 participating at‐risk families. Via longitudinal mediation analysis, we examined whether effects of the PAT on receptive and expressive language outcomes at 24 and 36 months were mediated by maternal sensitivity at 12 months. Within a moderated mediation framework, we investigated whether the level of family psychosocial stress affects this mediation. Results showed that intervention effects on language outcomes are mediated by maternal sensitivity—weakly and through specific pathways. Moderation and moderated mediation analyses indicated that effects of the PAT and also specific mediation effects increase with the level of psychosocial stress. Implications of the results for practice are discussed.     

Medicalizing tensions in counselor education?

The aim of this paper is to summarize research into the tensions associated with medicalization in graduate counselor education in a primarily Canadian context. Counselor education, until recently, has largely embraced pluralistic traditions of practice that are potentially at odds with a medicalized approach to practice. Medicalization here refers to a diagnostic and treatment focus most commonly associated with use of DSM5 diagnostic procedures and evidence-based treatment. Tensions, in this study, refer to competing accountabilities encountered in reconciling medicalized with other approaches to practice. Following a review of relevant textbooks, graduate program websites and curricula, Master’s-level counseling students, counselor educators, and profession leaders were surveyed and/or interviewed regarding how medicalization influenced counselor education, and for how they responded to its influence. Data across all sources were analyzed using the mapping procedures of Situational Analysis, a method useful in analyzing contested phenomena and processes. We report our findings as navigable, negotiable, and dilemmatic tensions shaping the experiences of students and other stakeholders in counselor education. We recommend ways to enable students and educators to navigate and negotiate potential dilemmas associated with medicalizing influences on counselor education. We close by discussing the implications of our findings with respect to practice and training in the UK context.