Individual and Dyadic Coping and Fear of Progression in Mothers and Fathers of Children with Hematologic Cancer

This study investigated the association of individual and dyadic coping strategies with fear of progression (FoP) in mothers and fathers of children with hematologic cancer. Parental couples (N = 44) whose children had been diagnosed with hematologic cancer were recruited at a university hospital and a rehabilitation clinic in Germany between 03/2017 and 08/2017. Data included parents' self-report on FoP (Fear of Progression Questionnaire—parent version, FoP-Q-SF/PR), individual coping (Coping Health Inventory for Parents, CHIP-D), and dyadic coping (Dyadic Coping Inventory, DCI). Statistical analyses were carried out for mothers and fathers individually as well as for parental couples using dyadic data analyses (e.g., actor-partner interdependence model, APIM). Individual and dyadic coping strategies were significantly correlated with FoP in mothers, but not in fathers. Fathers' evaluation of the couple's dyadic coping significantly predicted mothers' FoP. The more frequent use of familial integration (CHIP-D FAM) and maintaining social support (CHIP-D SUP) as well as a better evaluation of their partners' dyadic coping was significantly associated with lower FoP in mothers. Differences in individual and dyadic coping in parental couples were not associated with FoP. Individual and dyadic coping strategies should be addressed in the psychosocial care of mothers and fathers of children with hematologic cancer. Study results support the benefits of involving fathers in psychosocial interventions, for example, in couple-based interventions that acknowledge interpersonal effects of coping on FoP. Future research should further explore coping strategies applied by fathers of children with hematologic cancer for the regulation of FoP.     

Cross-lagged Models of Marital Relationships and Intergenerational Conflicts during Transition to Parenthood: Effect of Patrilineal Coresidence

The transition to parenthood is one of the most stressful intra- and interpersonal adjustment periods for new parents. Bidirectional associations among intergenerational relationships during the transition to parenthood have received limited attention, and the complexity of reciprocal relationships varies in accordance with living arrangements. The objectives of this study were to explore (1) the bidirectional associations between marital relationships and conflicts with in-laws during the transition to parenthood and (2) the moderation of patrilineal coresidence on the aforementioned relationships. A three-wave prospective longitudinal design was adopted for 359 married mothers. The Dyadic Adjustment Scale and Stryker Adjustment Checklist were used to assess marital relationships and conflicts with parents-in-law. Cross-lagged panel analysis was applied to examine reciprocal relationships, and multigroup analyses were employed to determine whether these relationships exhibited different patterns in accordance with the individuals’ living arrangements. The two cross-lagged models revealed the presence of a bidirectional relationship between marital distress and conflicts with parents-in-law during the mid- to late pregnancy stages. Meanwhile, the multigroup analyses suggested that conflicts with parents-in-law triggered marital distress during pregnancy in the coresidence group, whereas conflicts with fathers-in-law could intensify marital distress during late pregnancy to the postpartum period in the noncoresidence group. These findings shed light on cross-lagged associations with intergenerational conflicts. Healthcare professionals need to ensure that intergenerational relationships are positive during the transition to parenthood. This study enriches our understanding of the effect of patrilineal coresidence and can guide the future development of interventions based on culturally specific multidimensional approaches.     

From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.-based Evidence-Based Intervention to the Uganda Context

In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children’s drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process.     

Explaining the Asian American Youth Paradox: Universal Factors versus Asian American Family Process Among Filipino and Korean American Youth

This study used longitudinal survey data of Filipino American and Korean American youth to examine ways in which universal factors (e.g., peer antisocial behaviors and parent–child conflict) and Asian American (AA) family process variables (e.g., gendered norms) independently and collectively predict grade point average (GPA), externalizing, and internalizing problems. We aimed to explain the “Asian American youth paradox” in which low externalizing problems and high GPA coexist with high internalizing problems. We found that universal factors were extensively predictive of youth problems and remained robust when AA family process was accounted for. AA family process also independently explained youth development and, in part, the AA youth paradox. For example, gendered norms increased mental distress. Academic controls did the opposite of what it is intended, that is, had a negative impact on GPA as well as other developmental domains. Family obligation, assessed by family-centered activities and helping out, was beneficial to both externalizing and internalizing youth outcomes. Parental implicit affection, one of the distinct traits of AA parenting, was beneficial, particularly for GPA. This study provided important empirical evidence that can guide cross-cultural parenting and meaningfully inform intervention programs for AA youth.     

The Associations between Mothers’ and Grandmothers’ Depressive Symptoms,Parenting Stress,and Relationship with Children: An Actor–Partner Interdependence Mediation Model

Three-generation households that include parents and grandparents raising children together have become increasingly common in China. This study examined the relations among depressive symptoms, parenting stress, and caregiver–child relationships in the mother–grandmother dyadic context. Participants were mothers and grandmothers from 136 three-generation households. Results from Actor–Partner Interdependence Mediation Modeling indicated that mothers’ depressive symptoms were indirectly related to mother–child conflict/closeness through own parenting stress; grandmothers’ depressive symptoms were indirectly related to grandmother–child conflict through own parenting stress. Mothers’ depressive symptoms were indirectly related to grandmothers’ conflict with children through grandmothers’ parenting stress, and grandmothers’ depressive symptoms were indirectly related to mothers’ conflict/closeness with children through mothers’ parenting stress. The relation between mothers’ parenting stress and mother–child closeness was stronger than the relation between grandmothers’ parenting stress and grandmother–child closeness. Findings highlight the implications of using a family system perspective and the dyadic approach in understanding and improving family functioning in Chinese three-generation households.     

Reaching Up,Down, In,and Around: Couple and Family Coping During the Coronavirus Pandemic

The worldwide coronavirus (COVID-19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic’s challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience—“Reaching Up, Down, In, and Around.” “Reaching Up” includes accessing spiritual, religious, and ethical values. “Reaching Down” includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth’s recovery from decades of human-caused damage. “Reaching In” represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. “Reaching Around” involves reframing the mandate for “social distancing” as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed.     

Clinical Supervision of Couple and Family Therapy during COVID-19

This paper addresses the need for a swift transition from in-person clinical supervision to telesupervision during the time of the COVID-19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID-19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID-19; (3) the supervisee’s competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees’ vulnerabilities in the face of COVID-19.     

Displacement trauma: complex states of personal,collective and intergenerational fragmentation and their intergenerational transmission

Originally presented at the Journal’s one day conference entitled ‘Displacement: Contemporary Traumatic Experience’ held in London in November 2019, this paper expands on the author’s theory of the implicit psychological organizing gestalt, an associated pattern of psychic functions which operate in an integrated way to simultaneously structure and organize our experience of self-cohesion and self-continuity. The gestalt, which implicitly links the formation of psychic skin, body image, cultural skin and both personal and cultural identity with place, functions as an emergent non-conscious permanent presence or background ‘constant’. It develops over time and emerges out of embodied emotional experiencing with the total environment – both human and non-human. The author argues that it is the rupture of this gestalt and the disorganizing consequences of its loss which underlies the experience of displacement trauma. If disruptions in the formation of the gestalt and/or its later rupture remain unrecognized and unrepresented then the absence creates a void which can be intergenerationally transmitted. Case material is presented which describes this and which highlights the ways in which the gestalt can contribute to our understanding of collective displacement anxiety, cultural trauma and cultural complexes.     

Regression II. Development through regression

As shown in our previous paper (‘Regression I. Experimental approaches to regression’, JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung’s view that regression is not only a ‘return’ to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.