Considering context: Current relationship satisfaction in a second-generation model of men's physical intimate partner violence.

Despite a half-century of scholarship devoted to explicating and disrupting the intergenerational transmission of family violence, it remains a prominent and destructive social force in the United States. Theoretical models have posited a variety of historical and concurrent risk and protective factors implicated in the trajectory from childhood violence exposure to adult perpetration. Using a second-generation model of intimate partner violence (IPV), we integrated social learning and attachment conceptualizations to examine pathways from family-of-origin violence to IPV perpetration among adult men. A sample of mixed-sex couples (N = 233) completed self-report measures related to social learning and attachment-based factors (e.g., violence in past relationships, child exposure, IPV attitudes, adult attachment) and participated in a 10-min conversation about a desired area for change in their relationship. Following, each partner participated in a video-mediated-recall procedure assessing their anger volatility and eliciting attributions of their partners' behavior. We tested mediation pathways (consistent with social learning and attachment theories) between violence in men's families of origin and their adult IPV perpetration as a function of relationship satisfaction. The proposed model fit the data well (CFI = 0.95) but had notable modifications from the hypothesized model. Generally, social-learning pathways were more consistent with the data. Relationship satisfaction interacted with some parameters. Results support theoretical advances in understanding IPV. Although exposure to violence in men's family of origin confers risk for later IPV, and a social learning developmental pathway is consistent with results, some of these effects are altered by relationship context.

Scoping Review of Postvention for Mental Health Providers Following Patient Suicide.

INTRODUCTION: As suicides among military personnel continue to climb, we sought to determine best practices for supporting military mental health clinicians following patient suicide loss (i.e., postvention). MATERIALS AND METHODS: We conducted a scoping review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Our initial search of academic databases generated 2,374 studies, of which 122 were included in our final review. We categorized postvention recommendations based on the socioecological model (i.e., recommendations at the individual provider, supervisory/managerial, organizational, and discipline levels) and analyzed them using a narrative synthesizing approach. RESULTS: Extracted recommendations (N = 358) comprised those at the provider (n = 94), supervisory/managerial (n = 90), organization (n = 105), and discipline (n = 69) levels. CONCLUSIONS: The literature converges on the need for formal postvention protocols that prioritize (1) training and education and (2) emotional and instrumental support for the clinician. Based on the scoped literature, we propose a simple postvention model for military mental health clinicians and recommend a controlled trial testing of its effectiveness.

Exploring dental students' attitudes toward patient-centered management of dental fear.

PURPOSE/OBJECTIVES: A patient-centered care (PCC) paradigm undergirds modern dental education. PCC is particularly relevant in the management of patient dental fear. The aims of this study were three-fold: (a) to examine the preliminary psychometric properties of an author-designed survey administered to explore dental fear knowledge and perceptions, (b) to assess how 4th-year dental students regard dental fear, (c) and to investigate the relationship between students' knowledge and perceptions of dental fear and their clinical behavior. METHODS: In 2022, 4th-year dental students (N = 453) participated in a cross-sectional study. Participants completed a 16-item survey that assessed (a) knowledge and perceptions about dental fear, (b) common biases in patient fear assessment, and (c) patient management behaviors when fear is encountered. Exploratory factor analysis, descriptive statistics, and logistic regressions were run to address the study's aims. RESULTS: Exploratory factor analysis revealed three factors, with the two strongest factors pertaining to beliefs about the importance of dental fear (α = 0.87) and self-efficacy in managing fear (α = 0.74). Participants indicated that it is important to assess for dental fear and rated their self-efficacy in ability managing it as high. Ratings on both factors slightly increased the odds of engaging in routine patient screening for dental fear. Students also displayed assessment biases commonly seen among practicing dentists. CONCLUSION(S): Results indicate educational gaps within the current behavioral-science training for dental students. Changes to improve advanced dental students' appreciation of their patients' dental fear are warranted.

Leveraging technology to increase the disseminability of evidence-based treatment of dental fear: An uncontrolled pilot study.

OBJECTIVES: U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in-chair time, delivered only in person at a few sites). We developed a disseminable CBT-DF stepped-care treatment comprising (Step 1) a mobile-health application and, for those who remain fearful, (Step 2) a 1-h, one-on-one psychological treatment session that allows practice during exposure to the patient's most-feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0-3 "no/low fear" zone) and statistically significant changes in global dental fear. METHOD: Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2. RESULTS: As hypothesized, users found the stepped-care treatment highly usable, credible, and helpful. Critically, this stepped-care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11). CONCLUSIONS: This usable, credible, stepped-care approach to dental fear treatment holds promise for liberating evidence-based CBT-DF from specialty clinics, allowing broad dissemination.

Do Brief Lab-Based Interventions Decrease Coercive Conflict Within Couples and Parent-Child Dyads?

Coercive conflicts between parents and children and between couples are implicated in the pathogenesis of a variety of psychological and physical health problems. Despite its seeming importance to population health, there are no widely available, easy-to-use methods with demonstrated efficacy to engage coercive conflict and reduce it. Identifying and testing potentially efficacious and disseminable micro-interventions (i.e., interventions that can be delivered in under 15 minutes via computer or paraprofessional) for targets with cross-cutting health implications, such as coercive conflict, is the focus of the National Institutes of Health Science of Behavior Change initiative. We experimentally tested four micro-interventions targeting coercive conflict in couple and parent-child dyads in a within-between design. There were mixed but supportive findings for the efficacy of most of the micro-interventions. Attributional reframing, implementation intentions, and evaluative conditioning all reduced coercive conflict as assessed by some but not all measures of observed coercion. No findings indicated any iatrogenic effects. Interpretation bias modification treatment improved at least one measure of coercive conflict for couples, but not for parents and children; additionally, it increased self-reported coercive conflict. Overall, these results are encouraging and suggest that very brief and highly disseminable micro-interventions for coercive conflict are a fruitful direction for inquiry. Optimizing micro-interventions and deploying them across the health care infrastructure could tremendously enhance family functioning and, in turn, health behaviors and health (ClinicalTrials.gov IDs: NCT03163082, NCT03162822).

Trauma during Early Adolescence and Boys' Social Behavior: A Focus on Teen Dating Violence.

Although early adolescence is increasingly recognized as commencing a sensitive period for social development, little research exists on the impact of trauma exposure during this juncture. We hypothesized that trauma experienced during early adolescence would be particularly disruptive to the acquisition of social skills necessary for healthy future relationships. Among 1500 boys from the National Comorbidity Study Adolescent Supplement, we examined trauma exposure across developmental periods on interpersonal outcomes in late adolescence. Most (62.3%) participants reported prior exposure to at least one potentially traumatic event, and rates of such exposures generally increased linearly over time with a relative spike in exposure occurring at age 15. Trauma exposure during early adolescence, but not other developmental periods, uniquely predicted boys' perpetration of physical teen dating violence (TDV; OR = 2.2) and broader social problems (B = 2.061, SE = .091) in late adolescence. In contrast, and consistent with existing literature, trauma exposure early in development and during mid-adolescence predicted late adolescence conduct disorder diagnoses. At least in the context of early adolescent exposure, the link between trauma and TDV perpetration may be conceptualized within a broader framework of social competence rather than oft-purported antisociality. Early adolescence may present opportunities for targeted prevention of TDV and broader social problems.

Children's emotional and behavioral reactions to interparental aggression: The role of exposure to within-incident, cross-dyad aggression spillover.

Despite children's frequent exposure to psychological and physical intimate partner aggression (IPA) and associated long-term consequences, little is known about children's immediate, within-incident reactions to IPA. Additionally, differences in reactions to IPA based on exposure to within-incident "spillover" of aggression across interparental and parent-child dyads have previously remained unexamined. Parents of children age 2.5 years at study commencement (N = 203 from 111 families) reported on incidents of family aggression four times for 1 year. Among select IPA incidents with the child present (n = 163 incidents from 73 families), IPA severity and children's exposure to aggression spillover were uniquely associated with children's expression of greater fear. Moreover, children unexposed to spillover experienced high fear only during relatively severe IPA incidents, whereas spillover-exposed children experienced high fear regardless of IPA severity (supporting observations of fear reactivity in response to low-level threats). Additionally, IPA severity positively predicted, and spillover exposure negatively predicted, children's attempts to make peace or solve the problem for their parents. Further, spillover-exposed children were more likely to withdraw or attempt to make peace during relatively more severe incidents of IPA. Thus, spillover-exposed children may manage their fear during relatively severe IPA incidents by withdrawing and/or engaging in active peacemaking behaviors but not by using other methods that may increase risk of aggression turning toward them. These results extend existing research, illustrate the unique predictive value of within-incident aggression spillover, and provide a foundation for understanding mechanisms through which IPA affects children in a diversity of ways. (PsycINFO Database Record (c) 2019 APA, all rights reserved).