The reliability and validity of the Coder Impressions Questionnaire-Kindergarten for parenting and child behaviors.

Reliable and valid assessment of parenting and child behaviors is critical for clinicians and researchers alike, and observational measures of parenting behaviors are often considered the gold standard for assessing parenting and parent-child interaction quality. The present study sought to evaluate the reliability and validity of the Coder Impressions Questionnaire-Kindergarten (COIMP-K) measure. The present study was a secondary analysis of 274 parents and their children participating in a randomized control trial testing a brief parenting intervention for parents of children entering kindergarten. Families participated in baseline and follow-up assessments and videotaped observational tasks. Graduate and undergraduate coders completed the COIMP-K after achieving reliability. The aims of the present study were to assess COIMP-K's (a) internal consistency using intercorrelations among COIMP-K subscales, (b) construct validity, (c) convergent validity by comparing the COIMP-K subscales to parents' self-report of similar behaviors, (d) discriminant validity by comparing subscales to a parent-teacher communication measure as it is unrelated to parenting or child behaviors, and (e) congruence across time. The authors hypothesized that the COIMP-K would demonstrate adequate internal consistency (Cortina, 1993), adequate construct, convergent, and discriminant validity and find congruence of the measure across time. The results demonstrated that the factors had adequate internal consistency, construct, convergent, and discriminant validity, as well as longitudinal replicability and congruence over time. The study demonstrates that the COIMP-K is a reliable and valid tool for assessing observed family behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Translational Case Study of a Multisite COVID-19 Public Health Intervention Across Sequenced Research Trials: Embedding Implementation in a Community Engagement Phased Framework.

Through a COVID-19 public health intervention implemented across sequenced research trials, we present a community engagement phased framework that embeds intervention implementation: (1) consultation and preparation, (2) collaboration and implementation, and (3) partnership and sustainment. Intervention effects included mitigation of psychological distress and a 0.28 increase in the Latinx population tested for SARS-CoV-2. We summarize community engagement activities and implementation strategies that took place across the trials to illustrate the value of the framework for public health practice and research. (Am J Public Health. 2024;114(S5):S396-S401. https://doi.org/10.2105/AJPH.2024.307669).

Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence.

Introduction: Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence. Materials and Methods: The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children's symptom classes. Other covariates included parent depressive symptoms at child ages 4-5 and child race and ethnicity. Results: Analyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c' = .57) effects of socioeconomic stress on children's symptom class membership in the mediation analysis were significant (p <.001). Discussion: Study findings suggest that intervening on modifiable bioecological stressors-including parenting behaviors and socioeconomic stressors-may provide important protective influences on children's internalizing symptom trajectories.

Parenting self-efficacy in relation to the family check-up's effect on elementary school children's behavior.

Prior research points to the promotion of parenting self-efficacy (PSE) as an important component of parenting interventions; however, few studies have tested PSE as a mediator or moderator of the effects of parenting programs on child behavior. In the present study, we examined the efficacy of the family check-up (FCU), a brief, strengths-based parenting intervention adapted for kindergarten school entry. We tested the FCU's effects on reducing growth in parent-reported child conduct problems (CP) from kindergarten to fifth grade and whether PSE functioned as a mediator or moderator of intervention effects, using a latent growth curve model and intent-to-treat approach. Participants were parents of 321 children from five elementary schools in a northwestern U.S. city. Although we did not find a main effect of the FCU in reducing growth in CP from kindergarten through fifth grade, we found a significant indirect effect of the FCU on reducing CP growth via improving PSE in second grade and that the indirect effect was moderated by baseline levels of PSE. Together, our findings suggest that the FCU is effective in promoting PSE, which is subsequently associated with reduced CP growth, particularly for parents with initially low PSE. Our findings bolster existing work on the relationship between PSE and child CP in the context of a preventive parenting intervention and emphasize the importance of PSE as an agent of change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program.

OBJECTIVE: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions. METHOD: Families (N = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5-12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate. RESULTS: Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition. CONCLUSIONS: This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The pernicious role of stress on intergenerational continuity of psychopathology.

Development and Psychopathology has been a premier resource for understanding stressful childhood experiences and the intergenerational continuity of psychopathology. Building on that tradition, we examined the unique and joint influences of maternal stress on children's effortful control (age 7) and externalizing behavior (age 11) as transmitted via genetics, the prenatal environment, and the postnatal environment. The sample included N = 561 adopted children and their biological and adoptive parents. Path models identified a direct effect of biological mother life stress on children's effortful control (ß = -.08) and an indirect effect of her life stress on child externalizing behavior via effortful control (ß = .52), but no main or indirect effects of biological parent psychopathology, prenatal stress, or adoptive mother adverse childhood experiences (ACES). Adoptive mother ACES amplified the association between biological mother life stress and child effortful control (ß = -.08), externalizing behavior (ß = 1.41), and the indirect effect via effortful control, strengthening associations when adoptive mothers reported average or high ACES during their own childhoods. Results suggest that novel study designs are needed to enhance the understanding of how life stress gets "under the skin" to affect psychopathology in the offspring of adults who have experienced stress.

A randomized controlled trial to improve fathering among fathers with substance use disorders: Fathering in recovery intervention.

In early recovery for substance use disorders (SUDs), fathers may experience a desire to become more active in their role as a parent but may need support in using effective parenting strategies. Parent management training programs may be effective for fathers in recovery from SUD as they have been shown to improve parenting knowledge, self-efficacy, parenting practices, and child behavior, as well as decrease parent substance use. Using the Parent Management Training-Oregon model, we adapted a video-based program for text delivery to fathers in their first year of recovery from SUD, the fathering in recovery (FIR) intervention. In this pilot study, we randomized 41 fathers to control or 6 weeks of video content and three brief coaching calls and assessed outcomes in the parenting, child, and substance domains at baseline, 6-week, and 4-month follow-ups. We found FIR was effective for improving parenting knowledge, fathering efficacy, and in reducing fathers' ineffective parenting. The intervention showed promise for reducing child behavior problems. While larger studies are needed to replicate and build on these FIR findings, our data suggest that FIR holds promise for improving the lives of fathers and their families affected by SUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reaching Latinx Communities with Algorithmic Optimization for SARS-CoV-2 Testing Locations.

The COVID-19 pandemic has disproportionately affected communities of color, including Latinx communities. Oregon Saludable: Juntos Podemos (OSJP) is a randomized clinical trial aimed at reducing this disparity by both increasing access to testing for SARS-CoV-2, the virus that causes COVID-19, for Oregon Latinx community members and studying the effectiveness of health and behavioral health interventions on turnout and health outcomes. OSJP established SARS-CoV-2 testing events at sites across Oregon. A critical early question was how to locate these sites to best serve Latinx community members. To propose sites in each participating county, we implemented an algorithmic approach solving a facilities location problem. This algorithm was based on minimizing driving time from Latinx population centers to SARS-CoV-2 testing locations. OSJP staff presented these proposed testing locations to community partners as a starting place for identifying final testing sites. Due to differences in geography, population distributions, and potential site accessibility, the study sites exhibited variation in how well the algorithmic optimization objectives could be satisfied. From this variation, we inferred the effects of the drive time optimization metric on the likelihood of Latinx community members utilizing SARS-CoV-2 testing services. After controlling for potential confounders, we found that minimizing the drive time optimization metric was strongly correlated with increased turnout among Latinx community members. This paper presents the algorithm and data sources used for site proposals and discusses challenges and opportunities for community-based health promotion research when translating algorithm proposals into action across a range of health outcomes.

The ADAPT Parenting Intervention Benefits Combat Exposed Fathers Genetically Susceptible to Problem Drinking.

Testing a vantage sensitivity model from differential susceptibility theory (DST), we examined a G × E × I hypothesis; that is, whether a military parenting intervention program (I) might buffer a G × E susceptibility for military deployed fathers exposed to deployment combat stress and trauma. We hypothesized that combat stress (E, referring to the natural environmental factor) would lead to increases in problem drinking, and that the effect of problem drinking would be amplified by genetic predisposition (G) for drinking reward systems, substance use, and addictive behaviors (i.e., differential vulnerability). Providing a preventive intervention designed to improve post-deployment family environments (I, vantage sensitivity) is hypothesized to buffer the negative impacts of combat exposure and genetic susceptibility. The sample included 185 post-deployed military fathers who consented to genotyping, from a larger sample of 294 fathers enrolled in a randomized effectiveness trial of the After Deployment Adaptive Parenting Tools (ADAPT) intervention. Trauma-exposed military fathers at genetic susceptibility for problem drinking assigned to the ADAPT intervention reported significantly more reductions in risky drinking compared with fathers at genetic susceptibility assigned to the control group, with a small effect size for the G × E × I interaction (d = .2). Trial Registration. The ADAPT trial is registered at the US National Institutes of Health ( ClinicalTrials.gov ) # NCT03522610.

Effects of a Health Education Intervention for COVID-19 Prevention in Latinx Communities: A Cluster-Randomized Controlled Trial.

To promote COVID-19 preventive attitudes and behaviors among Latinx individuals, researchers and community partners implemented a culturally tailored health education intervention across 12 Oregon counties from February 2021 through April 2022. We did not identify any significant intervention effects on preventive attitudes and behaviors but did observe significant decreases in psychological distress. Although Latinx individuals' preventive attitudes and behaviors were not associated with the health education intervention, findings suggest the intervention has value in promoting their well-being (ClinicalTrials.gov Identifier: NCT04793464). (Am J Public Health. 2022;112(S9):S923-S927. https://doi.org/10.2105/AJPH.2022.307129).

Development and design of a culturally tailored intervention to address COVID-19 disparities among Oregon's Latinx communities: A community case study.

Background: Latinx communities are disproportionately affected by COVID-19 compared with non-Latinx White communities in Oregon and much of the United States. The COVID-19 pandemic presents a critical and urgent need to reach Latinx communities with innovative, culturally tailored outreach and health promotion interventions to reduce viral transmission and address disparities. The aims of this case study are to (1) outline the collaborative development of a culturally and trauma-informed COVID-19 preventive intervention for Latinx communities; (2) describe essential intervention elements; and (3) summarize strengths and lessons learned for future applications. Methods: Between June 2020 and January 2021, a multidisciplinary team of researchers and Latinx-serving partners engaged in the following intervention development activities: a scientific literature review, a survey of 67 Latinx residents attending public testing events, interviews with 13 leaders of community-based organizations serving Latinx residents, and bi-weekly consultations with the project's Public Health and Community Services Team and a regional Community and Scientific Advisory Board. After launching the intervention in the field in February 2021, bi-weekly meetings with interventionists continuously informed minor iterative refinements through present day. Results: The resulting intervention, Promotores de Salud, includes outreach and brief health education. Bilingual, trauma-informed trainings and materials reflect the lived experiences, cultural values, needs, and concerns of Latinx communities. Interventionists (21 Promotores) were Latinx residents from nine Oregon counties where the intervention was delivered. Conclusions: Sharing development and intervention details with public health researchers and practitioners facilitates intervention uptake and replication to optimize the public health effect in Oregon's Latinx communities and beyond.

Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial.

Importance: Latinx individuals have been disproportionately affected during the COVID-19 pandemic caused by the spread of SARS-CoV-2. It is imperative to evaluate newly developed preventive interventions to assess their effect on COVID-19 health disparities. Objective: To examine the effectiveness of a culturally tailored outreach intervention designed to increase SARS-CoV-2 testing rates among Latinx populations. Design, Setting, and Participants: In this cluster randomized trial performed from February 1 to August 31, 2021, in community settings in 9 Oregon counties, 38 sites were randomized a priori (19 to the community health promoters intervention and 19 to outreach as usual wait-listed controls). Thirty-three sites were activated. A total of 394 SARS-CoV-2 testing events were held and 1851 diagnostic samples collected, of which 919 were from Latinx persons. Interventions: A culturally informed outreach program was developed that made use of promotores de salud (community health promoters) to increase Latinx SARS-CoV-2 testing. Strategies addressed barriers by disseminating information on testing events in English and Spanish, mitigating misinformation, and increasing trust. Main Outcomes and Measures: The primary outcomes were the count of sample tests from Latinx persons and the sampled proportion of the Latinx populace. Site-level covariates included census tract Latinx populace, nativity (number of US-born individuals per 100 population), median age, and income inequality. Time-varying covariates included number of new weekly SARS-CoV-2-positive cases and percentage of vaccine coverage at the county level. Results: A total of 15 clusters (sites) were randomized to the control group and 18 to the community health promoters group. A total of 1851 test samples were collected, of which 995 (53.8%) were from female participants and 919 (49.6%) were from Latinx individuals. The intervention tested 3.84 (95% CI, 2.47-5.97) times more Latinx individuals per event than controls (incident rate ratio, 0.79; 95% CI, 0.46-1.34; Cohen d = 0.74; P < .001). The intervention was associated with a 0.28 increase in the proportion of Latinx populace being tested compared with control sites for the dependent variable scaled as the proportion of the Latinx populace ×100, or a 0.003 proportion of the raw populace count. The use of a standardized scaling of the proportion of Latinx individuals showed that the relative percentage increase was 0.53 (95% CI, 0.21-0.86) in the intervention sites compared with controls, representing a medium effect size. Conclusions and Relevance: To our knowledge, this was the first randomized evaluation of an outreach intervention designed to increase SARS-CoV-2 testing among Latinx populations. Findings could be used to implement strategies to reduce other health disparities experienced by these groups. Trial Registration: ClinicalTrials.gov Identifier: NCT04793464.

A single-case experimental design investigation of collaborative goal setting practices in hospital-based speech-language pathologists when provided supports to use motivational interviewing and goal attainment scaling.

The study investigated the impact of the electronic Goal Attainment Scaling (eGAS) process on medical speech-language pathologists' (SLPs) interviewing and goal setting. The process was trained via the eGAS app, designed to facilitate motivational interviewing and goal attainment scaling. The study utilized a single-case, nonconcurrent, multiple-baseline design replicated across three clinicians and their 27 respective clients. We observed client-clinician dyads engaged in setting rehabilitation goals pre and post eGAS training. The clients had neurogenic conditions and were being treated for cognitive, communication and/or swallowing challenges in an outpatient setting. Two measures were used to collect data on the clinician's interviewing and goal-setting behaviors: (1) Assessment of Client-Centeredness when Interviewing and Goal Setting (ACIG) scale, and (2) a task analysis, i.e., the Clinician Interview Behavior scale (CIB). Training with eGAS had a strong effect on clinicians' collaborative interviewing behaviors, an inconsistent effect on their ability to adhere to a three-phase interview structure, and a strong effect on their ability to generate valid goal attainment scales. This study provides preliminary support that the eGAS process provides a feasible framework for training hospital-based SLPs engaged in neurorehabilitation to use collaborative interviewing behaviors and produce valid person-centered rehabilitation goals.

PCIT engagement and persistence among child welfare-involved families: Associations with harsh parenting, physiological reactivity, and social cognitive processes at intake.

Parent-Child interaction therapy (PCIT) has been shown to improve positive, responsive parenting and lower risk for child maltreatment (CM), including among families who are already involved in the child welfare system. However, higher risk families show higher rates of treatment attrition, limiting effectiveness. In N = 120 child welfare families randomized to PCIT, we tested behavioral and physiological markers of parent self-regulation and socio-cognitive processes assessed at pre-intervention as predictors of retention in PCIT. Results of multinomial logistic regressions indicate that parents who declined treatment displayed more negative parenting, greater perceptions of child responsibility and control in adult-child transactions, respiratory sinus arrhythmia (RSA) increases to a positive dyadic interaction task, and RSA withdrawal to a challenging, dyadic toy clean-up task. Increased odds of dropout during PCIT's child-directed interaction phase were associated with greater parent attentional bias to angry facial cues on an emotional go/no-go task. Hostile attributions about one's child predicted risk for dropout during the parent-directed interaction phase, and readiness for change scores predicted higher odds of treatment completion. Implications for intervening with child welfare-involved families are discussed along with study limitations.

A Culturally Adapted Parenting Intervention for Mexican-Origin Immigrant Families with Adolescents: Integrating Science, Culture, and a Focus on Immigration-Related Adversity.

Low-income Latina/o immigrants are very likely to experience intense contextual challenges in the USA, such as limited exposure to culturally relevant parent training (PT) prevention interventions. This prevention study consisted of an exploratory randomized controlled trial, aimed at empirically testing the implementation feasibility and initial efficacy of a culturally adapted version of the evidence-based PT intervention known as GenerationPMTO©. The parenting intervention was adapted to overtly address immigration-related stressors, discrimination, and challenges associated with biculturalism. Seventy-one Mexican-origin immigrant mothers participated in this study and were allocated to one of two conditions: (a) culturally adapted GenerationPMTO (i.e., CAPAS-Youth) or (b) wait-list control. Measurements were completed at baseline (T1) and intervention completion (T2). When compared to mothers in the control condition at T2, CAPAS-Youth participants reported significant improvements on four of the core parenting practices delivered in the CAPAS-Youth intervention. As hypothesized, no significant differences in limit-setting skills were identified at T2. With regards to adolescents' outcomes, mothers exposed to CAPAS-Youth reported significant improvements in youth internalizing and externalizing behaviors at T2 when compared to a wait-list control condition. Mothers in both conditions also reported significant reductions in levels of immigration-related stress. Current findings indicate the feasibility of implementing CAPAS-Youth within a context of considerable adversity, as well as the beneficial impacts of the parent-based intervention on salient parenting and youth outcomes.

Emotion Regulation, Coercive Parenting, and Child Adjustment: A Serial Mediation Clinical Trial.

Objective: Prior intent to treat (ITT) evaluation of the Fathering Through Change (FTC) online interactive behavioral parent training program demonstrated a causal link from the FTC intervention to reductions in pre-post changes in fathers' coercive parenting, and in turn, reductions in pre-post changes in child behavioral problems (a moderate indirect effect size d = .30). The present study expands on this work by investigating mediational mechanisms. Methods: The present study employed a sample of 426 recently divorced or separated fathers who were each randomly assigned to either the FTC program or to the waitlist control. We tested a set of ITT serial mediation hypotheses positing effects of the FTC on fathers' reductions in coercive parenting would be mediated through reductions in emotion regulation problems. To be included in this intervention, fathers had been separated or divorced within the past two years and also had children between the ages of four and twelve. Results: The intervention obtained a significant total and set of unique pathways linking the FTC intervention to improved child adjustment. This supports a causal experimental link to reduced child behavior problems (d = .39). Emotion regulation did not fully mediate the intervention effect on parenting. Conclusions: Emotion regulation added both direct and indirect experimental explained variance over and above parenting alone. Clinical implications are discussed for the application of online training through pediatric settings.

Improving Parenting Practices Among Fathers Who Misuse Opioids: Fathering Through Change Intervention.

Fathers have been largely neglected in the parenting literature though there is a critical need to improve parenting practices among fathers who misuse opioids in the midst of the opioid epidemic. Urgency is critical to rapidly intervene in the lives of fathers and children to reduce misuse and interrupt intergenerational cycles of substance misuse. Thus, we provide an overview of solutions to adapt existing parenting interventions for fathers who misuse opioids to accelerate the pace of science for this population.

Using Motivational Interviewing to Improve Parenting Skills and Prevent Problem Behavior During the Transition to Kindergarten.

In this study, we examined the efficacy of a version of the Family Check-Up (FCU) adapted for kindergarten school entry with regard to parenting skills during the transition to school. We also examined whether improvements in parenting skills would mediate improvements in parent- and teacher-rated child behavior problems from kindergarten to second grade. The FCU is a motivational interviewing (MI) intervention designed to engage parents in treatment to improve parenting skills. Participants were parents of 365 children enrolled in one of five elementary schools in the Pacific Northwestern United States. Main and indirect effects were tested with structural equation path modeling using an intent-to-treat approach. The FCU was associated with improved change in parenting skills, and changes in parenting skills, in turn, predicted reductions in child behavior problems. Implications for embedding MI in family-centered interventions at kindergarten school entry are discussed. Trial registration: NCT02289092.

Participation in the Fathering through Change intervention reduces substance use among divorced and separated fathers.

Recent evaluations of parent training programs have demonstrated beneficial crossover effects in reducing parental substance use. Because divorce is associated with substance use risk and substance use interferes with effective parenting, parent training programs are critically important for divorced fathers but there are few evidence-based programs tailored to fathers. We tested whether an evidence-based parenting program would exhibit beneficial impact on fathers' substance use and whether these changes were mediated by changes in parenting efficacy. We tested hypotheses in a sample of 426 divorced and separated fathers randomly assigned to the online Fathering through Change (FTC) program or the wait-listed control condition. Models specified as 3-month pre-post analyses of self-reported substance use. The FTC was associated with reductions in total substance use (d = 0.14) and drinking (d = 0.26) but not with reductions in tobacco smoking and marijuana use. Data also supported a significant indirect effect for FTC through pre-post changes in parenting efficacy (d = 0.36). We discuss clinical implications for the integration of parent training within substance use treatment.

Differential physiological sensitivity to child compliance behaviors in abusing, neglectful, and non-maltreating mothers.

We examined time-ordered associations between children's compliance behavior and maternal respiratory sinus arrhythmia (RSA) in a sample of 127 child-maltreating (physical abuse, physical neglect, emotional abuse) and 94 non-maltreating mothers and their preschool-aged children. Child prosocial and aversive compliance behaviors and maternal RSA were continuously collected during a joint challenge task. Child behavior and mother RSA were longitudinally nested within-person and subjected to multilevel modeling (MLM), with between-person child maltreatment subtype and level of inconsistent parenting modeled as moderators. Both child maltreatment type and inconsistent parenting moderated the effects of child compliance on maternal RSA. Increases in children's prosocial compliance behaviors led to decreasing RSA in physically abusive mothers 30s later (i.e., increasing arousal), but predicted increases in non-maltreating mothers' RSA (i.e., increasing calm). Inconsistent parenting (vacillating between autonomy-support and strict control) also moderated the effects of children's compliance behavior on maternal physiology, weakening the effects of child prosocial compliance on subsequent maternal RSA. These findings highlight variations in mothers' physiological sensitivity to their children's prosocial behavior that may play a role in the development of coercive cycles, and underscore the need to consider individual differences in parents' physiological sensitivity to their children to effectively tailor interventions across the spectrum of risk.