Longitudinal associations between cognitive functioning and depressive symptoms among couples in the Mexican Health and Aging Study.

OBJECTIVE: To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time and replicate previous findings from the United States (US) in Mexico. DESIGN: Longitudinal, dyadic path analysis with the actor-partner interdependence model. SETTING: Data were from the three most recent interview waves (2012, 2015, and 2018) of the Mexican Health and Aging Study (MHAS), a longitudinal national study of adults aged 50+ years in Mexico. PARTICIPANTS: Husbands and wives from 905 community-dwelling married couples (N = 1,810). MEASUREMENTS: The MHAS cognitive battery measured cognitive function. Depressive symptoms were assessed using a modified nine-item Center for Epidemiologic Studies Depression Scale. Baseline covariates included age, education, number of children, limitation with any activity of daily living, limitation with any instrumental activity of daily living, and pain. RESULTS: As hypothesized, there were significant within-individual associations in which one person's own cognitive functioning and own depressive symptoms predicted their own follow-up cognitive functioning and depressive symptoms, respectively. In addition, a person's own cognitive functioning predicted their own depressive symptoms, and a person's own depressive symptoms predicted their own cognitive functioning over time. As hypothesized, there was a significant partner association such that one person's depressive symptoms predicted more depressive symptoms in the partner. CONCLUSION: Findings from this study of older Mexican couples replicates findings from studies of older couples in the US, showing that depressive symptoms in one partner predict depressive symptoms in the other partner over time; however, there was no evidence for cognition-depression partner associations over time.

The Implications of Early Marital Conflict for Children's Development.

Although negative associations between the frequency and intensity of marital conflict and children's adjustment are well documented, less is known about how parents' conflict styles are related to children's developmental outcomes. The present study examines whether exposure to different types of parents' conflict styles, during a child's first year of life, is related to children's behavioral outcomes in the first grade. Parents' conflict resolution styles (CRSs) and child outcomes were examined in a sample of 150 working-class, first-time parents and their children. It was hypothesized that infants' exposure to more conflictual conflict resolution styles would predict poorer child outcomes over time. Results revealed that parents' unique conflict styles mattered in unique ways for children's development, but also that the interaction of parents' styles, their dyadic conflict patterns, was also related to child outcomes. Results revealed that higher levels of parents' depressive or angry CRSs in the first year predicted more internalizing problems for children, while constructive CRS was related to fewer externalizing problems. However, gender effects showed that higher rates of parental compliance during conflict were related to more internalizing problems in girls. Furthermore, dyadic results revealed that having one parent angrily engage in conflict and the other parent - withdraw, comply or angrily engage - was related to more externalizing problems for boys. Overall, results showed that parents' different conflict resolution styles, during a child's first year of life, are related to their children's developmental outcomes 6 years later. These results emphasize children's early vulnerability to parental conflict and hold implications for clinicians and practioners.

Dyadic, longitudinal associations among outcome expectation and alliance, and their indirect effects on patient outcome.

Research indicates that patient outcome expectation (OE) correlates with improvement, and that this association may be mediated by better patient-therapist alliances. However, despite OE and alliance being dyadic and dynamic constructs, most research on these direct and indirect associations has assessed these variables from only one dyad member's perspective and at single time points. Addressing these gaps, we used a longitudinal actor-partner interdependence model to first examine OE-alliance associations. Namely, we assessed "actor" effects (relation between each member's OE at 1 session and his or her own next session alliance) and "partner" effects (relation between each member's partner's OE at 1 session and his or her own next session alliance). Second, we tested whether significant actor or partner effects of OE on alliance translated into better patient outcomes (indirect effects). Analyses were conducted at within- and between-dyad levels. Data derived from a generalized anxiety disorder trial in which 85 patients received 15 sessions of either cognitive-behavioral therapy (CBT) or CBT integrated with motivational interviewing. After every session, patients and therapists rated OE and alliance, and patients rated their worry. At the within-dyad level, there were OE-alliance actor effects for both patients and therapists. There was also a within-dyad partner effect; when patients had greater OE at one session their therapists reported better next-session alliances. Finally, all within-dyad effects in turn related to lower subsequent worry. Results reveal ways in which session-by-session fluctuations in both patient and therapist OE translate into better outcomes through their influence on alliance quality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Parents' work and children's development: A longitudinal investigation of working-class families.

The current study examines the relationship between working-class mothers' and fathers' job autonomy across the 1st year of parenthood and their children's behavior problems and adaptive skills in the 1st grade. Data came from a longitudinal study of 120 couples interviewed 5 times across the transition to parenthood and again when the target child entered the 1st grade. Mothers' job autonomy and fathers' work hours during the child's 1st year of life directly predicted fewer behavior problems and more adaptive skills in their children at 6-7 years of age. For all parents a mediated relationship emerged such that greater job autonomy predicted less parenting overreactivity, which in turn predicted better child outcomes. Parent involvement was also a significant mediator linking job autonomy to children's adaptive skills but not behavior problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The relation between outcome expectation, therapeutic alliance, and outcome among depressed patients in group cognitive-behavioral therapy.

OBJECTIVE: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy. METHOD: This study focused on such associative chains among 91 depressed outpatients who completed 10 weeks of group cognitive-behavioral therapy. We conducted simple and multiple mediation analyses, accounting for the nested data structure. RESULTS: As predicted, we found: (i) The relations between baseline outcome expectation and both posttreatment anxiety and depression were mediated by alliance quality; (ii) the early therapy outcome expectation-posttreatment anxiety relation was mediated by mid-treatment alliance; (iii) the relation between early alliance and posttreatment interpersonal problems was mediated by during-therapy outcome expectation; and (iv) the relation between baseline outcome expectation and posttreatment interpersonal problems was mediated by two variables acting in turn, early alliance and during-therapy outcome expectation. All other tested models were not significant. CONCLUSIONS: Results suggest that bidirectional relations between outcome expectation and alliance, with both directions influencing outcome. Clinical and empirical implications are discussed.

Division of Household and Childcare Labor and Relationship Conflict Among Low-Income New Parents.

We examine the relationships among the division of housework and childcare labor, perceptions of its fairness for two types of family labor (housework and childcare), and parents' relationship conflict across the transition to parenthood. Perceived fairness is examined as a mediator of the relationships between change in the division of housework and childcare and relationship conflict. Working-class, dual-earner couples (n = 108) in the U.S Northeast were interviewed at five time points from the third trimester of pregnancy and across the first year of parenthood. Research questions addressed whether change in the division of housework and childcare across the transition to parenthood predicted mothers' and fathers' relationship conflict, with attention to the mediating role of perceived fairness of these chores. Findings for housework indicated that perceived fairness was related to relationship conflict for mothers and fathers, such that when spouses perceived the change in the division of household tasks to be unfair to either partner, they reported more conflict, However, fairness did not significantly mediate relations between changes in division of household tasks and later relationship conflict. For childcare, fairness mediated relations between mothers' violated expectations concerning the division of childcare and later conflict such that mothers reported less conflict when they perceived the division of childcare as less unfair to themselves; there was no relationship for fathers. Findings highlight the importance of considering both childcare and household tasks independently in our models and suggest that the division of housework and childcare holds different implications for mothers' and fathers' assessments of relationship conflict.

Therapeutic alliance, subsequent change, and moderators of the alliance-outcome association in interpersonal psychotherapy for depression.

The therapeutic alliance has historically emerged as a pantheoretical correlate of favorable psychotherapy outcomes. However, uncertainty remains about the direction of the alliance-outcome link, and whether it is affected by other contextual variables. The present study explored (a) if early alliance quality predicted subsequent symptom change while controlling for the effect of prior symptom change in interpersonal psychotherapy (IPT) for depression, and (b) whether baseline patient characteristics moderated the alliance-outcome relation (to help specify conditions under which alliance predicts change). Data derived from an open trial of 16 sessions of individual IPT delivered naturalistically to adult outpatients (N = 119) meeting criteria for major depression. Patients rated their sociodemographic, clinical, and interpersonal characteristics at baseline, their alliance with their therapist at Session 3, and their depressive symptoms at baseline, after every session, and at posttreatment. Data were analyzed using hierarchical linear modeling. Results indicated that alliance quality did not predict subsequent depression change, controlling for prior depression change. However, a significant education by alliance interaction emerged in predicting quadratic depression change (γ = .0007, p = .03); patients with higher levels of education who reported good early alliances with their therapists had the most positively accelerated change trajectory (i.e., faster depression reduction), whereas patients with higher levels of education who reported poorer early alliances had the most negatively accelerated change trajectory (i.e., slower depression reduction). The findings may help clarify a specific condition under which alliance quality influences subsequent improvement in an evidence-based treatment for depression. (PsycINFO Database Record

From Discovery to Practice: Translating and Transforming Work-Family Research for the Health of Families.

The aim of this paper is to examine the meaning of translational research in the work and family field. Specifically, we review findings from a longitudinal study of low-wage workers across the transition to parenthood and examine how this basic discovery research informs the next step in translational research, that of clinical practice. The authors describe three specific sets of findings that hold direct and immediate implications for interventions and policy that could support working families. The paper closes with a discussion of how both translational and transdisciplinary research have the potential to inform evidence-based practice, social policy, and effective social action to decrease physical and mental health disparities among low-income, working families.