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Trauma survivors who suffer from posttraumatic stress symptoms (PTSS) are known to experience impairments in sexual satisfaction. However, the negative effects of PTSS are not limited to the primary survivors, as they can lead to secondary PTSS in their spouses as well. The implications of secondary PTSS in the sexuality of couples remain unknown. This study aimed to investigate whether specific symptom clusters of PTSS (i.e., intrusions, hyperarousal, and avoidance) are implicated in the sexual satisfaction of couples. We assessed a sample of primarily exposed Israeli veterans from the Yom Kippur War and their wives who had been secondarily exposed (N = 191). The dyadic data were analyzed in an Actor-Partner Independence Model. When scrutinizing specific PTSS clusters, the husbands' avoidance related to their own sexual satisfaction. The wives' hyperarousal related to their own and their spouses' sexual satisfaction, whereas their intrusions were associated only with their husbands' sexual satisfaction. In conclusion, PTSS in one spouse is related to both spouses' sexual satisfaction; it is therefore recommended that clinicians adopt a dyadic approach when delivering interventions. [ABSTRACT FROM AUTHOR]

Family systems theorists have forwarded a set of theoretical principles meant to guide family scientists and practitioners in their conceptualization of patterns of family interaction-intra-family dynamics-that, over time, give rise to family and individual dysfunction and/or adaptation. In this article, we present an analytic approach that merges state space grid methods adapted from the dynamic systems literature with sequence analysis methods adapted from molecular biology into a "grid-sequence" method for studying inter-family differences in intra-family dynamics. Using dyadic data from 86 parent-adolescent dyads who provided up to 21 daily reports about connectedness, we illustrate how grid-sequence analysis can be used to identify a typology of intrafamily dynamics and to inform theory about how specific types of intrafamily dynamics contribute to adolescent behavior problems and family members' mental health. Methodologically, grid-sequence analysis extends the toolbox of techniques for analysis of family experience sampling and daily diary data. Substantively, we identify patterns of family level microdynamics that may serve as new markers of risk/protective factors and potential points for intervention in families. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Purpose: Unpaid care is an important source of support of people with long-term conditions. Interdependence of carers' and care recipients' quality of life would be expected due to the relational nature of caregiving. This study aims to explore interdependence of quality of life in carer/care-recipient dyads, especially in relation to mutual interdependence due to social feedback in the caregiving relationship and also the partner effects of one partner's experience of long-term care support on the other's outcomes.Methods: Using data collected in an interview survey of 264 adults with care support needs and their unpaid carers in England, we employed regression analysis to explore whether there is mutual interdependence of care-related quality of life within carer/care-recipient dyads for three quality of life attributes: Control over daily life, Social participation and Occupation. The influence of factors, including satisfaction with long-term care, were also considered on individuals' and dyad partners' care-related quality of life.Results: We found mutual interdependence of quality of life at the dyad-level for Control over daily life, but not Occupation or Social participation. A partner effect of care recipients' satisfaction with long-term care on carers' Control over daily life was also observed. Higher care recipient satisfaction with care services was associated with higher Control over daily life. By contrast, for Social participation and Occupation, there were only significant effects of care recipients' satisfaction with long-term care and their own quality of life.Conclusions: These findings highlight the importance of considering the wider impact beyond the individual of long-term care on quality of life in the evaluation of long-term care policy and practice. [ABSTRACT FROM AUTHOR]

Background: Over half of men who receive treatment for prostate suffer from a range of sexual problems that affect negatively their sexual health, sexual intimacy with their partners and their quality of life. In clinical practice, however, care for the sexual side effects of treatment is often suboptimal or unavailable. The goal of the current study is to test a web-based intervention to support the recovery of sexual intimacy of prostate cancer survivors and their partners after treatment.Methods: The study team developed an interactive, web-based intervention, tailored to type of treatment received, relationship status (partnered/non-partnered) and sexual orientation. It consists of 10 modules, six follow the trajectory of the illness and four are theme based. They address sexual side effects, rehabilitation, psychological impacts and coaching for self-efficacy. Each includes a video to engage participants, psychoeducation and activities completed by participants on the web. Tailored strategies for identified concerns are sent by email after each module. Six of these modules will be tested in a randomized controlled trial and compared to usual care. Men with localized prostate cancer with partners will be recruited from five academic medical centers. These couples (N = 140) will be assessed prior to treatment, then 3 months and 6 months after treatment. The primary outcome will be the survivors' and partners' Global Satisfaction with Sex Life, assessed by a Patient Reported Outcome Measure Information Systems (PROMIS) measure. Secondary outcomes will include interest in sex, sexual activity, use of sexual aids, dyadic coping, knowledge about sexual recovery, grief about the loss of sexual function, and quality of life. The impact of the intervention on the couple will be assessed using the Actor-Partner Interaction Model, a mixed-effects linear regression model able to estimate both the association of partner characteristics with partner and patient outcomes and the association of patient characteristics with both outcomes.Discussion: The web-based tool represents a novel approach to addressing the sexual health needs of prostate cancer survivors and their partners that-if found efficacious-will improve access to much needed specialty care in prostate cancer survivorship.Trial Registration: Clinicaltrials.gov registration # NCT02702453 , registered on March 3, 2016. [ABSTRACT FROM AUTHOR]

Chronic pain has been linked to depression among individuals and their partners. Yet, little is known about long-term mutual influences between pain intensity and depressive symptoms within couples as they age. Using a nationally representative U.S. sample of wives and husbands aged 50 and older (mean = 64.53, SD = 7.86), this study explored the links between own and partner pain intensity and depressive symptoms across an 8-year period. A total of 963 heterosexual married couples drawn from the Health and Retirement Study completed interviews biennially from 2006 to 2014. Dyadic growth curve models examined mutual associations within couples and controlled for sociodemographic characteristics, length of marriage, and marital quality, along with self-rated health, number of chronic health conditions, and functional disability. For wives and husbands, their own greater baseline pain intensity was significantly linked to their own higher levels of depressive symptoms. Unexpectedly, wives with greater baseline pain intensity reported decreases in their depressive symptoms over time. There were also partner effects such that husbands' greater pain intensity at baseline was associated with increases in wives' depressive symptoms over time. Findings highlight the importance of considering both individual and spousal associations between pain intensity and depressive symptoms in later life. Understanding how individual and couple processes unfold may yield critical insights for the development of intervention and prevention efforts to maintain mental health among older chronic pain patients and their spouses. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are common in youth and cause significant distress and impairment to the individual and family. Oxytocin (OT), a nine amino acid peptide, is implicated in anxiety regulation and modulation of close interpersonal and attachment behavior. Anxiety disorders have been linked to low levels of salivary OT in youth. Research has also linked oxytocinergic functioning to social support, warm contact, and bonding, and indicated that contact with attachment figures stimulates OT response. We examined OT response to a brief, positive youth-mother interaction in clinically anxious youth. We investigated whether quality of the youth-mother interaction as well as the presence of particular anxiety disorders, are associated with youth OT response.Method: Salivary OT from 41 youth with primary DSM-5 anxiety disorders was assayed before and after a 7-min youth-mother interaction that was later systematically coded by two reliable coders. Youth and mothers also completed rating scales of youth anxiety symptoms.Results: Affective touch, maternal sensitivity, maternal intrusiveness, youth engagement, and youth initiative all contributed significantly to predicting youth OT response. Repeated measures analyses showed that when affective touch was high youth had greater OT response. OT response was positively associated with the presence of separation anxiety disorder (SAD) and with child ratings of separation anxiety.Conclusions: The findings highlight the importance of maternal and dyadic behavior patterns to oxytocinergic response in clinically anxious youth, shed light on the association between OT and SAD, and point to possible intervention strategies. [ABSTRACT FROM AUTHOR]

Purpose: Physical and psychological symptoms experienced by patients with advanced cancer influence their well-being; how patient and family caregiver symptom distress influence each other's well-being is less understood. This study examined the influence of patient and caregiver symptom distress on their threat appraisals and self-efficacy to cope with cancer.Methods: We conducted a secondary analysis of baseline data from an RCT that enrolled patients with advanced cancer and their family caregivers (N = 484 dyads). Structural equation modeling and the actor-partner interdependence mediation model (APIMeM) were used to examine two models: threat appraisals as a mediator of the relationship between symptom distress and individual and family-related self-efficacy; and, self-efficacy (individual and family dimensions) as mediators of the relationship between symptom distress and threat appraisals.Results: Data suggest the self-efficacy mediation model was the preferred model. More patient and caregiver symptom distress was directly associated with their own lower self-efficacy and more threatening appraisals. Patient and caregiver individual self-efficacy also mediated the relationship between their own symptom distress and threat appraisals. There were also significant interdependent effects. More patient symptom distress was associated with less caregiver family-related self-efficacy, and more caregiver symptom distress was directly associated with more threatening patient appraisals.Conclusions: Patient and caregiver symptom distress influenced their own and in some cases each other's cognitive appraisals. Limitations of this study include the use of cross-sectional data and assessments of individually-focused (vs. family-focused) threat appraisals. These findings highlight the need to consider the management of patient and caregiver symptoms during advanced cancer. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Problematic drinking and executive functioning deficits are two known risk factors for intimate partner aggression (IPA). However, executive functioning is a multifaceted construct, and it is not clear whether deficits in specific components of executive functioning are differentially associated with IPA perpetration generally and within the context of problematic alcohol use. To address this question, the present study investigated the effects of problematic drinking and components of executive functioning on physical IPA perpetration within a dyadic framework.Design and Methods: Participants were 582 heavy drinking couples (total n = 1164) with a recent history of psychological and/or physical IPA recruited from two metropolitan cities in the USA. Multilevel models were used to examine effects within an actor-partner interdependence framework.Results: The highest levels of physical IPA were observed among actors who reported everyday consequences of executive functioning deficits related to emotional dysregulation whose partners were problematic drinkers. However, the association between executive functioning deficits related to emotional dysregulation and IPA was stronger towards partners who were non-problematic drinkers relative to partners who were problematic drinkers. No such effect was found for executive functioning deficits related to behavioural regulation.Discussion and Conclusions: Results provide insight into how problematic drinking and specific executive functioning deficits interact dyadically in relation to physical IPA perpetration. [Parrott DJ, Swartout KM, Eckhardt CI, Subramani OS. Deconstructing the associations between executive functioning, problematic alcohol use and intimate partner aggression: A dyadic analysis. Drug Alcohol Rev 2017;36:88-96]. [ABSTRACT FROM AUTHOR]

When explored separately, child and parent catastrophic thoughts about child pain show robust negative relations with child pain. The objective of this study was to conduct a dyadic analysis to elucidate intrapersonal and interpersonal influences of child and parent pain catastrophizing on aspects of pain communication, including observed behaviours and perceptions of child pain. A community sample of 171 dyads including children aged 8 to 12 years (89 girls) and parents (135 mothers) rated pain catastrophizing (trait and state versions) and child pain intensity and unpleasantness following a cold pressor task. Child pain tolerance was also assessed. Parent-child interactions during the cold pressor task were coded for parent attending, nonattending, and other talk, and child symptom complaints and other talk. Data were analyzed using the actor-partner interdependence model and hierarchical multiple regressions. Children reporting higher state pain catastrophizing had greater symptom complaints regardless of level of parent state pain catastrophizing. Children reporting low state pain catastrophizing had similar high levels of symptom complaints, but only when parents reported high state pain catastrophizing. Higher child and parent state and/or trait pain catastrophizing predicted their own ratings of higher child pain intensity and unpleasantness, with child state pain catastrophizing additionally predicting parent ratings. Higher pain tolerance was predicted by older child age and lower child state pain catastrophizing. These newly identified interpersonal effects highlight the relevance of the social context to children's pain expressions and parent perceptions of child pain. Both child and parent pain catastrophizing warrant consideration when managing child pain. [ABSTRACT FROM AUTHOR]

Background.The cognitive model of depression suggests that cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive cognitive content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in cognitive content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves cognitive content; and (3) the extent to which cognitive content mediates continuation treatments’ effects on depressive symptoms and major depressive relapse/recurrence.Method.Out-patients with recurrent MDD who responded to acute-phase CT (n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive content was assessed approximately every 4 months using five standard patient-report measures.Results.Large improvements in cognitive content made during acute-phase CT were maintained for 32 months, with 78–90% of patients scoring in normal ranges, on average. Cognitive content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in cognitive content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments’ effects on depressive symptoms or on major depressive relapse/recurrence.Conclusions.Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in cognitive content. C-CT or FLX may not continue to improve patient-reported cognitive content substantively, and thus may treat recurrent MDD by other paths. [ABSTRACT FROM PUBLISHER]

This cross-sectional study examined the physical and mental health, grief and role functioning of 136 grandparents in the first year after death of their young grandchild (newborn through 6 years). Grandparents were 36-77 years old; 73 % female; 24 % Hispanic, 38 % Black/African American, and 38 % White. Mean age of the 115 deceased grandchildren was 12.8 months ( SD = 20.71) with 37 % <1 month old; 65 % were male, 77 % died in the hospital. Grandparents were recruited through state death records and interviewed by telephone. Grandparents experienced: clinical depression (31 %), PTSD (35 %); illnesses (28 %), hospitalizations, new chronic health conditions (mental disorders, hypertension, angina, cancer), and medication changes. Grandparents who provided care for the deceased grandchild had more intense symptoms of grief, depression and PTSD and more trouble focusing at their jobs. Severity of depressive and/or PTSD symptoms were more likely to be at clinically important levels for grandparents who had provided childcare for the deceased grandchild than for non-caregiving grandparents. Black grandparents had more severe symptoms of PTSD and thought more about their deceased grandchild on the job than White grandparents. The interaction effect of race/ethnicity and provision of child care was significant for PTSD and Blame and Anger. Hispanic grandparents who provided some child care for their deceased grandchild had less severe PTSD symptoms than caregiving Black and White grandparents. Caregiving Hispanic grandparents also experienced less Blame and Anger than White caregiving grandparents. [ABSTRACT FROM AUTHOR]

Objective Self-determination theory (SDT) may be a useful framework to understand why chronic pain affects partners. SDT postulates that individuals can engage in helping behaviors for different motives varying from more autonomous or volitional motives to more controlled or pressured motives. This article examines the relationship between partners' type of motivation to help (i.e., autonomous vs controlled) and their personal and relational functioning. Furthermore, mechanisms underlying this relationship (i.e., helping exhaustion and relationship-based need satisfaction) were examined. Methods In a sample of 48 couples, of which one partner had chronic pain (36 female patients), questionnaires measuring life satisfaction, positive and negative affect, anxiety and depressive feelings, relationship quality and relationship-based need satisfaction were filled out. Individuals with chronic pain (ICPs) also reported on pain intensity and disability whereas partners were requested to report on motives for helping and helping exhaustion. Results Data analysis with Structural Equation Modeling revealed that autonomous, relative to controlled, motives for helping among partners related positively to partners' well-being and relationship quality, and negatively to distress. The experience of helping exhaustion and relationship-based need satisfaction mediated these associations. Moreover, partners' autonomous helping motivation related positively to patient-reported relationship quality among ICPs high in pain intensity. Conclusions Applying SDT in a context of pain provides new insights into why chronic pain affects partners and how partners impact patient outcome. Directions for future research are outlined. [ABSTRACT FROM AUTHOR]

Context--Lung transplant recipients are encouraged to perform self-management behaviors to maximize health outcomes; however, performance is often less than ideal. Goal orientation is known to influence achievement of academic goals, but the influence of goal orientation on performance of self-management is unknown. Objectives--To identify characteristics at transplant that are predictive of higher goal orientation and examine relationships between Goal Orientation Index (GOI) subscores (Acting, Planning, Reflecting), self-management behaviors (adhering, self-monitoring, and communicating critical changes), and health-related quality of life (HRQOL) at 1 year after transplant. Design--A descriptive, secondary analysis of data from 33 lung transplant recipients who were assessed at transplant and followed for 1 year as part of a clinical trial. GOI subscores were dichotomized at the median to categorize recipients with high and low goal orientation. Logistic regression was used to identify predictors of higher GOI subscores. Correlations between higher GOI subscores, self-management, and HRQOL were examined. Results--Lung transplant recipients reported relatively high mean GOI subscores (Acting, Planning, and Reflecting) and the 3 subscores were correlated (r=0.31-0.86). Self-care agency was the only significant predictor (P=.04) of higher GOI (Reflecting). Lung transplant recipients with higher Planning and Reflecting subscores were more likely to adhere (r = 0.36 and 0.46, respectively). Recipients with higher GOI subscores reported significantly better mental HRQOL (r = 0.42-0.36). Recipients with higher GOI Planning or Acting subscores reported significantly less anxiety (r = -0.39-0.46) and fewer depressive symptoms (r = -0.40-0.43). Conclusion--Assessing goal orientation may offer a novel approach for promoting adherence and HRQOL after lung transplant. [ABSTRACT FROM AUTHOR]

Aims To investigate the causal associations between family relationships, family functioning, social circumstances and health outcomes in young children with cystic fibrosis. Background The anticipated health gains for patients with cystic fibrosis, promised by early diagnosis through newborn screening, have yet to be fully realized, despite advances in cystic fibrosis health care with aggressive management in multidisciplinary clinics and the development of specific medications. Adverse psychosocial functioning may underpin the current lack of progress as it is well recognized that compromised early parent-child attachment relationship experiences and adverse social circumstances have negative impacts on lifelong health status and health resource use, even in healthy children. Design A cross-sectional (initial) and longitudinal (progressive), multicentre study of children aged 3 months-6 years with cystic fibrosis, who have been diagnosed by newborn screening. Methods Questionnaire and observational measures of parent psychosocial functioning, parenting and parent-child attachment and social markers; and including clinical outcomes of regular health surveillance with clinical, lung imaging (computerized tomography) and bronchoalveolar lavage for airway microbiology and inflammation. Conclusion This will be the first study to investigate the causal effect of psychosocial functioning, parenting and attachment on physical health outcome measures in children with cystic fibrosis. [ABSTRACT FROM AUTHOR]

This study assessed how couples interdependently influence the relationship between family-of-origin triangulation and marital satisfaction across sub-samples in Stage III and Stage IV of the family life cycle. The total sample consisted of 569 couples between 24 and 49 years of age in Beijing, China. The analyses were performed in two sub-samples using the actor-partner interdependence model, a dyadic analysis technique. We found that couples in Stage III reported higher family-of-origin triangulation and less satisfaction and cohesion than couples in Stage IV. Furthermore, couples who lived with their parents or in-laws reported less affectional expression than those who lived on their own. The family-of-origin triangulation of both husbands and wives predicted marital satisfaction in the two sub-samples. Husband marital satisfaction was predicted by wife family-of-origin triangulation in the two sub-samples, whereas wife marital satisfaction was predicted by her own family-of-origin triangulation only in family Stage III. Moreover, model comparisons demonstrated that husband marital satisfaction was predicted equally by his own and his wife's family-of-origin triangulation in the sub-sample of couples in Stage III. In addition, individual marital satisfaction was equally predicted by his/her own and his/her spouse's family-of-origin triangulation in the sub-sample of couples in Stage IV. Family therapists should pay closer attention to intergenerational relationships in China, particularly in couples with young children, and should adopt culturally adapted family intervention programs. [ABSTRACT FROM AUTHOR]

Oxytocin appears to be centrally involved in socioemotional functioning, and is hypothesized to be relevant to the severe disruption in close relationships characteristic of borderline personality pathology. We examined whether a polymorphism of the oxytocin receptor gene ( OXTR rs53576) interacts with quality of family functioning to predict borderline personality disorder (BPD) symptomatology in a sample of youth at age 20. A total of 385 youth from a longitudinal study of offspring of depressed or nondepressed mothers who were well characterized with respect to their family conditions and BPD symptomatology provided DNA for genotyping. Analyses revealed a significant moderation of the link between early family quality and later BPD symptoms by OXTR rs53576, and the pattern was consistent with differential susceptibility (plasticity). Whereas A-allele carriers had high levels of BPD symptoms under negative family conditions and low levels under positive conditions, GG homozygotes had average levels of BPD symptoms regardless of their family quality. [ABSTRACT FROM AUTHOR]

A parent's distress is known to color children's experiences of their families. Studies, however, have rarely focused on the levels of distress experienced by fathers, and in particular, as they affect the emotional experiences of their children. We examine the impact that fathers' experience of distress throughout their children's early years has on children's emerging narrative representations of father-child relationships and of family conflict and cohesion. In this longitudinal investigation, fathers of young children reported their distress on two occasions in relation to self, the marital relationship, and the family climate. Fathers also concurrently reported on their children's temperament, specifically negative emotionality. Children responded to story stem beginnings about challenging situations in the family and their narratives were scored for dysregulated negative-disciplinary and positive parental behaviors of fathers, family conflict themes, and family harmony themes. It was hypothesized that children of more distressed fathers would represent greater dysregulated fathering and higher levels of family conflict, and lower levels of positive fathering and family harmony than children of less distressed fathers. Further, the study examined whether this effect was mediated through the fathers' reports of their children's negative emotionality. Results partially supported the hypothesized direct and indirect effects. Children's narratives of negative-disciplinary fathering and family conflict were more common in boys when fathers reported greater distress, and temperament ratings fully mediated this effect. However, their narratives of positive fathering and family harmony were not significantly affected. That positive family features were preserved in children's narratives even in the face of greater father distress suggests that families may be able to build resilience to internalized distress through these positive narrative features. [ABSTRACT FROM AUTHOR]

BackgroundAlthough there is a clear phenotypic relationship between the quality of the interparental or marital relationship and child conduct problems (CP), the etiology of this association is as yet unclear. One possibility is that this association takes the form of a genotype–environment interaction (G × E), whereby the quality of the interparental relationship acts to moderate the etiology of child CP. The current study sought to evaluate this possibility.MethodWe examined multiple measures and informant reports of the quality of the interparental relationship in a sample of more than 700 child twin families from the Michigan State University Twin Registry (MSUTR). Analyses consisted of a series of latent G × E models.ResultsThe ‘no moderation’ model provided the best fit to the data in nearly all cases, findings that collectively provide strong evidence against the possibility that the etiology of CP is moderated by the quality of the interparental relationship.ConclusionsOur findings suggest that, contrary to implicit (and sometimes explicit) assumptions in the field, it is not the case that every environmental risk (or protective) factor exacerbates (or suppresses) genetic influences on CP. Future research should seek to delineate the specific environmental experiences that do serve as etiologic moderators of CP, and to clarify how this G × E interplay might change over the course of development. [ABSTRACT FROM PUBLISHER]

The first 6 months of marriage are optimal for marriage enrichment interventions. The Hope-Focused Approach to couple enrichment was presented as two 9-hr interventions—(a) Handling Our Problems Effectively (HOPE), which emphasized communication and conflict resolution, and (b) Forgiveness and Reconciliation through Experiencing Empathy (FREE). HOPE and FREE were compared with repeated assessment controls. Couples were randomly assigned and were assessed at pretreatment (tl); 1 month posttreatment (t2) and at 3- (t3), 6- (t4), and 12-month (t5) follow-ups using self-reports. In addition to self-report measures, couples were assessed at tl, t2, and t5 using salivary cortisol, and behavioral coding of decision making. Of 179 couples who began the study, 145 cases were analyzed. Both FREE and HOPE produced lasting positive changes on self-reports. For cortisol reactivity, HOPE and FREE reduced reactivity at t2, but only HOPE at t5. For coded behaviors, control couples deteriorated; FREE and HOPE did not change. Enrichment training was effective regardless of the focus of the training. [ABSTRACT FROM AUTHOR]

The term gridlock describes the occurrence of rigid patterns in couples' conflict. This study aimed to describe strategies of conflict resolution and gridlock prevention from the perspectives of couples and couple therapists. Participants were couple therapists and highly adjusted couples scored by the dyadic adjustment scale ( DAS), distributed according to traditional and non-traditional position in life and duration of relationships. Conflict gridlock scenarios were used to create video stimulus that were presented to participants. A qualitative methodology was used to analyse couples' and therapists' commentaries on the scenarios. Results showed differences in preventing conflict gridlock among sub-groups of couples. Long-term traditional couples focused on loyalty to a common project and value sacrificing to a higher good; long-term non-traditional couples prioritised caring and validating the bond in the relationship. Short-term traditional couples focused on mutual love and the relief of hurt while short-term non-traditional couples supported the value of equity. [ABSTRACT FROM AUTHOR]

Objective:To prospectively examine the impact of parental mental health (PTSD, depression and anxiety), the couple’s relationship quality and the infant temperament on the parent–baby bond in first-time mothers and fathers.Background:Evidence suggests that poor parental mental health, difficult infant temperament and/or lower quality of the couple’s relationship may impede the parent–baby bond. However, little research has included both parents or followed these measures across time.Methods:75 women and 66 men completed questionnaire measures during pregnancy, 3 and 15 months postpartum, assessing mental health symptoms, the parent–baby bond, the couple’s relationship and infant characteristics. The response rates at different time-points were 90%, 77% and 70%.Results:The parent–baby bond was associated with parental mental health, the couple’s relationship and infant characteristics. The most important predictors of the parent–baby bond three months postpartum for both men and women were the couple’s relationship during pregnancy and their baby’s temperament at three months. At 15 months postpartum, after accounting for the parent–baby bond at 3 months, only concurrent infant temperament remained a significant predictor for women. However, men’s bond with their baby at 15 months was predicted by their relationship with their partner in pregnancy and concurrent affective symptoms. Few significant gender differences were found, apart from women reporting more mental health symptoms than men.Conclusion:This study highlights the significance of the couple’s relationship in pregnancy and the infant’s temperament on the development of the parent–baby bond. Future research is needed to examine this in larger more representative samples. [ABSTRACT FROM PUBLISHER]

We assessed anxiety consistent (i.e., 'traditional') and inconsistent (i.e., 'atypical') with diagnostic and statistical manual (DSM) definitions in autism spectrum disorder (ASD). Differential relationships between traditional anxiety, atypical anxiety, child characteristics, anxiety predictors and ASD-symptomology were explored. Fifty-nine participants (7-17 years, M = 10.48 years; IQ > 60) with ASD and parents completed semi-structured interviews, self- and parent-reports. Seventeen percent of youth presented with traditional anxiety, 15 % with atypical anxiety, and 31 % with both. Language ability, anxious cognitions and hypersensitivity predicted traditional anxiety, whereas traditional anxiety and ASD symptoms predicted atypical anxiety. Findings suggest youth with ASD express anxiety in ways similar and dissimilar to DSM definitions. Similarities support the presence of comorbid anxiety disorders in ASD. Whether dissimilarities are unique to ASD requires further examination. [ABSTRACT FROM AUTHOR]

Although a majority of premarital education occurs in religious contexts, research in this area is limited. The current authors studied the religious service delivery model of premarital education among 1244 married Orthodox Jews. Results indicate that education focusing on the religious approach and practices regarding the sexual relationship is significantly associated with greater marital quality. The findings also suggest a need for increased premarital education related to communication and conflict resolution. [ABSTRACT FROM PUBLISHER]

The secure base construct represents one of attachment theory’s most important contributions to our understanding of parent–child relationships and child development. The present study represents the first examination of how parents’ self-reported attachment styles relate to parental secure base provision and adolescent (mean age = 16.6 years, SE = .59) secure base use during an observed parent–adolescent interaction. Further, the present study is the first to examine how fathers’, as well as mothers’, attachment styles relate to observed behavior in a parent–child interaction. At the bivariate level, maternal avoidance, but not anxiety, was negatively associated with observed adolescent secure base use. In addition, path analysis revealed that maternal avoidance was indirectly related to less adolescent secure base use through mothers’ self-reported hostile behavior toward their adolescents and through adolescents’ less positive perceptions of their mothers. Further, paternal anxiety, but not avoidance, was indirectly related to less adolescent secure base use through fathers’ self-reported hostile behavior toward their adolescents. No significant findings emerged in relation to parental secure base provision. We discuss these results in the context of attachment theory and suggest directions for future research. [ABSTRACT FROM PUBLISHER]

Two studies examined the relationship between maternal attitudes and symptoms of depression and anxiety during pregnancy and the early postpartum period. In the first study, a measure of maternal attitudes, the Attitudes Toward Motherhood Scale (AToM), was developed and validated in a sample of first-time mothers. The AToM was found to have good internal reliability and convergent validity with cognitive biases and an existing measure of maternal attitudes. Exploratory and confirmatory factor analyses determined that the measure comprises three correlated factors: beliefs about others' judgments, beliefs about maternal responsibility, and maternal role idealization. In the second study, we used the AToM to assess the relationship between maternal attitudes and other psychological variables. The factor structure of the measure was confirmed. Maternal attitudes predicted symptoms of depression and anxiety, and these attitudes had incremental predictive validity over general cognitive biases and interpersonal risk factors. Overall, the results of these studies suggest that maternal attitudes are related to psychological distress among first-time mothers during the transition to parenthood and may provide a useful means of identifying women who may benefit from intervention during the perinatal period. [ABSTRACT FROM AUTHOR]

This study investigated the associations among depression, relationship quality, and demand/withdraw and demand/submit behavior in couples' conflict interactions. Two 10-min conflict interactions were coded for each couple (N = 97) using Structural Analysis of Social Behavior (SASB; Benjamin, 1979a, 1987, 2000a). Depression was assessed categorically (via the presence of depressive disorders) and dimensionally (via symptom reports). Results revealed that relationship quality was negatively associated with demanding behavior, as well as receiving submissive or withdrawing behavior from one's partner. Relationship quality was positively associated with withdrawal. Demanding behavior was positively associated with women's depression symptoms but negatively associated with men's depression symptoms. Sequential analysis revealed couples' behavior was highly stable across time. Initiation of demand/withdraw and demand/submit sequences were negatively associated with partners' relationship adjustment. Female demand/male withdraw was positively associated with men's depression diagnosis. Results underscore the importance of sequential analysis when investigating associations among depression, relationship quality, and couples' interpersonal behavior. [ABSTRACT FROM AUTHOR]

This study explored connections between initiator tendency (the propensity to initiate relationship discussions with spouses), value placed on supportive communication, and partner satisfaction. We predicted that supportive communication values would moderate the association between initiator tendency and partner satisfaction. Participants (60 married couples) completed measures tapping initiator style, value placed on supportive communication, and marital satisfaction. As predicted, the association between husband initiator tendency and wife marital satisfaction increased as a function of the value husbands placed on supportive communication. The association between wife initiator tendency and husband satisfaction, though positive, was not moderated by wives’ communication values. [ABSTRACT FROM AUTHOR]

Mothers of children with autism report higher levels of depression than mothers of children with other developmental disabilities. We explored the relations between child characteristics of diagnostic severity and problem behaviors, parenting stress, relationship quality, and depressive symptoms in 70 mothers of young children with autism. We hypothesized that relationship quality and parenting stress would relate to maternal depression beyond contributions of child characteristics. Multiple regression analysis revealed a main effect of parenting stress above and beyond child problem behaviors and autism severity. A significant interaction emerged, with relationship quality buffering the effect of parenting stress on depression. Results suggest that the relation between child problem behaviors and maternal depression should be considered in conjunction with other measures of marriage and family stress. Relationship quality and parenting stress may also represent important factors to be explicitly considered within intervention paradigms for young children with autism spectrum disorders. [ABSTRACT FROM PUBLISHER]

The purpose of the current study was to understand the experiences of a subset of military couples regarding the effects of war deployment on couple functioning. The authors used the core “couple functioning” variables included in the Couple Adaptation to Traumatic Stress Model as sensitizing concepts to guide the qualitative analysis process. Participant interviews (n = 15 couples, 30 total participants) were divided into subgroups according to high and low trauma symptom and relationship satisfaction scale scores. Five primary themes were identified in the results: communication, conflict management, roles, support/nurturance, and posttraumatic growth. Overall, highly satisfied couples and those with the lowest levels of traumatic stress symptoms reported more positive relationship functioning in the identified areas, while couples reporting higher traumatic stress symptoms and lower relationship satisfaction indicated varied or inconsistent qualitative results. Clinical and research implications for military couples also are identified. [ABSTRACT FROM PUBLISHER]

The study examined factors related to change in treatments for depression in couple therapy (CT; N = 29) and treatment-as-usual (TAU; N = 22). Treatments were adapted in accordance with the patient's need. The patients' depressive symptoms, general mental health and marital satisfaction were assessed at baseline and at 6 months post-baseline. The Hamilton Depression Rating Scale, the Beck Depression Inventory (BDI), the Symptom Check List-90, and the Dyadic Adjustment Scale (DAS) were used for the patients. The BDI and the DAS were used for the spouses. The couples in CT group assessed their subjective distress (SD) at every session by using the Outcome Rating Scale. The results showed that the spouses' gender, the spouses' depressive symptoms at baseline, and the number of therapy sessions were related to differing changes in the CT and TAU groups at the 6-month post-baseline assessment. The spouses in the CT group demonstrated a higher treatment response than those in the TAU group. In the CT group, the spouse's benefit from the treatment was related to SD at the outset on the part of either the patient or the spouse or both. The change in the patient's SD predicted the patient's change in depressive symptoms, general mental health, and was associated with the patient's change in marital satisfaction. The study emphasizes the importance of the spouse's involvement in the treatment of depression, the provision of feedback on SD, and discussion of individual well-being and relational issues, in addition to the focus on depression. [ABSTRACT FROM AUTHOR]

With marital breakdown and discord relatively common, we examined whether family structure and the quality of marital relationship have a long-term impact on offspring’s psychopathology in early adulthood. This study aimed to examine the association of family structure and marital discord in the family with a wide range of offspring’s mental health and problem behaviours at 21 years. Data were from the Mater-University of Queensland Study of Pregnancy, a population based birth cohort study, which commenced in Brisbane, Australia in 1981. Mothers and children were followed up at birth, 6 months and 5, 14 and 21 years after the initial interview. Marital status and marital quality were assessed at the 14 year follow-up. Young Adult Self-Report sub-scales of mental health and problem behaviours were measured at the 21-year follow-up. Type of family structure and the quality of marital relationship (at the 14-year follow-up) predicted offspring’s psychopathology at 21 years. When a selected group of confounding factors were included in the multivariate analyses, children who lived with a step-father, un-partnered mother, or in families where parents had conflict in marital relationship reported higher symptoms of psychopathology at 21 years. The association between marital problems and young adult psychopathology does not appear to be confounded by a wide range of confounding variables. Further research is needed to explore the mechanism of these associations to develop preventive programmes. [ABSTRACT FROM AUTHOR]

The article discusses a study on the paternal post-adoption depression published online in the December 3, 2012 issue of the journal "Psychology of Men and Masculinity." The researchers Karen J. Foli, Susan C. South, and Megan Hebdon conducted descriptive statistics evaluating demographics, postpartum depression predictors inventory-revised, and the mother-to-infant bonding scale. They conclude adoptive fathers should be assessed for depressive symptoms.

Background High levels of expressed emotion ( EE) in parents have been found to put children at risk for emotional and behavioural problems. However, the majority of existing studies have focused on mothers of school-aged children and adolescents rather than younger children, and have only rarely included fathers. Methods The present study examined the reliability of EE in mothers and fathers of 1-year old children. It also investigated whether depression and marital problems in the postnatal period predicted EE toward the child at 12 months. EE was assessed with the Preschool Five Minute Speech Sample in 163 families. Results The rater-interrater and code-recode reliability was high for most EE dimensions. Mothers and fathers were found to display quite similar EE scores. Regression analyses showed that depression and couple relationship significantly predicted EE in mothers, but not fathers. Conclusions The findings suggest that EE provides a reliable and useful assessment of the family environment in families of young children. [ABSTRACT FROM AUTHOR]

Military deployment affects thousands of families each year, yet little is known about its impact on nondeployed spouses ( NDSs) and romantic relationships. This report examines two factors-attachment security and a communal orientation with respect to the deployment-that may be crucial to successful dyadic adjustment by the NDS. Thirty-seven female NDSs reported on their relationship satisfaction before and during their partner's deployment, and 20 also did so 2 weeks following their partner's return. Participants provided a stream-of-consciousness speech sample regarding their relationship during the deployment; linguistic coding of sample transcripts provided measures of each participant's (a) narrative coherence, hypothesized to reflect attachment security with respect to their deployed spouse; and (b) frequency of first person plural pronoun use ( we- talk), hypothesized to reflect a communal orientation to coping. More frequent first person plural pronounuse- we- talk- was uniquely associated with higher relationship satisfaction during the deployment, and greater narrative coherence was uniquely associated with higher relationship satisfaction during postdeployment. Discussion centers on the value of relationship security and communal orientations in predicting how couples cope with deployment and other types of relationship stressors. [ABSTRACT FROM AUTHOR]

Relationship quality and partner dynamics provide important insights into understanding sexual behavior within HIV sero-positive and sero-discordant couples. Individuals in long-term partnerships may be vulnerable to HIV/sexually transmitted infections (STI) within their relationships due to misperceptions of their partners risk behaviors and potential concurrent (e.g., extramarital, nonprimary) sexual partnerships. This study sought to examine relationship quality among HIV sero-positive and sero-discordant couples in Zambia, and its association with safer sex behavior. This study utilized data drawn from an ongoing translational study, The Partnership II Project – a couples-based sexual risk reduction intervention in Lusaka, Zambia. Couples (n=240) were assessed on demographics, relationship quality, and sexual risk behavior. Overall, couples perceiving their relationships more positively engaged in less risky sexual behavior (i.e., more condom use (b=0.011,t=3.14,p=0.002) and fewer partners (χ2=11.4,p=0.003). Within the dyad, condom use was “actor driven,” indicating that the association between relationship quality and condom use did not depend on the partner's evaluation of the relationship. Safer sex behavior was positively influenced by communication about condoms. Results support the paradigm shift from prevention strategies with HIV-positive and at-risk individuals to concentrated efforts addressing male–female dyads, and suggest that interventions to address the role of couples' relationship quality, a modifiable target for decreasing sexual risk behavior, are needed. [ABSTRACT FROM AUTHOR]

This study examined how the revealing of underlying vulnerable emotion relates to session and final outcome in the context of emotion-focused therapy for couples. Segments of videotaped therapy sessions were rated on a measure of underlying vulnerable emotional expression for twenty-five couples. Results indicated that partners rated sessions in which underlying vulnerable emotion was expressed significantly more positively than control sessions on a measure of session outcome. Moreover, from pre to post, couples who were found to have expressed underlying vulnerable emotion at least once improved significantly more on a measure of trust, and marginally significantly more on a measure of unfinished business, than couples who were not found to have expressed underlying vulnerable emotion. Recommendations for treatment are provided in light of the findings. Practitioner points It is recommended that couple therapists help partners to access and express underlying vulnerable emotion, because this appears to be associated with better session and final outcomes., When an underlying vulnerable emotion begins to emerge, it is recommended that the therapist maintain the focus on this emotion and help to facilitate its full expression. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) and partner relationship difficulties commonly co-occur among Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). This study reports upon results for six male OEF-OIF Veterans with PTSD and their female relationship partners who completed cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD), which is a treatment that targets reductions in PTSD and couple distress. Case- and group-level data supported reductions in Veterans' PTSD symptoms and female partners' relationship distress. These findings suggest that CBCT for PTSD may be a promising intervention for OEF-OIF Veterans' PTSD and their partners. [ABSTRACT FROM PUBLISHER]

Recent studies have shown that the presence of a caring relational partner can attenuate neural responses to threat. Here we report reanalyzed data from Coan, Schaefer, and Davidson (2006), investigating the role of relational mutuality in the neural response to threat. Mutuality reflects the degree to which couple members show mutual interest in the sharing of internal feelings, thoughts, aspirations, and joys - a vital form of responsiveness in attachment relationships. We predicted that wives who were high (versus low) in perceived mutuality, and who attended the study session with their husbands, would show reduced neural threat reactivity in response to mild electric shocks. We also explored whether this effect would depend on physical contact (hand-holding). As predicted, we observed that higher mutuality scores corresponded with decreased neural threat responding in the right dorsolateral prefrontal cortex and supplementary motor cortex. These effects were independent of hand-holding condition. These findings suggest that higher perceived mutuality corresponds with decreased self-regulatory effort and attenuated preparatory motor activity in response to threat cues, even in the absence of direct physical contact with social resources. [ABSTRACT FROM AUTHOR]

The current study evaluated the efficacy of a single-session brief motivational enhancement (BME) interview to increase treatment compliance and reduce recidivism rates in a sample of 82 recently adjudicated male perpetrators of intimate partner violence (IPV). Batterer intervention program attendance and completion as well as re-arrest records served as the primary outcome measures and were collected 6 months post-adjudication. Results indicated that BME was associated with increases in session attendance and treatment compliance. BME was not directly associated with reductions in recidivism. The relationship between BME and treatment compliance was moderated by readiness to change such that BME participants with low readiness to change attended more sessions and were more likely to be in compliance with the terms of a treatment than control participants with low readiness, while participants with high readiness attended sessions equally, regardless of study condition. Results indicate that outcomes may be improved through treatment efforts that consider individual differences, such as one's readiness to change, in planning interventions for IPV perpetrators. [ABSTRACT FROM AUTHOR]

Thome M. & Arnardottir S.B. (2013) Evaluation of a family nursing intervention for distressed pregnant women and their partners: a single group before and after study. Journal of Advanced Nursing 69(4), 805-816. doi: 10.1111/j.1365-2648.2012.06063.x Abstract Aim. To report a study of the effects of an antenatal family nursing intervention for emotionally distressed women and their partners. Background. High levels of depressive symptoms and anxiety are common in pregnant women, and their partners are likely to suffer from a higher degree of these symptoms than those of non-distressed women. Maternal anxiety and depressive symptoms influence the development of the foetus and child negatively. Distress-reducing interventions for couples are scarce. Design. The design was a pre- and post-test single group quasi-experiment. Methods. All women distressed during the last two trimesters of pregnancy were referred by midwives to a family nursing home-visiting service in a primary care setting in Iceland. They were invited to participate in the study from November 2007-September 2009. The final sample was 39 couples. Assessment of distress was through self-reporting of depressive symptoms and anxiety, self-esteem, and dyadic adjustment. The couple received four home visits that were guided by the Calgary Family Nursing Model. Results. Women experienced a higher degree of distress than men before the intervention. Couple's distress was interrelated, and improvement was significant on all indicators after the intervention. Conclusion. Healthcare professionals who care for distressed expectant women should attend to their partners' mental health status. The Calgary Family Nursing Model is an appropriate guide for nursing care of distressed prospective couples in a primary care setting. [ABSTRACT FROM AUTHOR]

From choosing a partner to date to deciding to cohabit or marry, individuals are faced with many relationship choices. Given the costs of failed relationships (e.g., personal distress, problems with work, lower well-being for children, lost opportunities to meet other partners), it is important to consider how individuals are approaching these decisions. The current study tested if more thoughtful and clear relationship decision-making processes would relate to individuals’ levels of satisfaction with and dedication to their partners as well as their extradyadic involvements. In a sample of 252 men and women, the results showed that regardless of relationship status (i.e., dating, cohabiting, or married), those who reported more thoughtful decision-making processes also reported more dedication to their partners, higher satisfaction with the relationship, and fewer extradyadic involvements. [ABSTRACT FROM PUBLISHER]

Drawing on a series of 141 couple therapy cases, the main goal of the present study was to determine whether romantic attachment, pre-treatment relationship distress and therapeutic mandates (i.e., reduction of couple distress or ambivalence resolution) are prognostic indicators of early termination. Couples completed the Dyadic Adjustment Scale (Spanier ) and the Experiences in Close Relationships Questionnaire (Brennan et al. ) at intake, whereas therapists filled in the Classification of Therapeutic Mandates (Poitras-Wright and St-Père ) after the 4th session. Results showed that an ambivalence resolution mandate, elevated couple distress and higher levels of attachment anxiety were associated with early termination. The implications of these findings to further understand early termination in couple therapy are discussed. [ABSTRACT FROM AUTHOR]

This article presents a longitudinal study of the development of 'family alliance' from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions ( N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self-reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: 'high stable' ( n = 19), 'high to low' ( n = 10), and 'low stable' ( n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family-level and individual-level variables for understanding individual differences in the social and cognitive development of children. [ABSTRACT FROM AUTHOR]

Some people who have a visible difference (disfigurement) experience psychosocial adjustment problems that can lead to social anxiety and isolation. The aim of thisstudy was to assess the effectiveness of a new computerised CBT-based intervention (Face IT) in reducing anxiety and appearance-related distress for individuals with visible differences. Face IT was tested against a non-intervention control group and standard CBT-based face-to-face delivery. Eighty-three participants were assessed at four time points using the Hospital Anxiety and Depression Scales, Derriford Appearance Scale-24, Body Image Quality of Life Inventory and Fear of Negative Evaluation (FNE). The findings indicate a significant reduction in anxiety and appearance-related distress in both the Face IT intervention and the face-to-face condition. Similar findings were reported for depressive symptoms and FNE. Results at the three and six months follow-up demonstrate increased improvements in psychological functioning with both interventions. This new online psychosocial intervention has been found to be effective at reducing anxiety, depression and appearance concerns amongst individuals with disfigurements, whilst increasing positive adjustment. A remote-access, computer-based intervention offers the potential to provide psychosocial support more easily and in a cost-effective manner to adults with appearance-related distress. [ABSTRACT FROM AUTHOR]

Childhood exposure to family aggression is associated with various harmful outcomes, including poor adult relationship functioning (i.e., greater relationship dissatisfaction and partner aggression). The mechanisms by which this transmission occurs, however, are less well understood. In this study, the mediating effects of adult depression and childhood antisocial behavior on the link between childhood exposure to family aggression and adult relationship functioning were investigated using a community sample of 98 couples expecting their first child. Childhood exposure to aggression was linked to greater relationship dissatisfaction and higher rates of partner aggression perpetration for both men and women. For men, symptoms of depression partially mediated the association between aggression exposure and relationship satisfaction. For women, childhood antisocial behavior fully mediated the link between aggression exposure and both indices of poor relationship functioning (dissatisfaction and aggression). These gender-specific results have implications for improving relationship functioning and breaking the intergenerational transmission of relationship dysfunction. [ABSTRACT FROM AUTHOR]

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes. [ABSTRACT FROM AUTHOR]

To identify factors associated with antiretroviral therapy (ART) adherence and virologic control among HIV-positive men on ART in primary relationships, data were collected from 210 male couples (420 men). Dyadic actor-partner analyses investigated associations with three levels of adherence-related dependent variables: self-efficacy (ASE), self-reported adherence, and virologic control. Results indicated that higher patient ASE was related to his own positive beliefs about medications, higher relationship autonomy and intimacy, and fewer depressive symptoms. Fewer depressive symptoms and less relationship satisfaction in the partner were linked to higher ASE in the patient. Better self-reported adherence was related to the patient's positive appraisal of the relationship and the partner's positive treatment efficacy beliefs. Greater medication concerns of both patient and partner were associated with less adherence. The partner's higher relationship commitment was associated with lower viral load in the patient. Findings suggest that depressive symptoms, treatment beliefs, and relationship quality factors of both partners may influence adherence-related outcomes. [ABSTRACT FROM AUTHOR]

The article reports on a study identifying groups of young children with distinct internalising and externalising symptom trajectories across early childhood. The results revealed that children with persistent mental health symp­toms can be identified in the early toddler years. Harsh discipline and maternal stress were important risk factors throughout early childhood for developing internalising and externalising difficulties by the time chil­dren reach the age of five.