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This study aimed to examine: (1) the relationship between parental psychopathology and child psychopathology in military families and (2) parenting sense of competence as a mediator of the relationship between veteran psychopathology and child psychopathology. As part of their standard clinical evaluations, 215 treatment-seeking veterans who reported having a child between the ages of 4 and 17 were assessed for psychopathology (posttraumatic stress disorder, depression, anxiety, and stress), their sense of competence as a parent, and their child's psychopathology (internalizing, externalizing, and attentional symptoms). A path analysis model examining parenting sense of competence as a mediator of the relationship between veteran psychopathology and child psychopathology showed significant indirect effects of veteran depression on all child psychopathology outcomes via parenting sense of competence. Parental sense of competence may be a critical mechanism linking veteran depression and child psychopathology, and may therefore be an important target for intervention.

Since September 11, 2001, more than two million U.S. service members have deployed to Iraq or Afghanistan, many returning home with posttraumatic stress disorder (PTSD) and additional psychological and general medical complaints. Nonetheless, many do not seek care or may not respond to traditional outpatient approaches, warranting innovative, multidisciplinary treatment approaches. To help address these complex needs, the Wounded Warrior Project has funded four academic medical centers to develop a care network across the nation. As part of this Warrior Care Network, the Emory Healthcare Veterans Program in Atlanta; the Home Base Program at Massachusetts General Hospital, in collaboration with the Red Sox Foundation, in Boston; Road Home at Rush Medical Center in Chicago; and Operation Mend at the University of California, Los Angeles, have each developed innovative, intensive programs to treat PTSD among post-9/11 veterans and service members. The programs offer two- to three-week intensive PTSD treatment programs with evidence-based approaches embedded in a broader program. To date, 328 post-9/11 veterans and active-duty service members have received care in these intensive outpatient programs. The average completion rate is approximately 95%, which demonstrates the acceptability of this brief but intensive care model for a complex population who can be challenging to engage or retain in care.

Mind-body interventions reduce stress and improve overall health and functioning among caregivers but are not readily available in the community. We adapted an existing 8-week mind-body program into a 28-day daily podcast series that included psychoeducation about the stress response, relaxation-response training, and self-compassion practices. The intervention was piloted among military caregivers in an open trial. Participants were N = 55 caregivers (100% cisgender women, M(SD)age = 42.3 (9.1)) who were assessed at baseline, midpoint (on the fourteenth day of the program), and endpoint (upon completion of the 28-day program) for symptoms of perceived stress (primary outcome), depression, anxiety, somatic complaints, and functioning. From baseline to endpoint, there were significant decreases in perceived stress (coefficient = −1.77, SE = 0.47, p < 0.001, d = 0.5), depressive symptoms (coefficient = −1.33 SE = 0.39, p < 0.001, d = 0.53), and somatic complaints (coefficient = −4.01, SE = 1.66, p = 0.02, d = 0.36); and increase in ability to perform social roles (coefficient = 0.84, SE = 0.24, p < 0.001, d = 0.46). A mind-body daily podcast program is feasible and may be effective in reducing perceived stress and symptoms of depression and anxiety among military and veteran caregivers. Public Significance Statements: A mind-body program can be delivered through a daily podcast over 28 days. A mind-body program delivered through a daily podcast may reduce perceived stress and symptoms of depression and anxiety among caregivers of service members and veterans. [ABSTRACT FROM AUTHOR]

Aims/BackgroundDesign/MethodsResultsConclusionAlthough the Pregnancy-Related Anxiety Scale – also referred to as the Pregnancy-Related Thoughts Scale (PRT) – is one of the most widely utilised measures of pregnancy-related anxiety (PrA), there is limited research exploring its factor structure and psychometric properties. The present study sought to (a) explore the factor structure of the PRT and (b) examine whether specific dimensions of PrA differentially predict postpartum outcomes.A community sample of pregnant women (N = 159) was recruited from a Midwestern city in the United States and completed the PRT alongside other self-report measures of stress and maternal health and mood during pregnancy. Participants also completed measures of maternal health and mood, as well as parenting/infant outcomes, at 1- and 6-months postpartum.Results provided support for a bifactor model with two unique dimensions of the PRT capturing baby- and self-focused concerns, respectively. Maternal self-focused PrA uniquely predicted postpartum internalising problems (β = .22), worse physical health (β = -.27), and impaired mother-infant bonding (β = .19) when controlling for baby-focused and general PrA.Findings highlight the utility of screening for specific dimensions of PrA to promote both maternal and infant wellbeing following childbirth. Specifically, evidence suggests that screening for self-focused PrA, above and beyond baby-focused PrA, might facilitate prevention and intervention efforts and allow researchers to better understand antecedents and consequences of unique facets of PrA. [ABSTRACT FROM AUTHOR]

There is an increased risk for depression and anxiety across the perinatal period (i.e., spanning pregnancy and the first year postpartum); however, limited research has examined elevations in core negative affectivity underlying internalizing disorders more broadly. The current study sought to characterize trajectories of core internalizing problems among both mothers and fathers across the perinatal period and explored whether modifiable risk and protective factors buffered risk for elevated symptoms during this key developmental transition. A community sample of mixed‐sex couples (N = 159) completed assessments during pregnancy and at four postpartum timepoints. Using growth mixture modeling, we found that 21.2% of mothers demonstrated clinical elevations in core internalizing symptoms that persisted up to 2 years postpartum. In contrast, 7.8% of fathers demonstrated clinical elevations in core internalizing symptoms across this period, with an additional 29.0% of fathers demonstrating subthreshold symptom elevations. Concerns related to pregnancy and childbirth and paternal (partner) internalizing problems during pregnancy conferred risk for elevated symptoms in mothers, whereas psychological flexibility, emotional intimacy, and the quality of received support were identified as protective factors for fathers. Results highlight the importance of repeated screening for internalizing problems and suggest that promoting a strong interparental relationship is critical for emotional health and well‐being across the perinatal period. [ABSTRACT FROM AUTHOR]

The present study aimed to characterize the immediate impacts of the COVID‐19 pandemic on families with preschool age children and to identify pre‐pandemic factors that explained unique family experiences. We leveraged an ongoing longitudinal study of relatively well‐resourced community families who had reported on family functioning prior to the pandemic and completed surveys 6 months after pandemic onset. Both parents of dual parenting households endorsed significant hardships as a direct result of the pandemic (e.g., disrupted family routines, challenges at work); however, families also reported aspects of flourishing (i.e., experiencing positive outcomes in response to adversity) such as spending more time together as a family. Families were prone to greater hardships and fewer opportunities for growth to the extent that parents were lower in psychological resources (i.e., greater stress and internalizing symptoms, poor well‐being) and were not on the same page as a couple (i.e., interparental discord, low quality coparenting) prior to pandemic onset. Finally, greater pandemic hardships predicted poorer parental mental health, greater family dysfunction, and elevated child psychopathology, controlling for pre‐pandemic levels. Parents who reported more family flourishing from the pandemic had a stronger interparental relationship. Results are intended to inform theories of family stress and family interventions that can be tailored to promote resiliency (i.e., adaptation to challenging life events) and prevent dysfunction when families face rapid change and adjustment and high degrees of uncertainty and stress. [ABSTRACT FROM AUTHOR]

Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent–infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent–infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent–child relationship. [ABSTRACT FROM AUTHOR]

We report on a novel 2-week intensive outpatient treatment program (IOP) for 24 widows bereaved by the suicide death of their veteran spouse. We targeted symptoms of posttraumatic stress disorder (PTSD) and complicated grief (CG) concurrently in three separate cohorts. All patients either witnessed the death or discovered the body of their deceased partner, who was a veteran of the United States military. PTSD, CG, and depression symptom severity decreased significantly from pre- to post-treatment, with effect sizes of 0.85, 1.21, and 1.35, respectively. These outcomes provide preliminary support for an IOP to treat co-occurring PTSD and CG among widowed survivors of veteran suicide. [ABSTRACT FROM AUTHOR]

Abstract Post-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes. Highlights • The development of an innovative two-week intensive day program is described. • High completion rates and reductions in military service-related mental health symptoms were observed. • Brief intensive, multidisciplinary PTSD and TBI treatment is a promising approach. [ABSTRACT FROM AUTHOR]

Child socioemotional difficulties emerge as early as infancy, increase over time, and place children at risk for future internalizing and externalizing symptoms. The aim of the present study was to investigate pathways that originate within the interparental relationship during pregnancy and unfold during infancy that mitigate risk for toddler socioemotional difficulties and to examine the differential effects of these pathways for children with varying degrees of temperamental fearfulness. Specifically, we examined whether dyadic mutually responsive orientation (MRO; i.e., a system of attunement, reciprocity, cooperation, and warmth) observed in the prenatal interparental relationship and in both mother-infant and father-infant relationships predicted child socioemotional functioning at age 2. Findings revealed a significant direct effect of observed prenatal interparental MRO on mother-infant and father-infant MRO. Results also demonstrated an indirect effect of prenatal interparental MRO on socioemotional functioning via father-infant MRO. Temperamental fearfulness did not interact with interparental MRO, mother-infant MRO, or father-infant MRO to impact socioemotional functioning. Taken together, findings suggest high interparental MRO during pregnancy contributes to similar relational qualities in the parent-infant relationship and mitigates the risk for toddler socioemotional difficulties. Further, results underscore the importance of integrating fathers into prevention and intervention efforts when they are part of the family system.

Pregnancy represents a unique time during which women's bodies undergo significant physical changes (e.g., expanding belly, larger breasts, weight gain) that can elicit increased objectification. Experiences of objectification set the stage for women to view themselves as sexual objects (i.e., self-objectification) and is associated with adverse mental health outcomes. Although women may experience heightened self-objectification and behavioral consequences (such as body surveillance) due to the objectification of pregnant bodies in Western cultures, there are remarkably few studies examining objectification theory among women during the perinatal period. The present study investigated the impact of body surveillance, a consequence of self-objectification, on maternal mental health, mother-infant bonding, and infant socioemotional outcomes in a sample of 159 women navigating pregnancy and postpartum. Utilizing a serial mediation model, we found that mothers who endorsed higher levels of body surveillance during pregnancy reported more depressive symptoms and body dissatisfaction, which were associated with greater impairments in mother-infant bonding following childbirth and more infant socioemotional dysfunction at 1-year postpartum. Maternal prenatal depressive symptoms emerged as a unique mechanism through which body surveillance predicted bonding impairments and subsequent infant outcomes. Results highlight the critical need for early intervention efforts that not only target general depression, but also promote body functionality and acceptance over the Western "thin ideal" of attractiveness among expecting mothers.