While the prevalence of type 1 diabetes (T1D) in the pediatric population has been increasing dramatically in recent years, most youths with T1D do not meet the treatment targets recommended by the American Diabetes Association. The multiple self-report scales for parents and adolescents that have been investigated in relation to treatment adherence and glycemic control in pediatric T1D show limited predictive abilities. This longitudinal observational study investigates whether the Global Assessment of Relational Functioning (GARF) can predict the medical outcome for newly diagnosed youths with T1D. The GARF is a brief structured interview assessing important areas of family functioning. The GARF assesses three main areas of family functioning: The organization, the emotional climate, and the problem-solving attributes of the family. Fifty-one youths recently diagnosed with diabetes and their families were recruited from a care facility in Canada. The age of the youths ranged from 1 to 16 years (M = 8.89; SD = 4.2), comprising 13 preschoolers, 28 school-aged children, and 10 teenagers. Including family members, a total of 139 people participated in the assessments. Correlations were sought between GARF scores, patients' serum glycosylated hemoglobin (HbA1c) and the frequency of ER visits, hospitalizations, episodes of ketoacidosis, severe hypoglycemia, insulin resistance, and mental health referrals over 21 months. The GARF score was significantly inversely correlated with outcome HbA1c scores (r = -0.61, p < 0.001), indicating that higher family functioning is associated with better metabolic control. These results suggest the GARF could be administered at diagnosis to predict diabetes outcome among a pediatric population.

Childhood maltreatment (CM), a complex trauma, has long been recognized as a detrimental predictor of marital quality in adulthood. Although research has almost exclusively focused on the associations of CM with a range of relationship outcomes from an individual perspective, the dyadic effects of CM on couple interactions and marital quality remain understudied. Relying on the Couple Adaptation to Traumatic Stress model, the present study examined whether CM of each partner is associated with their own and their partner's relationship quality through observed negative couple interaction. The study included 115 mixed-gender Israeli married couples, recruited using a convenience sampling method. During a laboratory session, couples completed self-report questionnaires assessing CM and relationship quality and engaged in a 10-min couple conflict discussion. Actor-partner Interdependence Models revealed an indirect effect from CM of women on the marital quality of women and men. Specifically, women's CM was associated with more expressions of negative communication by women, which in turn was associated with lower marital quality reported by men and women. The study points to systemic intergenerational effects of CM in women on adult relationships through negative couple communication, underscoring the need to assess CM history in couple therapy and to focus on improving communication patterns to prevent the intergenerational transmission of relational dysfunction.

ABSTRACTWhile parenting practices significantly influence children's developmental outcomes on a global scale, there has been limited comprehensive assessment of the cultural appropriateness of global parenting questionnaires in diverse cultural contexts by researchers. This study examined the cultural relevance of the widely used measure of parenting, the Alabama Parenting Questionnaire (APQ) among the Runyankole‐speaking community in Uganda. Using a semi‐structured interview approach, we interviewed 14 local experts to evaluate the measure. Additionally, 16 parents were interviewed to assess their comprehension of APQ scale items. Feedback from both experts and parents was used to revise and adapt the 42‐item APQ scale. Additionally, we used feedback from experts and parents to add five items addressing key parenting practices relevant to the Ugandan context. The process resulted in a 32‐item adapted APQ tailored for the target Ugandan context. This research is notable for its contribution to the decolonization of parenting assessment instruments, centered on the perspectives of participants in Uganda, a culturally diverse context. The availability of an adapted parenting measure holds significance for clinicians and researchers as it enables a more efficient and culturally sensitive evaluation of parenting practices. Furthermore, utilizing such a measure facilitates a deeper understanding of the components of parenting, warranting attention in the development of interventions for parents in the target setting.

Female sex workers as mothers are disproportionately disadvantaged and experience myriad intersecting vulnerabilities, including poverty, physical and mental health challenges, limited access to health care and health care providers, stigma and discrimination, substance use, and histories of trauma. These risks elevate the potential for negative developmental outcomes for their children. To date, little information exists on the contextual and familial dynamics of female sex workers and their children. Yet, this information is critical for providing effective, evidence-informed interventions. This is a life-course developmental examination of female sex workers and their children residing in an urban brothel district in India, framed in ecological systems theory. From mothers, we were particularly interested in developmental trajectories that led to commercial sex work, intergenerational family dynamics, microsystems of mothers and their children (residence patterns), and concerns for child wellbeing given environmental dangers of the red-light areas. Inquiries with children were aimed at understanding the family microsystem-dynamics and residence, other influential microsystems (peer and school), as well as the larger red-light district neighborhood (exosystem) and future aspirations. Most mothers had been trafficked into the sex industry. Because of their work, few remained in contact with families of origin. Mothers' concerns included generating income, getting children educated, and returning children to hostels. Prior to the pandemic, most child participants lived in hostels rather than the red-light area and described it as dirty and unsafe. Children described types of social support given and received by mothers and prioritized education. Continued policy and research that explore innovative measures for limiting social disparities in educational attainment for vulnerable children (e.g., mobile school programs) are recommended.

This study aimed to reveal the association between spousal stress perception and marital instability across different stages of the family life cycle, focusing on the actor and partner effects and exploring the mediating role of daily communication in this relationship. With rising divorce rates, it's essential to examine factors affecting marital instability. Drawing from the stress-divorce model, spouses' stress perception likely permeates into marriage via daily communication. It is important to consider challenges unique to different marital stages to understand variations among couples through the family life cycle. The study used the Perceived Stress Scale, the Primary Communication Inventory, and the Marital Instability Scale to survey 654 couples in the newlywed, couples with pre-school children, couples with school-age children, and empty-nest stages. The study revealed that the actor-partner effects between stress perception and marital instability were initially present in the early stages of marriage. As the duration of the marriage progressed, during the stages of pre-school age and school-age children, only actor effects existed. In the empty nest stage, the actor-partner effects gradually diminish. Throughout the life cycle, daily communication served as a mediating factor in the relationship between stress and marital instability. This research uncovers a dynamic evolution in the association between couples' stress perception and marital instability across marital longevity: at the beginning of marriage, spouses have interactive effects; at the stage with child(ren), the interactive effect diminishes; at the empty-nest stage, the role is imposed only through the medium of daily communication. Our research reveals that maintaining communication during all stages of marriage is key to effectively managing stress and maintaining marital instability.

This study focuses on validating a Negative Interaction Scale using a Bayesian approach for confirmatory factor analysis. Considering the significant impact of negative interactions on couple relationships, both in terms of satisfaction and the mental and physical health of individuals, the aim was to provide a reliable and precise tool for measuring these behaviors in a specific cultural context, such as that of young and adult individuals in Peru. A non-probabilistic convenience sampling design was used, involving 313 participants, predominantly women, and a majority identifying as heterosexual. The average age was around 26 years, encompassing various types of couple relationships. The Negative Interaction Scale (NIS-5) and the Peruvian version of the Relationship Assessment Scale (RAS) were employed for data collection, using Bayesian statistical tools for analysis, particularly Bayesian confirmatory factor analysis (BCFA), offering advantages in flexibility, precision, and the evaluation of the proposed unidimensional structure. The NIS-5 demonstrated a unidimensional structure with excellent fit indices, moderate to strong factor loadings, and good internal consistency, supported by an omega reliability coefficient of 0.836. These results validate the unifactorial structure of the NIS-5, reflecting that negative interaction can be globally and uniquely interpreted within the study context. The study confirms the validity and reliability of the NIS-5 as an instrument for measuring negative interaction in couple relationships in Peru. It highlights the importance of considering negative interaction to improve relationship quality and suggests the implementation of programs or theoretical models to promote healthier relationships.

Literature has consistently linked family elements as risk and/or protective factors in adolescence. Consequently, numerous family-focused prevention programs have been developed. In the context of selective and indicated prevention, the most structured actions take place within the municipal services. However, studies demonstrating the effectiveness of these interventions are scarce. Our aim was to explore the effectiveness of the Brief Intervention Program for addiction prevention in the family context (IBAF) to improve family protective dynamics. We used a quasi-experimental pretest-posttest design. The final sample consisted of 136 cases and 191 family members (64.9% women and 35.1% men). The dimensions of family functioning were measured with the self-reported Madrid Family Functioning scale. Results indicated a statistically significant increase post-intervention in family climate, family consensus, setting of rules and boundaries, coping patterns, and improvement in stress/anxiety. There were no significant differences based on the sex of the family members. The IBAF program shows promise in addressing the demand for structured interventions in family indicated prevention. Future research could build on these preliminary findings by testing the efficacy of the intervention using rigorous methodologies.

This article compares exoneration with the correlated concept of forgiveness. According to Contextual Therapy, a fundamental distinction exists between the two. It states that exoneration depends on an adult reassessment of history, resulting in the offender being freed of guilt. Conversely, according to Contextual Therapy, forgiveness is beyond reassessment and relies on the generosity of the forgiver while retaining the assumption of guilt on the part of the wrongdoer. After briefly introducing and concisely overviewing contextual theory, the five core elements of exoneration are identified as (a) an intrapersonal, interpersonal, or posthumous process; (b) motivated by loyalty and obligation; (c) recognition of suffered injustice; and (d) an adult reassessment, leading to (e) a promise of improvement. Then, the core elements are compared with the findings of a previously conducted international phenomenological research study on forgiveness processes between children and parents. Instead of finding evidence of the distinction between exoneration and forgiveness as Contextual Therapy proposes, this article confirms the importance of the five identified elements for both exoneration and forgiveness.

Multisystemic Therapy (MST) is an evidence- and family-based treatment for youth with serious aggressive and delinquent behavior. Despite randomized controlled trials demonstrating short- and long-term effectiveness of MST, arrest is still a concern for many youths who complete treatment. Prior studies examined risk factors for arrest after MST treatment but accounted for risk at pre-treatment rather than over the course of treatment and failed to consider the combined impact of risk and protective factors by the end of treatment on long-term outcomes. Models of resilience suggest that when faced with cumulative stress, the effects of family could serve as a protective factor that promotes either stabilizing, enhancing, or reactive effects. As such, the current study examined family environment (i.e., cohesion and flexibility) at the end of treatment as a moderator of relations between cumulative stress by the end of treatment and the likelihood of arrest at follow-up. Results demonstrated that high family cohesion and flexibility served as protective factors by decreasing the likelihood of arrest when cumulative stress was low; however, these effects faded as cumulative stress increased. These results suggest the protective effects of known targets of MST (i.e., family cohesion and flexibility) do not buffer against post-treatment arrest for all youth in treatment. Treatment targeting family cohesion and flexibility is less likely to be effective in preventing arrest for youth that continue accumulating stressful life events during treatment. Results of this study suggest that MST treatment should be further tailored to account for these families.

Depression, in recent decades, has shown a clear trend to occur at a younger age, emerging as a prevalent mental health concern among primary school children. According to family system theory and social-ecological principles, parent individual factors, as distal factors, are able to influence the depression of child individual through the proximal factor of parent-child dyadic interaction. Within this integrated theory framework, this study aimed to utilize the principle of the actor-partner independence model to investigate the indirect pathway from paternal and maternal positive/negative emotional expressiveness to primary school children's depression via father-child and mother-child closeness/conflict. The study comprised 403 Chinese families, assessed at two separate time points with a 6-month interval. Our results showed that both paternal and maternal positive emotional expressiveness indirectly predicted children's depression through their own conflict with their child, while both parental negative emotional expressiveness indirectly predicted the children's depression through mother-child conflict. This study elucidated two pathways of (a) family distal factors to proximal factors, and subsequently to the child; (b) parent individual factors to the parent-child dyadic interaction, and subsequently to the child individual factors within the family system. Our findings suggest that regulating parental emotional expressiveness and fostering good parent-child relationships represent potential effective strategies for preventing primary school children's depression.