Almost half of the sample appeared resilient during this important developmental period of transition to school. This enables clinicians to be cautiously optimistic in their work with high-risk children and their families. However, more than half the sample was not faring well. Child maltreatment and caregiver depressive symptoms were strongly associated with poor outcomes. These children and families deserve careful attention by pediatric practitioners and referral for prevention and early intervention services.
This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence. In a randomized clinical trial, 228 partner-violent men with hazardous or problem drinking were recruited at three Intimate Partner Violence (IPV) treatment agencies and randomly assigned to receive one of two 4-session alcohol interventions: Motivational Enhancement Therapy (MET: N = 110) or Alcohol Education (AE: N = 118). After completing alcohol intervention, participants received standard agency counseling services for IPV. Participants completed assessments of alcohol use, drug use, and IPV at pre-treatment, post-alcohol intervention, and quarterly follow-ups for 12 months. At the end of the 4-session alcohol intervention, MET participants displayed greater acknowledgment of problems with alcohol than AE participants (Partial ή = 0.039, p = 0.006). Significant changes from baseline across treatment conditions (at p < 0.001) were observed for percent days of alcohol abstinence [95% empirical CI for Partial ή =0.226, 0.296], heavy drinking [0.292, 0.349], illicit drug use [0.096, 0.156] and partner violence [0.282, 0.334]. No significant condition differences (treatment by time interactions) were found for alcohol abstinence [95% empirical CI for Partial ή = 0.007, 0.036], heavy drinking [0.016, 0.055], illicit drug use [0.005, 0.035] or partner violence [0.001, 0.004]. Results encourage continued use of brief alcohol interventions in community IPV services, but do not provide evidence of a unique benefit of MET in reducing alcohol use in this population.
Background Food insecure children are at increased risk for medical and developmental problems. Effective screening and intervention are needed. Methods Our purpose was to (1) evaluate the validity and stability of a single item food insecurity (FI) screen. (2) Assess whether use may lead to decreased FI. Part of a larger cluster randomized controlled trial, pediatric residents were assigned to SEEK or control groups. A single FI question (part of a larger questionnaire) was used on SEEK days. SEEK residents learned to screen, assess, and address FI. A subset of SEEK and control clinic parents was recruited for the evaluation. Parents completed the USDA Food Security Scale (“gold standard”), upon recruitment and 6-months later. Validity, positive and negative predictive values (PPV, NPV) was calculated. The proportion of screened families with initial and subsequent FI was measured. Screening effectiveness was evaluated by comparing SEEK and control screening rates and receipt of Supplemental Nutrition Assistance Program (SNAP) benefits between initial and 6-month assessments. Results FI screen stability indicated substantial agreement (Cohen’s kappa =0.69). Sensitivity and specificity was 59% and 87%, respectively. The PPV was 70%; NPV was 81%. SEEK families had a larger increase in screening rates than control families (24% vs. 4.1%, p<0.01). SEEK families were more likely to maintain SNAP enrollment (97% vs. 81%, p=0.05). FI rates remained stable at approximately 30% for both groups. Conclusions A single question screen can identify many families with FI, and may help maintain food program enrollment. Screening may not be adequate to alleviate FI.
Objective: Past research has linked posttraumatic stress disorder (PTSD) symptoms to increased risk for intimate partner violence (IPV) perpetration. However, little is known about the impact that PTSD may have on treatment engagement or violence recidivism following treatment for IPV. The current study examined whether PTSD predicts treatment engagement and criminal recidivism in a 20-session, community-based, cognitive-behavioral abuse intervention program. Method: Participants (N ϭ 293) completed assessments of PTSD symptoms, depression, drug use, and alcohol problems during agency intake. These variables were examined as predictors of group treatment engagement (session attendance, working alliance, cognitive-behavioral therapy homework compliance, group cohesion, and task orientation) and criminal recidivism during the 2 years after scheduled completion of treatment. Results: Individuals with higher levels of PTSD symptoms at pretreatment had lower homework compliance during treatment. Further, individuals with probable PTSD reported lower task orientation and group cohesion later in treatment. Individuals with a probable PTSD diagnosis at pretreatment had 4 times higher odds of general violence recidivism than those without a probable PTSD diagnosis, and this association remained significant when controlling for substance use and depression. In addition, participants with probable PTSD were more likely to have intimate partner abuse recidivism compared with those without (adjusted odds ratio ϭ 2.5), although this effect was not statistically significant. Conclusions: Trauma symptoms affect violence cessation in IPV treatment, further highlighting the need to address unique clinical issues and underlying mechanisms associated with traumatic stress symptoms in treatments for this population.
The study results suggest that while SAH-M does not need to be modified to address the interaction between PTSD and treatment, outcomes could be enhanced through additional direct treatment of PTSD symptoms. Results extend prior analyses by demonstrating the effectiveness of SAH-M in reducing use of IPA in both the treatment and ETAU conditions. (PsycINFO Database Record
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