Although the negative impact of marital conflict on children has been amply documented, few studies have examined the process of risk in a long-term, longitudinal design. We examined parent–child attachment security as a mechanism that may account for the impact of interparental conflict on children's long-term risk of internalizing problems. Sixty-two community mothers, fathers, and children were followed from ages 2 to 10. Parents reported on their conflicts when their children were 2. Trained observers produced parent–child attachment security scores (Attachment Q-Set, Waters, 1987), based on lengthy naturalistic observations of the child with each parent. Parents rated children's internalizing problems at age 10. A conditional process model and bootstrap approach were implemented to examine conditional indirect effects of conflict on child internalizing problems through attachment security for girls versus boys. Maladaptive marital conflict (destructive strategies, severity of arguments) increased internalizing problems 8 years later due to the undermined security for girls, whereas negative emotional aftermath of conflict (unresolved, lingering tension) increased internalizing problems for both boys and girls. The emotional aftermath of conflict is often overlooked, yet it appears to be a key dimension influencing emotional security in the family system, with significant consequences for children's development.
We examined whether support underprovision (receiving less support than is desired) and support overprovision (receiving more support than is desired) should be examined as qualitatively distinct forms of inadequate support in marriage. Underprovision of partner support, overprovision of partner support, and marital satisfaction were assessed 5 times over the first 5 years of marriage in a sample of newlywed husbands and wives (N = 103 couples), and were analyzed via actor-partner interdependence modeling (APIM) and growth curve analytic techniques. Increases in underprovision and overprovision of support were each uniquely associated with declines in marital satisfaction over the first 5 years of marriage; however, overprovision of support was a greater risk factor for marital decline than underprovision. Further, when examining support from a multidimensional perspective, overprovision was at least as detrimental, if not more detrimental, than underprovision for each of 4 support types (i.e., informational, emotional, esteem, and tangible support). The present study is the first to examine the utility of differentiating between underprovision and overprovision of partner support. Theoretical, empirical, and clinical implications are discussed.
Depressive and anxiety disorders are severe and disabling conditions that result in substantial cost and global societal burden. Accurate and efficient identification is thus vital to proper diagnosis and treatment of these disorders. The Inventory of Depression and Anxiety Symptoms (IDAS) is a reliable and well-validated measure that provides dimensional assessment of both mood and anxiety disorder symptoms. The current study examined the clinical utility of the IDAS by establishing diagnostic cutoff scores and severity ranges using a large mixed sample (N = 5,750). Results indicated that the IDAS scales are good to excellent predictors of their associated Structured Clinical Interview for DSM-IV diagnoses. These findings were replicated using Diagnostic and Statistical Manual of Mental Disorders–Fifth edition(DSM-5) criteria assessed via the Mini-International Neuropsychiatric Interview. We provide three cutoff scores for each scale that can be used differentially depending on the goal of their use: screening, efficiency, or diagnosis confirmation. The identified severity ranges allow users to characterize individuals as mild, moderate, or severe, providing clinical information beyond diagnostic status. Finally, the 10-item IDAS Dysphoria scale and 20-item General Depression scale demonstrate strong ability to predict internalizing diagnoses and may represent an efficient way to screen for the presence of internalizing psychopathology.
Background: Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset.Method: Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA.Results: Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) < 0.01]. The structure of EPDS responses significantly differed between Europe and the USA (∆*CFI > 0.01), but not between European countries (∆*CFI < 0.01).Conclusions: Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted.