UMBC Psychology Department

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    Promoting Safety While Addressing Dangerous Behavior via Telehealth: A Clinical Case Investigation Serving the Family of an Autistic Adolescent Living in India
    (Sage, 2024-03-29) Rajaraman, Adithyan; Whelan, Cory J.; Jessel, Joshua; Gover, Holly C.
    When clinicians address dangerous behavior via remote telehealth consultation, it may be especially important to ensure remote implementers can apply behavioral interventions in a manner that keeps recipients and implementers safe while still achieving effective outcomes. We present the case of a 13-year-old autistic adolescent with limited communication skills, living in South India, whose dangerous behavior was escalating and becoming more pervasive during the pandemic quarantine, putting himself and his family at risk. In this study, we evaluated the effects of an enhanced choice model of skill-based treatment—informed by a practical functional assessment of dangerous behavior. We systematically replicated and extended procedures that have been shown to address dangerous behavior while avoiding difficult situations that place the individual and others at risk. The intervention yielded elimination of dangerous and associated non-dangerous behavior and socially valid acquisition of multiple alternative behaviors. We report multiple strategies to overcome barriers unique to remotely addressing dangerous behavior and discuss implications for the safe, telehealth application of behavior analysis in research and practice.
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    Constructive outcomes of repetitive thought
    (Nature, 2024-03-18) Flynn, Aidan
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    Technology-assisted opioid education for out-of-treatment adults with opioid use disorder.
    (APA, 2021-07-29) Toegel, Forrest; Novak, Matthew; Rodewald, Andrew M.; Leoutsakos, Jeannie-Marie; Silverman, Kenneth; Holtyn, August F.
    Objective: To evaluate the feasibility and potential efficacy of a technology-assisted education program in teaching adults at a high risk of opioid overdose about opioids; opioid overdose; and opioid use disorder medications. Method: A within-subject, repeated-measures design was used to evaluate effects of the novel technology-assisted education program. Participants (N = 40) were out-of-treatment adults with opioid use disorder, recruited in Baltimore, Maryland from May 2019 to January 2020. The education program was self-paced and contained three courses. Each course presented information and required answers to multiple-choice questions. The education program was evaluated using a 50-item test, delivered before and after participants completed each course. Tests were divided into three subtests that contained questions from each course. We measured accuracy on each subtest before and after completion of each course and used a mixed-effects model to analyze changes in accuracy across tests. Results: The technology-assisted education program required a median time of 91 min of activity to complete. Most participants completed the program in a single day. Accuracy on each subtest increased only after completion of the course that corresponded to that subtest, and learning comparisons were significant at the p < .001 level for all subtests. Accuracy on each subtest was unchanged before completion of the relevant course, and increases in accuracy were retained across subsequent tests. Learning occurred similarly independent of participant education, employment, and poverty. Conclusions: Technology-assisted education programs can provide at-risk adults with access to effective education on opioids, opioid overdose, and opioid use disorder medications. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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    Frequent Use of Contingency Management and Opioid Treatment Programs that Provide Treatment for More than Only Opioid Use Disorder
    (Sage Journals, 2024-03-10) Ware, Orrin D.; Novak, Matthew; Toegel, Forrest
    Contingency management is an effective behavioral intervention for treating substance use disorders that provides patients with incentives for objective verification of completed targeted recovery behaviors including abstinence from substances, attending treatment, and medication adherence. Accredited/licensed opioid treatment programs provide effective, medications for opioid use disorder. This study evaluated the prevalence of frequent contingency management use among a national sample of opioid treatment programs in the U.S. (N = 672). A binary logistic regression model examined factors associated with providing contingency management, including state-level fatal overdoses, number of pharmacotherapies, outpatient treatment, facility ownership, and residential treatment. Most evaluated facilities provided contingency management (n = 440; 65.5%). Facilities that prescribed more pharmacotherapies, were located in states with high drug overdose death rates, and for-profit (compared to nonprofit) providers were more likely to offer contingency management. Because contingency management effectively treats substance use disorders, contingency management should be offered more broadly across opioid treatment programs.
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    Assessing departmental readiness to support minoritized faculty
    (Wiley, 2024-02-27) Carter-Veale, Wendy Y.; Cresiski, Robin H.; Sharp, Gwen; Lankford, Jordan D.; Ugarte, Fadel
    Though increasing numbers of racially and ethnically minoritized (REM) individuals earn PhDs and national initiatives focus on faculty diversity, challenges persist in recruiting, hiring, and retaining REM faculty. While a pervasive issue nationally, the literature predominantly focuses on faculty diversity at research-intensive institutions. This exploratory case study pilots a readiness instrument to evaluate the commitment and willingness of a biomedical department at a primarily undergraduate institution to embrace faculty diversity before initiating a postdoctoral faculty conversion program. We introduce the Community Readiness Model (CRM) into an academic context, offering academic departments a robust framework and tool to evaluate readiness and capacity to recruit, retain, and support REM faculty. Practical Takeaways Academic departments can be conceived of as a type of community. The adapted Department Readiness Tool can be a valuable method of evaluating a department's readiness to support the success of underrepresented minority faculty. Departments may score highly on some areas of readiness but relatively low on others, which provides insight into where time and resources should be invested to improve readiness.
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    Abstinence-contingent wage supplements to promote drug abstinence and employment: Post-intervention outcomes
    (Elsevier, 2022-01-20) Novak, Matthew; Holtyn, August F.; Toegel, Forrest; Leoutsakos, Jeannie-Marie; Silverman, Kenneth
    Background Substance use disorder, unemployment, and poverty are interrelated problems that have not been addressed adequately by existing interventions. This study evaluated post-intervention effects of abstinence-contingent wage supplements on drug abstinence and employment. Methods Unemployed adults enrolled in opioid agonist treatment were randomly assigned to an abstinence-contingent wage supplement group (n = 44) or a usual care control group (n = 47). All participants could work with an employment specialist throughout a 12-month intervention period. Those in the abstinence-contingent wage supplement group earned stipends for working with the employment specialist and, after gaining employment, abstinence-contingent wage supplements for working in their community job but had to provide opiate- and cocaine-negative urine samples to maximize pay. To assess post-intervention effects of abstinence-contingent wage supplements and compare those effects to during-intervention effects, we analyzed urine samples and self-reports every 3 months during the 12-month intervention and the 12-month post-intervention period. Results During the intervention, abstinence-contingent wage supplement participants provided significantly more opiate- and cocaine-negative urine samples than usual care control participants; abstinence-contingent wage supplement participants were also significantly more likely to become employed and live out of poverty than usual care participants during intervention. During the post-intervention period, the abstinence-contingent wage supplement and usual care control groups had similar rates of drug abstinence, similar levels of employment, and similar proportions living out of poverty. Conclusions Long-term delivery of abstinence-contingent wage supplements can promote drug abstinence and employment, but many patients relapse to drug use and cease employment when wage supplements are discontinued.
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    Psychosocial Interventions to Promote Undetectable HIV Viral Loads: A Systematic Review of Randomized Clinical Trials
    (Springer, 2021-11-16) Toegel, Forrest; Rodewald, Andrew M.; Novak, Matthew; Pollock, Sarah; Arellano, Meghan; Leoutsakos, Jeannie-Marie; Holtyn, August F.; Silverman, Kenneth
    Suppressing HIV viral loads to undetectable levels is essential for ending the HIV/AIDS epidemic. We evaluated randomized controlled trials aimed to increase antiretroviral medication adherence and promote undetectable viral loads among people living with HIV through November 22, 2019. We extracted data from 51 eligible interventions and analyzed the results using random effects models to compare intervention effects between groups within each intervention and across interventions. We also evaluated the relation between publication date and treatment effects. Only five interventions increased undetectable viral loads significantly. As a whole, the analyzed interventions were superior to Standard of Care in promoting undetectable viral loads. Interventions published more recently were not more effective in promoting undetectable viral loads. No treatment category consistently produced significant increases in undetectable viral loads. To end the HIV/AIDS epidemic, we should use interventions that can suppress HIV viral loads to undetectable levels.
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    The effects of oral and vaporized cannabis alone, and in combination with alcohol, on driving performance using the STISIM driving simulator: A two-part, double-blind, double-dummy, placebo-controlled, randomized crossover clinical laboratory protocol
    (Frontiers, 2022-09-05) Zamarripa, C. Austin; Novak, Matthew; Weerts, Elise M.; Vandrey, Ryan; Spindle, Tory R.
    The legalization of cannabis for medicinal and non-medicinal purposes, and the corresponding increase in diversity of cannabis products, has resulted an urgent need for cannabis regulatory science. Among the most pressing needs is research related to impairment due to cannabis exposure, especially on driving performance. The present project was designed to evaluate the impact of oral and vaporized cannabis, when administered alone or in combination with alcohol, on simulated driving performance (STISIM driving simulator), cognitive/psychomotor ability, and field sobriety performance. Healthy adults will complete two, double-blind, double-dummy, placebo-controlled, randomized crossover clinical laboratory studies, one with oral cannabis (16 men/16 women) and the second with vaporized cannabis (16 men/16 women). In each study, participants will complete seven experimental sessions during which acute doses of placebo or high Δ9-THC cannabis containing 0, 10, or 25 mg Δ9-THC will be administered both alone and in combination with placebo or alcohol-containing beverages (target breath alcohol concentrations, BAC, of 0.0% or 0.05%). A positive control session (i.e., alcohol at target BAC of 0.08% with placebo cannabis) will also be completed. Simulated driving performance tests (available for download; see Methods), field sobriety assessments, subjective drug effect questionnaires, a mobile device impairment test (DRUID app), and collection of whole blood specimens will be completed repeatedly during each session. Linear mixed models will be used to test for differences across experimental conditions and a priori planned comparisons will be used to determine differences between conditions of interest (e.g., cannabis alone vs cannabis with alcohol). This research is designed to extend prior studies of cannabis and alcohol on driving performance by using oral and vaporized routes of cannabis administration. By increasing understanding of impairment associated with co-use of alcohol and these novel forms of cannabis, this research could inform impairment detection standards for cannabis and alcohol and have important implications for law enforcement, public policy decisions regarding accessibility of these substances, and education of the general population who may use cannabis and/or alcohol. Lastly, this manuscript provides interested researchers with access to the simulated driving scenarios and data extraction tools developed for this study as a means of facilitating future cross-study comparisons, which is important given the heterogeneity in methods used across laboratories in prior research.
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    Cost and cost-effectiveness of abstinence contingent wage supplements
    (Elsevier, 2022-12-23) Orme, Stephen; Zarkin, Gary A.; Luckey, Jackson; Dunlap, Laura J.; Novak, Matthew; Holtyn, August F.; Toegel, Forrest; Silverman, Kenneth
    Background Substance use disorders are correlated with unemployment and poverty. However, few interventions aim to improve substance use, unemployment, and, distally, poverty. The Abstinence-Contingent Wage Supplement (ACWS) randomized controlled trial combined a therapeutic workplace with abstinence-contingent wage supplements to address substance use and unemployment. The ACWS study found that abstinence-contingent wage supplements increased the percentage of participants who had negative drug tests, who were employed, and who were above the poverty line during the intervention period. This study presents the cost of ACWS and calculates the cost-effectiveness of ACWS compared with usual care. Methods To calculate the cost and cost-effectiveness of ACWS, we used activity-based costing methods to cost the intervention and calculated the costs from the provider and healthcare sector perspective. We calculated incremental cost-effectiveness ratios and cost-effectiveness acceptability curves for negative drug tests and employment. Results ACWS cost $11,310 per participant over the 12-month intervention period. Total intervention and healthcare costs per participant over the intervention period were $20,625 for usual care and $30,686 for ACWS. At the end of the intervention period an additional participant with a negative drug test cost $1437 while an additional participant employed cost $915. Conclusions ACWS increases drug abstinence and employment and may be cost-effective at the end of the 12-month intervention period if decision makers are willing to pay the incremental cost associated with the intervention.
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    Deployment and Post-Deployment Predictors of Dyadic Adjustment in Military Couples in Long-Term Relationships
    (2023-01-01) Woodward, Bonnie; Franz, Molly; Psychology; Psychology
    Military service members (MSMs) who undergo deployments face many stressors, and this is compounded for those in relationships, for whom deployments can cause strain as the couple navigates life apart. It is important to understand deployment-related factors that increase risk for romantic relationship problems post-deployment. There are indications that stress about life back home, PTSD, and within-unit social support all play a role in romantic relationship outcomes; however, research synthesizing these risk and protective factors has not yet been conducted with MSMs in long-term relationships using longitudinal data. The present study utilized self-report questionnaire data from 84 MSMs in long-term relationships to examine longitudinal predictors and mechanisms of long-term dyadic adjustment. The goal of the study was to investigate a moderated mediation model in which greater homefront stressors were expected to predict lower dyadic adjustment indirectly via higher PTSD avoidance and numbing symptoms, and these associations were expected to be buffered by higher unit support. No significant moderation was found. The trimmed mediation model showed a negative main effect of homefront stress on dyadic adjustment. Contrary to hypotheses, higher avoidance symptoms (but not numbing symptoms) mediated the relationship between greater homefront stress and higher dyadic adjustment. Findings point to the importance of homefront stress as an indicator of later dyadic challenges and suggest that avoidance symptoms may uniquely contribute to MSM-reported dyadic adjustment. Overall, stress experienced during deployment is associated with negative long-term outcomes for MSMs, suggesting the importance of interventions aimed at promoting healthy coping during deployment.
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    “Things that People on the Outside Looking in Don’t Understand”: Child Welfare System Workers' Perspectives of Child Fatality
    (2023-01-01) Peralta, Sarah; Hunter, Bronwyn; Psychology; Psychology
    Across most cultures, the death of a child has been referenced as one of the most traumatic losses imaginable. It challenges our core beliefs about the natural order of the human lifespan and leaves a tremendous impact on the grieving community (Geiss et. al, 1998). Critical examinations of experiences surrounding child death can reveal deeply held attitudes and common beliefs regarding grief responses. This qualitative study explored specific experiences of grief and bereavement from the perspectives of child welfare professionals who are involved in child fatality cases. Nine interviews explored the perspectives of Maryland’s child welfare workers. A rigorous thematic analysis identified and organized patterns in the data across interviews. Emergent themes included persistent sorrow, navigating judgment and blame, coping with emotions and preventing death. Implications are discussed for grief-informed practice in child fatality settings.
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    Trauma Symptoms, Social Support Processes, and Relationship Satisfaction in Newlywed Couples with Histories of Child Maltreatment
    (2023-01-01) Nguyen, Rebecca Le; Franz, Molly R.; Psychology; Psychology
    Many survivors of childhood maltreatment face lifelong problems with relationships, including difficulties with healthy communication and martial satisfaction. Given the increased prevalence and severity of trauma symptoms in survivors of childhood maltreatment, it is important to examine relationship factors that contribute to reduced relationship satisfaction in survivors. Further, there is a paucity of longitudinal, empirical research on couples where both partners have histories of trauma (dual-trauma couples). Therefore, the current study aimed to explore negative social support provision and self-disclosure as mechanisms through which trauma symptoms might impact relationship satisfaction among couples in which both partners have been exposed to childhood maltreatment. At baseline, couples completed self-report measures of trauma symptom severity and were observed in a social support task to measure the frequency of their negative social support provision. One year later, couples self-reported the frequency of their self-disclosure and two years later completed a self-reported measure of marital satisfaction. Higher trauma symptom severity predicted lower marital satisfaction, and negative social support provision predicted lower confiding frequency, among selves and partners. Further, effects emerged such that confiding frequency predicted each person’s (but not their partner’s) relationship satisfaction. The current study extends the literature by demonstrating these associations longitudinally and highlighting implications for clinical practice with dual trauma couples.
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    Behind the Screens of Young Adult Romantic Relationships: A Qualitative Exploration of When Technology Hurts and Why
    (2023-01-01) Farrell, Danielle Margaret; Murphy, Christopher; Psychology; Psychology
    The existing literature on cyber dating abuse (CDA) has largely relied on quantitative research methods focused heavily on defining and measuring the prevalence of CDA, but less is understood regarding the impact of CDA experiences. To address this gap, the current study utilized qualitative, semi-structured interviews with 18 college students who had previously reported having some CDA experiences. Employing Braun and Clarke's framework (2006) for thematic analysis, ten overarching themes were created from the data. Participant responses shed light on the multifaceted nature of CDA, and expressed experiencing far-reaching and oftentimes long-standing impacts to their emotional well-being and social relationships. A notable gap in social awareness of CDA was revealed, indicating the potential utility of a social norms approach to prevention. Research and practice recommendations are provided as well as suggestions for future research.
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    Coping Self-Efficacy and PTSD in Individuals with Substance Use Disorder: The Role of Emotion Regulation
    (2023-01-01) Mette, Meghan ; Schacht, Rebecca L; Psychology; Psychology
    Posttraumatic stress disorder (PTSD) can result from experiencing a single or multiple traumatic event(s), and often co-occurs with substance use disorders (SUD). Coping self-efficacy (CSE) and emotion regulation difficulties have been independently associated with both PTSD and SUD. However, no studies have examined these constructs in tandem as predictors of PTSD, nor has this been studied among a sample of individuals with SUD. The purpose of the current study was to assess the main effects and interaction between CSE and emotion regulation difficulty as predictors of PTSD symptom severity in a sample of 126 individuals in residential substance use treatment. Regression analyses indicated that CSE and emotion regulation difficulty independently predicted PTSD. However, when placed in the model together, CSE did not predict PTSD and there was no interaction between CSE and emotion regulation. These findings suggest that emotion regulation ability may be more significant than CSE in predicting PTSD.
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    A qualitative analysis of trauma narratives among people in treatment for PTSD and substance use disorders
    (2023-01-01) Berg, Samantha Karen; Schacht, Rebecca L; Psychology; Psychology
    Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) are highly comorbid yet PTSD treatment is seldom offered in residential SUD treatment facilities. Written Exposure Therapy (WET) was introduced as a brief PTSD intervention to a clinical sample of participants with comorbid PTSD-SUD. As part of this treatment, patients wrote accounts about the traumatic events that they experienced and the impact of the trauma on their lives. This master's thesis presents a qualitative analysis of trauma narratives among individuals (N = 38) undergoing treatment for PTSD and SUD. There is limited qualitative data on traumatic experiences and reactions of people with comorbid PTSD-SUD. Through thematic analysis, the researcher investigated the intricate connections between trauma, emotional expression, physiological expression, and substance use, aiming to gain insights into the unique challenges and coping mechanisms of this sample. Participants' accounts explore the significant impact of trauma on emotional well-being, relationships, and perspective shift, providing potential implications for trauma-informed interventions in dual-diagnosis treatment settings. The findings shed light on the complex interplay between traumatic experiences, PTSD symptomatology, and patterns of substance use. Four themes emerged from Session 1 accounts: (1) My Heart Dropped, (2) The Pain was Unbearable, (3) All My Fault, and (4) I Started Using. Two themes emerged from Session 5 accounts: (1) My Life has Been Changed and (2) The Future Holds Promise. This study further contributes to the existing literature on trauma and substance use, providing a deeper understanding of the subjective experiences of individuals in residential SUD care with co-occurring PTSD.
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    New U.S. News rankings honor UMBC strengths in teaching, innovation, and inclusion
    (UMBC News, 2020-09-14) McCaffrey, Kait; Winnick, Dinah
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    A vignette-based study examining attitudes toward mental and brain illness in the United States and Pakistan.
    (APA, 2024) Malik, Hinza; Norman, Jasmine B.; Puente, Antonio E.
    Research from both Pakistan and the United States shows a relatively higher stigma for mental illness than physical illness. However, research comparing mental and brain illness is limited. Therefore, using an online survey, the present study examined mental and brain illness stigma, discriminatory potential as manifested via social distance, and perceived causes (biogenetic/moral) in a cross-cultural sample. A total of 918 students (458 Pakistani and 460 American) were recruited from academic institutions. They completed a within-group design survey where measures of stigma (Attribution Questionnaire–9), discriminatory potential (Social Distance Scale), and causal beliefs were administered in the context of mental (either depression or schizophrenia) and brain illness (either dementia or traumatic brain injury) vignettes. The primary analysis of variance results showed that Pakistan had a relatively higher stigma and discriminatory potential than the United States. However, there was no difference in stigma and discriminatory potential between mental and brain illness. Moreover, Pakistani respondents highly endorsed moral causal beliefs, whereas the U.S. respondents endorsed biogenetic causal beliefs, which were relatively higher for mental illness than brain illness in both countries. Notably, these results were sensitive to covariates as investigated in the exploratory model. Hence, this study should be a precursor for future research aimed at the identification of moderators and mediators that account for cross- and within-culture variation. Last, given the cultural variation in causal beliefs and experiences of symptoms, it is essential to engage those with lived experience and locals to identify and include the unique cultural factors that are crucial to the success of an intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
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    Comparing generating predictions with retrieval practice as learning strategies for primary school children
    (2024-02-23) Carvalho, Paulo; Godwin, Karrie E.
    This eye tracking study examines the learning benefits of two common active learning approaches ? generating predictions and retrieval ? for young children. Both generating predictions and retrieval practice are active learning approaches that involve generating responses and then being provided with the correct information or retrieving previously provided correct information. Participants included 90 children (mean age: 7 years; Female = 46, Male = 42). Parents reported children?s race and ethnicity as follows: 2% Asian/Pacific Islander, 5% African American, 74% Caucasian, 3% other, and 6% identified as two or more categories; demographics largely reflective of the county where the data was collected, but nevertheless the generalizability of these findings to more diverse populations may be limited. In this study, young children learned facts about insects (e.g., ?insects are hard on the outside?) while we measured their attention to the lesson using eye tracking technology. Then their knowledge was assessed on an immediate test. All children were presented with the same materials but the presentation order was modified based on condition assignment. In the generating predictions condition, children saw examples of animals and were asked if an animal was an insect or they saw animals and were asked to identify which one was the insect, followed by the correct response. In the retrieve condition, the presentation order was reversed such that children first saw the correct response and then were asked if the animal was an insect or which of two examples was an insect. Results suggest that although retrieval practice results in overall better learning outcomes, generating predictions increased children's attention to the materials (d = 1.92), and among children who were able to maintain attention, learning outcomes were equal among the two conditions.
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    Parent-child relationship buffers the impact of maternal psychological control on aggression in temperamentally surgent children
    (Wiley, 2023-11-07) Sun, Yao; Cheah, Charissa S. L.; Hart, Craig H.
    Children's temperamental surgency is associated with later child behavioral problems. However, the underlying mechanisms linking child surgency and child aggression, such as negative parental control, are relatively understudied. Moreover, the potential protective effect of a close parent-child relationship on these associations remains untested, particularly among non-White families. Participants included 259 Chinese American preschoolers (Mₐgₑ = 4.5 years, SD = .9 years, 50% girls) and their mothers (Mₐgₑ = 37.9 years, SD = 4.7 years), the present study examined the moderating effects of parent-child relationship quality on the association between mother-rated child surgency and teacher-rated child aggression as mediated by maternal psychological control. Overall, results showed that child surgency was linked positively to maternal psychological control, which, in turn, led to higher levels of child aggression six months later, but only when the parent-child relationship quality was less optimal. These findings indicate that psychological control is one underlying mechanism linking child temperament and child maladjustment, and that parent-child relationship quality is an important protective factor. Findings also expand an existing theoretical framework by explicating how these variables are applicable to an Asian American population, suggesting the critical buffering role that parent-child relationship quality plays. The study findings inform efforts to mitigate the potential negative effect of psychological control in reducing childhood aggression.
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    Cascading effects of Chinese American parents' COVID-19 racial discrimination and racial socialization on adolescents' adjustment
    (Wiley, 2023-11-20) Ren, Huiguang; Cheah, Charissa S. L.; Cho, Hyun Su; Aquino, Ana Katrina
    Using a three-wave longitudinal sample of 108 Chinese American parent-adolescent dyads (Mparent-ageW1=45.44 years, 17% fathers; Madolescent-ageW1=13.34 years, 50% boys), this study examined the effects of parents’ COVID-19-related racial discrimination experiences on adolescents’ ethnic identity exploration and anxiety as mediated by parents’ awareness of discrimination (AOD) socialization and moderated by parents’ anxiety and racial socialization competency (RSC). Parents’ racial discrimination experiences in 2020 predicted adolescents' greater ethnic identity exploration or greater anxiety in 2022 via parents’ greater use of AOD in 2021 depending on the levels of parents’ anxiety and RSC. These findings highlighted the roles of individual and contextual factors in impacting racial socialization processes in Chinese American families.