Parental conflict is a well-established risk factor for children’s emotional and behavioral adjustment. Consequently, psychometrically valid tools are required to assess the frequency and type of interparental conflict. The O’Leary-Porter Scale (OPS) is a 10-item caregiver-report measure of overt hostility displayed in front of children. While commonly used, the OPS’s construct validity is not extensively tested outside the United States. The present study evaluated the psychometric properties and measurement invariance of the OPS as part of a multi-country parenting program. Caregivers (n = 752) of children aged 2 to 9 completed the OPS in North Macedonia, Moldova, and Romania. Convergent validity was evaluated through correlations with measures of caregiver distress, parenting stress, couple satisfaction, and positive parenting. Confirmatory factor analysis (CFA) tested a unidimensional structure in each country, followed by multi-group CFA and differential item functioning (DIF) analysis. The original model showed marginal to acceptable fit. Item 10 (reverse‑scored “display affection”) was removed due to low or negative loadings and correlating one item pair improved model fit. Loadings for the final 9-item model were moderate to strong with good internal consistency. Metric invariance was established. Convergent validity showed consistent but variable effects. This is the first multi-country validation of the OPS in over four decades, extending evidence beyond U.S. samples. The OPS shows viability as a tool for measuring children’s exposure to interparental hostility in comparable contexts, and item-level recommendations discussed herein may contribute to refining the scale and improving its applicability in future research.

Background Forcibly displaced adolescents face high rates of mental health problems, yet evidence on the efficacy of psychosocial interventions for this population remains limited. We therefore conducted a meta-analysis of effects on common mental health outcomes. Methods This study was preregistered with PROSPERO (CRD42022354834). We searched PubMed, Web of Science, EMBASE/Medline, and PsycINFO for randomized controlled trials evaluating psychosocial interventions targeting common mental health outcomes in forcibly displaced adolescents, defined as refugees, asylum-seekers and internally displaced persons, aged 10–19 years. Primary outcome was a composite of common mental health outcomes (symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and general psychological distress). We applied a multilevel meta-analytic model to account for correlated effect sizes across studies, intervention arms, outcomes, and timepoints. Publication bias was assessed and subgroup and meta-regression analyses were performed to assess sources of heterogeneity. Findings Across 29 trials and 5,391 participants, psychosocial interventions were associated with a small but statistically significant effect in the composite outcome compared to the control conditions (SMD = −0·22 [95% CI −0·37 to −0·06]; p = 0·005). Secondary analyses showed significant effects for symptoms of PTSD (SMD = −0·25) and anxiety (SMD = −0·56), but not for symptoms of depression or general psychological distress and the long-term follow-up (6−1 2 months). Evidence of publication bias was detected for the composite outcome across timepoints, PTSD, and short-term follow-up. Family-inclusive approaches and interventions for internally displaced adolescents were represented by few studies and require further investigation. Interpretation Psychosocial interventions show short-term promise for better mental health symptoms compared to control conditions in forcibly displaced adolescents, particularly for PTSD and anxiety. The evidence base remains limited because of substantial heterogeneity between studies, publication bias and a lack of high-quality trials, especially in low-income and disaster-affected settings.

PurposeParental conflict is a well-established risk factor for children's emotional and behavioral adjustment. Consequently, psychometrically valid tools are required to assess the frequency and type of interparental conflict. The O'Leary-Porter Scale (OPS) is a 10-item caregiver-report measure of overt hostility displayed in front of children. While commonly used, the OPS's construct validity is not extensively tested outside the United States. The present study evaluated the psychometric properties and measurement invariance of the OPS as part of a multi-country parenting program.MethodsCaregivers (n = 752) of children aged 2 to 9 completed the OPS in North Macedonia, Moldova, and Romania. Convergent validity was evaluated through correlations with measures of caregiver distress, parenting stress, couple satisfaction, and positive parenting. Confirmatory factor analysis (CFA) tested a unidimensional structure in each country, followed by multi-group CFA and differential item functioning (DIF) analysis.ResultsThe original model showed marginal to acceptable fit. Item 10 (reverse-scored "display affection") was removed due to low or negative loadings and correlating one item pair improved model fit. Loadings for the final 9-item model were moderate to strong with good internal consistency. Metric invariance was established. Convergent validity showed consistent but variable effects.ConclusionThis is the first multi-country validation of the OPS in over four decades, extending evidence beyond U.S. samples. The OPS shows viability as a tool for measuring children's exposure to interparental hostility in comparable contexts, and item-level recommendations discussed herein may contribute to refining the scale and improving its applicability in future research.

The World Health Organization Five Well-Being Index (WHO-5) is commonly applied to assess subjective well-being. However, evidence on its ordinal measurement properties among young adolescents, especially in low- and middle-income countries, is scant. In particular, there is a lack of studies that have comprehensively evaluated key Mokken model assumptions, including scalability, monotonicity and invariant item ordering. Evaluating these properties is important as they support the ordinal interpretation of WHO-5 scores and clarify whether the items form an invariant hierarchy. Baseline data from the FLOURISH project, a multi-country study evaluating a family-focused prevention program in Moldova and North Macedonia, were used. The sample comprised 653 adolescents aged 10–14 years. The ordinal scaling properties of the WHO-5 were examined using Mokken Scale Analysis, a non-parametric item response theory approach. Specifically, overall and item-level scalability were evaluated using Loevinger’s H coefficients. Single monotonicity was evaluated by examining local decreases in item step response functions, while invariant item ordering was assessed by examining pairwise intersections between manifest item response functions. The accuracy of the estimated ordering was evaluated using the HT coefficient. Analyses were also conducted separately by gender and country. The WHO-5 demonstrated strong overall scalability (h = 0.53, 95

Sexual violence against women is a global health concern, frequently perpetrated by intimate partners. However, meta-analytical evidence on the effectiveness of psychosocial interventions on intimate partner sexual violence (IPSV) remains limited. This study systematically reviewed and meta-analyzed randomized controlled trials evaluating such interventions. Following PRISMA guidelines, we searched ERIC, PsycINFO, PsycArticles, PubMed, and Web of Science databases from inception through July 1, 2024. Eligible studies were RCTs evaluating psychosocial programs (defined as structured interventions targeting individual or relational skills, behaviors, or wellbeing through educational, cognitive, behavioral, or counseling components) and reporting women's experiences of IPSV as an outcome. Risk of bias was assessed using the revised Cochrane tool. Random-effects meta-analyses pooled odds ratios (ORs), and subgroup and meta-regression analyses explored moderators. Thirty-two trials (22,715 women; 13,588 men) met inclusion criteria. Women-only interventions showed a modest effect on IPSV (OR = 0.79; 95% CI: 0.66-0.95), but this was no longer evident after adjustment for publication bias (trim-and-fill OR = 1.00; 95% CI: 0.81-1.20). In contrast, couple-based interventions were associated with a lower likelihood of IPSV (OR = 0.55; 95% CI: 0.39-0.79), with no indication of publication bias. Subgroup analyses indicated stronger effects for couple-based than women-only interventions. Overall, women-only interventions remain central for survivor support but show limited evidence of effectiveness for IPSV, whereas couple-based approaches may hold promise, particularly in primary prevention contexts. Further rigorous trials are needed to clarify the role of prevention aims, intervention mechanisms, and target populations.

Introduction Parenting interventions have shown promise in improving mental well-being for parents and children and strengthening family relationships. Parenting for lifelong health (PLH) is an open-access, evidence-informed programme that aims to improve positive parenting practices, reduce family violence and promote mental health, particularly in low-resource settings. This study will evaluate the implementation and (cost-)effectiveness of an adapted version of the PLH for Parents and Teens programme. It will focus on supporting positive parenting, communication, mental health and well-being of adolescents and their caregivers in North Macedonia and Moldova. Methods and analysis This multicountry hybrid type 1 effectiveness-implementation randomised waitlist-controlled trial will recruit 660 adolescents aged 10–14 years and their caregivers through schools, Youth Clinics and community partner organisations, including vulnerable and linguistically diverse families. The intervention group will receive the adapted PLH programme with assessments conducted postintervention and at 6-month follow-up. The waitlist control group will receive the adapted PLH programme after completion of the intervention group’s 6-month post-baseline assessment. Primary outcomes include adolescent emotional problems, family functioning, parenting practices, adolescent and caregiver quality of life. Secondary outcomes assess a range of mental well-being, family and other psychosocial outcomes. Other prespecified outcomes include implementation and cost outcomes. Primary analyses will compare intervention and waitlist control groups at postintervention and 6-month follow-up using intention-to-treat, baseline-adjusted linear mixed models. A within-trial economic evaluation will include cost–utility analysis and cost-effectiveness analysis. A macroeconomic analysis will assess broader economic impacts using public financing and budget impact analysis. The study uses a mixed-methods process evaluation, and integrates qualitative data, budget impact analysis and simulation modelling to inform scale-up considerations. Ethics and dissemination The study has received ethical approval from all relevant sites. Results will be disseminated through peer-reviewed publications, scientific conferences and webinars, newsletters, social media and open-access platforms, alongside engagement with researchers, clinicians, policymakers and the public. The Family-Focused Adolescent & Lifelong Health Promotion project uses a targeted communication and dissemination strategy for families, implementers and policy stakeholders to promote the adoption and scale-up of evidence-informed, open-access parenting interventions for adolescents and caregivers in low-resource settings. Dissemination focuses primarily on North Macedonia and Moldova while also engaging actors across the wider Eastern European region. Trial registration number NCT07240571 .

Introduction Adolescent mental health problems represent a significant global health issue, particularly in low- and middle-income countries, such as the Republic of North Macedonia and the Republic of Moldova. Effective and scalable interventions are urgently needed to address these challenges.Methods and analysis This protocol outlines a multicountry cluster randomised factorial trial, implemented according to the multiphase optimisation strategy (Phase 2), which evaluates the effectiveness and costs of three add-on components for the Parenting for Lifelong Health for Parents and Teens programme: adolescent mental health tools based on UNICEFs Helping Adolescents Thrive comics, adolescent peer support based on UNICEFs ‘I Support My Friends’ intervention and engagement booster designed to enhance attendance and programme completion through incentives. The study will recruit 720 families and involve 64 clusters in North Macedonia and Moldova. Primary outcomes will include adolescent internalising problems and social support, family functioning and attendance during the programme. Secondary outcomes will assess broader aspects of mental health among caregivers and adolescents, as well as implementation and cost outcomes. Data will be collected at baseline and postintervention, approximately, 8 weeks later. Statistical analyses will include regression models to assess the main and interaction effects of the intervention components and cost analyses.Ethics and dissemination The study received ethical approval from the University of Klagenfurt in Austria (approval number: 2023–013), the Medical Faculty at St. Cyril and Methodius University in North Macedonia (approval number: 03-2144/4) and the National Committee of Ethical Expertise for Clinical Trials in Moldova (approval number: 1476). The results will be disseminated through peer-reviewed journals, conferences, webinars in multiple languages, regional forums, stakeholder meetings with policymakers and practitioners, public communication through media engagement and open access platforms, including data sharing and early release of findings.Trial registration details Trial registration: NCT06562244; Project page: https://www.flourish-study.org/about.html

Despite the high rates and detrimental consequences of co-occurring intimate partner violence (IPV) and offspring child maltreatment (CM), research regarding their potential spillover mechanisms is scarce. This study aims to examine the relation between IPV and CM and the potential mediating roles of maternal depression, anxiety and stress symptoms as well as children´s externalizing behavior problems. Within this model, the potential moderating effect of mothers' own history of CM in the link between IPV and maternal depression, anxiety and stress symptoms is investigated. In this cross-section and longitudinal study, an Eastern European sample of 701 mothers (Mage = 35.5; range 21 – 52) with children aged 2–9 years completed a battery of self-report questionnaires at three timepoints (baseline, after 7 and 11 months). Mothers reported on IPV victimization (Conflict Tactics Scale), offspring CM (ISPCAN Child Abuse Screening Tool), maternal mental health symptoms (Depression Anxiety Stress Scales), and children’s externalizing behavior problems (Child Behavior Checklist). Path models were used to test indirect and moderated indirect effects. Cross-sectionally, maternal mental health and child externalizing behavior partially mediated the effect of IPV on CM. Results could not be replicated when using longitudinal data. Maternal history of CM did not moderate the strength of the association between IPV and maternal mental health problems. Cross-sectional findings implicate that maternal and child mental health problems, as well as the mother’s own history of CM, seem to be key players in the cycle of violence. Findings may encourage practitioners to target more than one outcome when implementing early interventions for preventing mental health problems or reducing family violence. NCT03865485 registered in ClinicalTrials.gov on March 5, 2019.

Importance:Sexual violence against children is a global concern, yet worldwide figures of its prevalence are scant. Objective:To estimate the global prevalence of sexual violence against children using national-level population-based studies. Data Sources:We searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024. Study Selection:Reports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children's self-reports of sexual violence perpetrated by anyone. Data Extraction and Synthesis:Data extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators. Main Outcomes and Measures:Primary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment. Results:We identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses. Conclusions and Relevance:The findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys. Study Registration:PROSPERO CRD42022327090.

ImportanceSexual violence against children is a global concern, yet worldwide figures of its prevalence are scant.ObjectiveTo estimate the global prevalence of sexual violence against children using national-level population-based studies.Data SourcesWe searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024.Study SelectionReports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children’s self-reports of sexual violence perpetrated by anyone.Data Extraction and SynthesisData extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators.Main Outcomes and MeasuresPrimary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment.ResultsWe identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses.Conclusions and RelevanceThe findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys.Study RegistrationPROSPERO CRD42022327090

Objective: Interpersonal partner violence (IPV) is a pervasive social and public health problem worldwide. In the context of the response by the World Health Organization to this issue, proposals were developed to improve the usefulness of International Classification of Diseases (ICD-11) descriptions for helping clinicians to reliably identify relational problems and maltreatment (RPM), including IPV, as part of clinical practice. This study focuses on factors associated with the accuracy of diagnostic decisions made by mental health professionals (MHPs) around the world when using the proposed ICD descriptions for RPM with standardized clinical vignettes in an ICD-11 internet-based field trial study. Method: A total of 1,221 MHPs from ninety countries evaluated randomly assigned vignettes, which described patients presenting with or without RPM and with or without a co-occurring depressive or anxiety disorder. Results: Findings showed that increased diagnostic accuracy for RPM was associated with MHPs being female or having greater knowledge/experience of RPM, as well as with the absence of a mental disorder in the patient. Conclusions: Findings highlight the importance of providing IPV-related training programs for MHPs to (a) better identify and address IPV in mental health settings and (b) improve knowledge and understanding of the consequences of IPV for physical and mental health.

Health-related worries can be either self-directed or occur in close relationships by proxy (e.g., among parents, couples, or pet owners). Our aim was to test the feasibility of assessing health anxiety by proxy in parents and to examine the relationship of health anxiety with family well-being. Health anxiety by proxy was measured between parent-child and parent-partner relationships with adapted versions of the modified Short Health Anxiety Inventory. Parents reported significantly higher levels of health anxiety by proxy regarding their child than for themselves, t (585) = −3.61, p < .001. Exploratory factor analysis showed that each health anxiety questionnaire formed a distinct latent factor. Parenting stress and poorer family functioning had small associations with health anxiety towards one’s self, child, and partner ( r = 0.15 to r = 0.20). Further research is needed to determine clinical relevance and its impact on health behaviors and functioning within the family unit.

Child abuse is prevalent worldwide, with most of the burden in developing countries. To reduce and prevent child abuse occurrence, many efforts are directed toward reducing maladaptive parental behaviors (MPBs), a predictor of parents' risk of engaging in child abusive behaviors. MPBs have been associated with child (e.g., behavioral difficulties) and parent characteristics (e.g., parenting stress and parental cognitions), although little research tested for mediational pathways. This study aimed to test the pathways through which child and parent characteristics are linked to MPB. Consistent with the social information processing model of parenting, we hypothesized that child behavioral difficulties would exert an indirect influence on MPB through parenting stress and that parenting stress will exert a direct and indirect effect on MPB through parental cognitions (i.e., expectations, attitudes, and attributions). This study used data from 243 mothers of children aged between 2 and 9 years in Romania. Two-stage structural equation modeling was employed to test the hypothesized model. Results support the role of child behavior, parenting stress, and parental cognitions in predicting MPB (R 2 = 0.69). Significant indirect effects were found from child behavior to MPB via parenting stress and parental cognitions. Direct effects from parenting stress and parental cognitions to MPB were significant. Findings show that parenting stress and parental cognitions are important mechanisms through which child behavioral difficulties influence maladaptive parental behavior, underscoring the need to focus on these mechanisms when assessing or intervening with families at risk for child abuse.

BackgroundHealth promotion and growth-based interventions can effectively improve individual well-being; however, significant gaps in access and utilization still exist. ObjectiveThis study aims to develop and test the effectiveness and implementation of a new, widely targeted conversational agent prevention program (Zenny) designed to enhance well-being. MethodsA total of 1345 individuals in the United States were recruited online and randomly assigned to either (1) a self-help program intervention delivered via an automated conversational agent on WhatsApp or (2) an active control group that had access to evidence-based wellness resources available online. The primary outcomes were well-being (measured using the 5-item World Health Organization Well-being Scale), psychosocial flourishing (assessed with the Flourishing Scale), and positive psychological health (evaluated with the Mental Health Continuum-Short Form). Outcome measures were collected at baseline and again 1 month postassessment. All analyses were conducted using an intention-to-treat approach. ResultsBoth groups showed significant improvements in well-being (self-help program intervention group effect size: Cohen d=0.26, P<.001; active control group effect size: d=0.24, P<.001), psychosocial flourishing (intervention: d=0.19, P<.001; active control: d=0.18, P<.001), and positive psychological health (intervention: d=0.17, P=.001; active control: d=0.24, P<.001) at postassessment. However, there were no significant differences in effectiveness between the 2 groups (P ranged from .56 to .92). As hypothesized a priori, a greater number of days spent actively engaging with the conversational agent was associated with larger improvements in well-being at postassessment among participants in the intervention group (β=.109, P=.04). ConclusionsThe findings from this study suggest that the free conversational agent wellness self-help program was as effective as evidence-based web resources. Further research should explore strategies to increase participant engagement over time, as only a portion of participants were actively involved, and higher engagement was linked to greater improvements in well-being. Long-term follow-up studies are also necessary to assess whether these effects remain stable over time. Trial RegistrationClinicalTrials.gov NCT06208566; https://clinicaltrials.gov/ct2/show/NCT06208566; OSF Registries osf.io/ahe2r; https://doi.org/10.17605/osf.io/ahe2r

Objective: This study aimed to evaluate the factor structure of the Depression Anxiety and Stress Scale (DASS-21) among caregivers of young children in Southeastern Europe. Background: The DASS-21 is a widely used measure in prevention and intervention research with families. Studies regarding the scale's psychometric properties among caregivers, particularly from non-Western countries, are limited and additional research is required. Method: The DASS-21 was administered to N = 835 primary caregivers from North Macedonia, the Republic of Moldova, and Romania. Competing models were tested with confirmatory factor analysis (CFA). Measurement invariance was assessed using multigroup CFA (MGCFA). Bifactor dimensionality and reliability indices were used to evaluate the validity of the composite and subscale scores. Results: A tripartite bifactor model with two specific factors (depression and anxiety) and one general factor (negative affectivity) represented the data well. This model showed cross-country configural and partial metric invariance. Dimensionality and reliability indices supported a unidimensional interpretation of the measure, with the general negative affectivity factor accounting for a substantial share of the variance (82%) compared to the specific factors of depression (10%) and anxiety (8%). Conclusion: The tripartite model best represented the data. Configural and partial metric invariance were verified for this model. Dimensionality and reliability indices, however, indicate that the DASS-21 functions best as a general measure of negative affectivity.

Abstract Background Clinicians and researchers should consider the expected benefits and potential harms of an intervention. Parenting programmes are a widely used evidence-based intervention for child behaviour problems. However, few data are available on potential negative effects. The aims of this paper were to increase systematic knowledge of adverse event (AE) assessment in parenting programmes and to provide an AE assessment tool. Methods As part of the RISE project (prevention of child mental health problems in South-eastern Europe—adapt, optimise, test and extend parenting for lifelong health), we developed and tested an AE assessment procedure in three sequential studies for parents of children with child behaviour problems aged 2 to 9 years in North Macedonia, Republic of Moldova, and Romania. This paper reports on the development of the assessment tool in phase 1 (N = 140), phase 2 (N = 835), and the final experiences with using the optimised procedures in phase 3 (multisite randomised controlled trial, N = 823) in which AEs were assessed before, three times during intervention delivery, and at 1 year follow-up. At each time point, the participants completed a 12-item AE checklist. If moderate-to-severe problems of parent or child were reported, a structured follow-up interview was conducted. Results The response rate on the AE assessment tool increased from 6% (phase 1) to 100% (phase 3) indicating improvement in collecting these data based on the experiences of each phase. Results of the RCT (phase 3) showed generally low (S)AE frequencies with the finally optimised procedure: During the intervention, no serious adverse events (SAE) were registered; at least one AE was reported by 10% (after the first session), 7% (after the third session), and 4% (after the last fifth session) of participants. None of the identified (S)AEs was causally related to the study or intervention. Cost–benefit considerations are needed to determine the best way to ensure participant safety in parenting programmes. Conclusion The applied active AE assessment procedure provides a comprehensive AE assessment tool that can be used by others—with adaptations for the specific context, if needed. Based on our experiences, we outline recommendations for future studies. Trial registration ClinicalTrials.gov, registration number phase 1: NCT03552250; phase 2: NCT03865485, phase 3: NCT04721730. Registered on 13 January 2021.

Information and communication technologies (ICT) provide digital tools to support and facilitate social engagement. However, the extent to which new ICTs, such as instant messaging, and training on its use, enhance intergenerational family interactions and reduce social isolation and loneliness needs further exploration. In the present study, we developed a brief psychoeducational intervention to promote older adults and their family members (N = 64) to use new technologies to increase communication with each other. With a randomized controlled trial design, we evaluated the effectiveness of the intervention in changing primarily participants' intergenerational interactions, perceived social isolation, and loneliness. Through repeated-measures analysis of variance, an overall condition by time effect was found in younger family members such that contact frequency improved in the intervention condition compared with the waitlist control condition. Using a dyadic framework, we further investigated the role of the intervention in fostering interactions among family members. Dyadic analyses showed a partner effect with contact frequency in younger adults at pre-assessment predicting contact frequency of older adults at post-assessment. This suggests that support and encouragement from younger family members could increase intergenerational interactions and technology adoption among older adults. Moreover, online phone calls served as a promising tool to enhance intergenerational communication; higher user satisfaction was associated with increased ICT use, perceived usefulness, and fewer barriers to technology. This study provides preliminary findings on the effectiveness of ICT-based interventions for engaging older adults and their family members in the use of newer technologies to promote intergenerational interactions and reduce social isolation.

ObjectiveThe goal was to test the validity of the dual filial piety model in Austria and examine how the reciprocal and authoritarian filial piety interplay with familial factors and one's tobacco and alcohol use. BackgroundFamilial influences on substance use have been identified. Being conceptualized as a Chinese construct, research on filial piety and its interplay with substance use is insufficient in Western populations. MethodUsing a cross-sectional survey including filial piety, familial variables, psychopathy traits, and alcohol use, we collected data from 201 Austrian community members (63.0% female; M-age = 35.15 years). Another age-stratified random sample with 202 Austrians was also subsequently recruited to replicate the original findings. Multiple correlational analyses and confirmatory structural equation modeling were utilized on both samples, separately. ResultsThe dual filial piety model was found as a robust construct in both samples, with an acceptable scalability (Cronbach's alpha > .70). Although filial piety was unassociated with substance use, earlier experiences and psychopathy traits both showed consistent correlations with substance use. Un-directional network analysis among variables further revealed an association between ever smoking experience and adverse childhood experiences, which was replicated in the second sample. ConclusionsThis study highlights the utility of filial piety in non-Eastern populations. Filial piety was associated with substance use in one sample, but more research from family and developmental psychology is needed given its close relationships with childhood aversive experiences and remembered parental support.

This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N-1( )= 112, N-2 ( ) = 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Mothe ŕs own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence.