Promoting Effective Coping by Children Exposed to Post-divorce Interparental Conflict to Reduce Risk for Mental Health Problems
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Arizona State University
- Enrollment
- 148
- Locations
- 1
- Primary Endpoint
- interparental emotional security
Study Overview
Brief Summary
This study will identify components for inclusion in a coping intervention package to reduce mental health problems among children exposed to high interparental conflict after parental separation/divorce. Reappraisal, distraction, and relaxation coping strategies are related to fewer mental health problems among children, making intervention components based on these strategies key candidates for inclusion in an optimized coping intervention. The primary aim is to experimentally assess the main and interactive effects of three digital intervention coping components (reappraisal, distraction, relaxation) on children's coping efficacy, emotional security, and internalizing and externalizing problems. Secondary aims are to assess indirect effects of the intervention components on children's coping efficacy, emotional security, and internalizing and externalizing problems through their cognitive, emotional, and behavioral reactions to post-separation/divorce interparental conflict events.
Detailed Description
A randomized and counterbalanced 2x2x2 factorial trial (N = 144 children, ages 9-12) will be conducted to assess the individual effects of the three digital coping intervention components. The three components to be tested will be: (1) Reappraisal (No vs. Yes), (2) Distraction (No vs. Yes), (3) Relaxation (No vs. Yes). Components that meet a priori thresholds for meaningful change will be combined to form an intervention package that will be evaluated in a subsequent randomized controlled trial.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Factorial
- Primary Purpose
- Prevention
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 9 Years to 12 Years (Child)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •child between ages 9-12 whose parents are separated or divorced
- •child and one parent are fluent in English
- •a parent with sufficient contact (i.e., at least 4 overnights and/or 12 daytime visits per month) with child who is willing to complete study assessments and has legal right to give permission for the child to participate in research
- •child-report of high exposure to IPC (mean Z score ≥ 40th percentile on the two child report measures of IPC; score standardization based on data from 559 youth whose parents participated in an experimental parenting program)
- •elevated internalizing or externalizing problems (T score in the borderline clinical range according to either child or parent report on the BPM).
Exclusion Criteria
- •in active therapy
- •score ≥ 99th percentile on either internalizing and externalizing problems subscale
- •endorse suicidality (will be ineligible for the study and referred for treatment)
Arms & Interventions
Education + Reappraisal
Participants will complete an educational digital module and a skills-based digital module that teaches reappraisal coping.
Intervention: Reappraisal Coping (Behavioral)
Education + Distraction
Participants will complete an educational digital module and a skills-based digital module that teaches distraction coping.
Intervention: Education (Behavioral)
Education + Distraction
Participants will complete an educational digital module and a skills-based digital module that teaches distraction coping.
Intervention: Distraction Coping (Behavioral)
Education + Relaxation
Participants will complete an educational digital module and a skills-based digital module that teaches relaxation coping.
Intervention: Education (Behavioral)
Education + Relaxation
Participants will complete an educational digital module and a skills-based digital module that teaches relaxation coping.
Intervention: Relaxation Coping (Behavioral)
Education + Reappraisal + Relaxation
Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches relaxation coping.
Intervention: Education (Behavioral)
Education + Reappraisal + Relaxation
Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches relaxation coping.
Intervention: Reappraisal Coping (Behavioral)
Education + Reappraisal + Relaxation
Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches relaxation coping.
Intervention: Relaxation Coping (Behavioral)
Education + Distraction + Relaxation
Participants will complete an educational digital module and two skills-based digital modules, one that teaches distraction coping and one that teaches relaxation coping.
Intervention: Distraction Coping (Behavioral)
Education + Distraction + Relaxation
Participants will complete an educational digital module and two skills-based digital modules, one that teaches distraction coping and one that teaches relaxation coping.
Intervention: Relaxation Coping (Behavioral)
Education + Reappraisal + Distraction + Relaxation
Participants will complete an educational digital module and three skills-based digital modules, one that teaches reappraisal coping, one that teaches distraction coping, and one that teaches relaxation coping.
Intervention: Education (Behavioral)
Education + Reappraisal + Distraction + Relaxation
Participants will complete an educational digital module and three skills-based digital modules, one that teaches reappraisal coping, one that teaches distraction coping, and one that teaches relaxation coping.
Intervention: Reappraisal Coping (Behavioral)
Education + Reappraisal + Distraction + Relaxation
Participants will complete an educational digital module and three skills-based digital modules, one that teaches reappraisal coping, one that teaches distraction coping, and one that teaches relaxation coping.
Intervention: Distraction Coping (Behavioral)
Education
Participants will complete an educational digital module and no skills-based digital modules.
Intervention: Education (Behavioral)
Education + Reappraisal
Participants will complete an educational digital module and a skills-based digital module that teaches reappraisal coping.
Intervention: Education (Behavioral)
Education + Reappraisal + Distraction
Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches distraction coping.
Intervention: Reappraisal Coping (Behavioral)
Education + Reappraisal + Distraction
Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches distraction coping.
Intervention: Distraction Coping (Behavioral)
Education + Reappraisal + Distraction
Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches distraction coping.
Intervention: Education (Behavioral)
Education + Reappraisal + Distraction + Relaxation
Participants will complete an educational digital module and three skills-based digital modules, one that teaches reappraisal coping, one that teaches distraction coping, and one that teaches relaxation coping.
Intervention: Relaxation Coping (Behavioral)
Education + Distraction + Relaxation
Participants will complete an educational digital module and two skills-based digital modules, one that teaches distraction coping and one that teaches relaxation coping.
Intervention: Education (Behavioral)
Outcomes
Primary Outcomes
interparental emotional security
Time Frame: pretest at study entry
Security in the Interparental Subsystem Scale - Short Form (SIS-SF; Holt et al., 2020) 17 items rated on 4 point scale (0 = not at all true, 3 = very true for me) higher scores indicate better outcome
family emotional security
Time Frame: pretest at study entry
Security in the Family System Scale (SIFS; Forman \& Davies, 2005) 24 items rated on 4 point scale (0 = completely disagree, 3 = completely agree). higher scores indicate better outcome
interparental emotional security
Time Frame: posttest at one month after completion of the last assigned intervention module
Security in the Interparental Subsystem Scale - Short Form (SIS-SF; Holt et al., 2020) 17 items rated on 4 point scale (0 = not at all true, 3 = very true for me) higher scores indicate better outcome
family emotional security
Time Frame: posttest at one month after completion of the last assigned intervention module
Security in the Family System Scale (SIFS; Forman \& Davies, 2005) 24 items rated on 4 point scale (0 = completely disagree, 3 = completely agree). higher scores indicate better outcome
coping efficacy
Time Frame: pretest at study entry
Coping Efficacy Scale (CES; Sandler et al., 2000) 7 items rated on 4 point scale (0 = not at all, 3 = very) higher scores indicate better outcome
coping efficacy
Time Frame: posttest at one month after completion of the last assigned intervention module
Coping Efficacy Scale (CES; Sandler et al., 2000) 7 items rated on 4 point scale (0 = not at all, 3 = very) higher scores indicate better outcome
internalizing problems
Time Frame: pretest at study entry
Brief Problem Monitor (BPM; parent and child report) 6 items rated on a 3 point scale (0= not true, 2 = very true) higher scores indicate worse outcome
internalizing problems
Time Frame: posttest at one month after completion of the last assigned intervention module
Brief Problem Monitor (BPM; parent and child report) 6 items rated on a 3 point scale (0= not true, 2 = very true) higher scores indicate worse outcome
externalizing problems
Time Frame: pretest at study entry
Brief Problem Monitor (BPM; parent and child report) 7 items rated on a 3 point scale (0= not true, 2 = very true) higher scores indicate worse outcome
externalizing problems
Time Frame: posttest at one month after completion of the last assigned intervention module
Brief Problem Monitor (BPM; parent and child report) 7 items rated on a 3 point scale (0= not true, 2 = very true) higher scores indicate worse outcome
interparental emotional security
Time Frame: follow-up at 3 months after completion of the last assigned intervention module
Security in the Interparental Subsystem Scale - Short Form (SIS-SF; Holt et al., 2020) 17 items rated on 4 point scale (0 = not at all true, 3 = very true for me) higher scores indicate better outcome
family emotional security
Time Frame: follow-up at 3 months after completion of the last assigned intervention module
Security in the Family System Scale (SIFS; Forman \& Davies, 2005) 24 items rated on 4 point scale (0 = completely disagree, 3 = completely agree). higher scores indicate better outcome
coping efficacy
Time Frame: follow-up at 3 months after completion of the last assigned intervention module
Coping Efficacy Scale (CES; Sandler et al., 2000) 7 items rated on 4 point scale (0 = not at all, 3 = very) higher scores indicate better outcome
externalizing problems
Time Frame: follow-up at 3 months after completion of the last assigned intervention module
Brief Problem Monitor (BPM; parent and child report) 7 items rated on a 3 point scale (0= not true, 2 = very true) higher scores indicate worse outcome
internalizing problems
Time Frame: follow-up at 3 months after completion of the last assigned intervention module
Brief Problem Monitor (BPM; parent and child report) 6 items rated on a 3 point scale (0= not true, 2 = very true) higher scores indicate worse outcome
Secondary Outcomes
- Emotional distress(daily (6 weeks))
- Cognitive appraisals - conflict specific(daily (6 weeks))
- Cognitive appraisals - general(daily (6 weeks))
- Physiological arousal(daily (6 weeks))
- Coping behaviors - conflict specific(daily (6 weeks))
- Coping behaviors - general(daily (6 weeks))
Investigators
Karey O'Hara
Assistant Professor
Arizona State University