Effects of parenting education with expectant and new parents: A meta-analysis.

The present meta-analysis integrates the effects of randomized controlled trials that focus on promoting effective parenting in the transition to parenthood. We included 142 papers on interventions which started during pregnancy or in the first 6 months after birth. Computations were based on random-effects models. On average, interventions had small to very small significant effects on parenting (d = .35 SD units), parental stress (d = .20), child abuse (d = .13), health-promoting behavior of parents (d=.15), cognitive development (d = .24), social development (d = .30), motor development of the child (d = .15), child mental health (d = .40), parental mental health (d = .31), and couple adjustment (d = .13). Most of the effects were maintained at follow-up. Effects varied by onset of the intervention, delivery mode, qualification of the intervener, length of intervention, intervention goals, and gender distribution. In addition, we found that older studies reported greater effect sizes. We conclude that parenting-focused interventions are effective and should be made accessible to more expectant and new parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of childhood sexual abuse and family functioning on four dimensions of women's later parenting

OBJECTIVE: While child sexual abuse and its negative effects have been of increasing interest to researchers and practitioners, more empirical focus has been given to measuring mental health consequences rather than other areas of life functioning such as parenting. Furthermore, recent questions have been raised about whether documented negative effects of abuse stem from the abuse itself or the more general negative family environment which often accompanies it. The aim of the current study was to examine the impact of a history of child sexual abuse and more general family relationship quality on the parenting of a sample of low-income mothers. METHOD: The current study was a secondary analysis of archived data collected by Zuravin (1996) on 518 low-income mothers. Parenting was assessed using measures such as frequency of worry about child problems, views of self as a parent, and how child discipline problems were handled. RESULTS: Child sexual abuse was associated with more negative views of self as a parent and the greater use of physical punishment strategies even after accounting for differences in family-of-origin relationship quality. CONCLUSIONS: The findings indicate that sexual abuse may be a risk factor for more negative views of self as a parent beyond differences between abused and nonabused samples in more general assessments of family-of-origin quality. Implications for future research and intervention are discussed.     

Effects of maternal age on parenting role.

Examined the proposition that maternal age influences parental role performance and satisfaction. Mothers, ranging in age from 16 to 38 yrs, comprised 53 full-term and 52 preterm dyads. Perceptions of parenting role were assessed 1 mo after hospital discharge of infancts using the Satisfaction with Parenting Scale; interactive behaviors were observed when infants were 4 mo old. When other demographic factors and psychosocial variables were controlled, increased maternal age was significantly related to greater satisfaction with parenting, to greater time commitment to that role, and to more optimal observed behavior. Effects of maternal age on observed behavior were stronger in the term sample, whereas effects of maternal age on role satisfaction were stronger in the preterm group. Results indicate that maternal age should be accounted for in studies of mother–infant interaction and child outcomes; the suggestion of linear age effects argues against popular beliefs that adolescent and late childbearing represent unique categories of risk for poor parenting outcomes. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of antihypertensive drugs on coronary artery disease risk: a meta-analysis

1. The effects of antihypertensive drugs on lipids may also influence their effect on coronary artery disease (CAD). However, the clinical significance of these effects and the extent to which they persist during long-term therapy is uncertain. 2. We performed a meta-analysis on 23 randomized trials published between 1988 and 1994 that compared the effects of atenolol, celiprolol (a beta-blocker with beta 2-adrenoceptor intrinsic sympathomimetic activity), enalapril, nifedipine and doxazosin on plasma cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides and blood pressure (BP). 3. Predicted changes in CAD risk were calculated by incorporating the results for these parameters into the Framingham equations. 4. While there were no differences in antihypertensive efficacy between the drugs, atenolol significantly (P < 0.05) reduced HDL-C and increased total cholesterol, LDL-C and triglycerides compared with celiprolol, enalapril, doxazosin and nifedipine. 5. The magnitude of the effects on lipids was not significantly influenced by the duration of therapy (up to 3 years for atenolol and doxazosin and up to 2 years for celiprolol). 6. The improvement in Framingham equation point scores (systolic BP formula) was significantly (P < 0.05) less for atenolol (-0.54; confidence intervals (CI) -0.29-(-0.78)) than for celiprolol (-1.69; CI -0.68-2.70), doxazosin (-1.67; CI -1.11-(-2.23)), enalapril (-1.43; CI 0.23-(-3.07)) and nifedipine (-1.91; CI -1.22-(-2.59)). Similar results were obtained for the Framingham diastolic BP formula. 7. These results suggest that the adverse effects of atenolol ]on plasma lipids do not improve with prolonged therapy and are theoretically great enough to reduce its efficacy in reducing CAD by approximately two thirds compared with antihypertensive drugs that do not adversely affect plasma lipids. However it must be emphasized that these are theoretical effects. In order to determine the actual differences between these drugs on CAD end points, studies using these end points are required.     

Effects of diet and diet-plus-exercise programs on resting metabolic rate: a meta-analysis

Studies examining the effects of diet (D) and diet-plus-exercise (DE) programs on resting metabolic rate (RMR) report equivocal results. The purpose of this study was to use meta-analysis to determine if exercise prevents the decrease in RMR observed with dieting. Results from the 22 studies included in this analysis revealed that the majority of studies used female subjects ages 31-45 years, who were fed a relatively low-fat, high-carbohydrate diet of less than 5,023 kJ.day-1. The predominant prescribed exercise was aerobic in nature, 31-60 min in duration, performed 4-5 days per week, and of moderate intensity (51-70% of VO2max). Contrary to what is reported in narrative reviews, RMR decreased significantly with both D and DE programs, and the drop with D was significantly greater than that with DE. In conclusion, the addition of exercise to dietary restriction appears to prevent some of the decrease in RMR observed in premenopausal women.     

Effects of involvement on persuasion: A meta-analysis.

Defines involvement as a motivational state induced by an association between an activated attitude and the self-concept. Integration of the available research suggests that the effects of involvement on attitude change depended on the aspect of message recipients' self-concept that was activated to create involvement: (a) their enduring values (value-relevant involvement), (b) their ability to attain desirable outcomes (outcome-relevant involvement), or (c) the impression they make on others (impression-relevant involvement). Findings showed that (a) with value-relevant involvement, high-involvement subjects were less persuaded than low-involvement subjects; (b) with outcome-relevant involvement, high-involvement subjects were more persuaded than low-involvement subjects by strong arguments and (somewhat inconsistently) less persuaded by weak arguments; and (c) with impression-relevant involvement, high-involvement subjects were slightly less persuaded than low-involvement subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding child-based effects on parenting: Temperament as a moderator of genetic and environmental contributions to parenting.

The degree to which child temperament moderates genetic and environmental contributions to parenting was examined. Participants were drawn from the Nonshared Environment and Adolescent Development project and included 720 sibling pairs, ages 13.5 + 2.0 years (Sibling 1) to 12.1 + 1.3 years (Sibling 2). The sample consisted of 6 sibling types: 93 monozygotic twin pairs, 99 dizygotic twin pairs, and 95 full sibling pairs from never-divorced families and 182 full-sibling, 109 half-sibling, and 130 unrelated-sibling pairs residing in stepfamilies. Composite child temperament ratings (negative emotionality, activity, shyness, and sociability) were derived from mothers' and fathers' reports. Composite parenting ratings (negativity, warmth) for mothers and fathers were generated from children's and parents' reports. Analyses indicated that at higher levels of negative emotionality and sociability, child-based genetic contributions to mothers' and fathers' negativity increased, whereas the contributions of environmental factors declined. The opposite pattern was observed for child shyness. These same characteristics had less impact on parental warmth. For fathers only, nonshared environmental contributions to fathers' warmth increased in the presence of high child activity and sociability but declined when children were very shy. Overall these findings indicate that child-based effects on negative parenting are enhanced when children demonstrate potentially challenging characteristics but are weaker in the absence of such characteristics. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Parental factors and the young child's postdivorce adjustment: A meta-analysis with implications for parenting arrangements.

A model-based meta-analytic review highlighted relationships critical for understanding the young child's postdivorce adjustment when planning parenting arrangements. This review confirmed the utility of an interactional model that includes preseparation information and information about father, mother, and the parental alliance. Interactions among the quality and frequency of father's involvement in relation to postdivorce child adjustment that were not clear in studies looking only at direct effects of father-access variables were identified. Results indicated that maternal variables should not be viewed in isolation from the parental alliance or from the father-child relationship. The review discusses variables promoting developmental competence as well as risk factors that clearly interfere with both parental and child functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influences of socioeconomic status, social network, and competence on subjective well-being in later life: A meta-analysis.

Meta-analysis is used to synthesize findings from 286 empirical studies on the association of socioeconomic status (SES), social network, and competence with subjective well-being (SWB) in the elderly. All three aspects of life circumstances are positively associated with SWB. Income is correlated more strongly with well-being than is education. The quality of social contacts shows stronger associations with SWB than does the quantity of social contacts. Whereas having contact with friends is more strongly related to SWB than having contact with adult children, there are higher associations between life satisfaction and quality of contact with adult children when compared with quality of friendships. Moderating influences of gender and age on the effects of SES, social network, and competence on SWB are also investigated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of venlafaxine on blood pressure: a meta-analysis of original data from 3744 depressed patients

BACKGROUND: Venlafaxine hydrochloride, a structurally novel antidepressant, is also the first nontricyclic serotonin/norepinephrine reuptake inhibitor. Although venlafaxine has an overall side effect and safety profile that is comparable to other newer antidepressants, it can cause both transient and sustained elevations of supine diastolic blood pressure (SDBP), probably the result of noradrenergic potentiation. METHOD: Presented here is a meta-analysis of original data on blood pressure, using both random effects and a multivariate survival analyses. The sample consisted of 3744 patients with major depression who were studied in controlled clinical trials comparing venlafaxine with imipramine and/or placebo. Patients were treated for 6 weeks of acute phase therapy; some responders received up to 1 year of continuation phase therapy. RESULTS: Venlafaxine and imipramine were associated with small, but statistically significant, increases in SDBP during acute phase therapy. When compared with imipramine and placebo, venlafaxine was also associated with a greater proportion of persistent elevations of SDBP during continuation therapy. The effect of venlafaxine was highly dose dependent, and the incidence of elevated SDBP was statistically and clinically significant only at dosages above 300 mg/day. Venlafaxine did not adversely affect the control of blood pressure for patients with preexisting high blood pressure or elevated baseline values. CONCLUSION: Venlafaxine has a dose-dependent effect on SDBP that is clinically significant at high dosages. Concern about blood pressure effects should not deter first-line use of this effective antidepressant, although more extensive studies of patients with cardiovascular diseases are still necessary.     

Effects of psychotherapeutic treatments for PTSD: a meta-analysis of controlled clinical trials

This meta-analysis synthesized the results from controlled, clinical trials of psychotherapeutic treatments for posttraumatic stress disorder (PTSD). Psychotherapeutic modalities included behavioral, cognitive, and psychodynamic treatments, in group and individual settings. Participants in the studies included combat veterans from the Vietnam and Lebanon Wars, crime-related victims, and severe bereavement sufferers. The impact of psychotherapy on PTSD and psychiatric symptomatology was significant, d = .52, r = .25, when measured immediately after treatments were administered. Similarly, there was no decay in the effect of treatment at follow-up, d = .64, r = .31. Moreover, for target symptomes of PTSD and general psychological symptomes (intrusion, avoidance, hyperarousal, anxiety, and depression), effect sizes were significant, ranging from r's of .2-.49. Results suggest substantial promise for improving psychological health and decreasing related symptoms for those suffering from PTSD.     

Effects of marital conflict on subsequent triadic family interactions and parenting.

This study examined marital conflict's indirect effects on children through disruptions in family alliances and parenting. Forty married couples were observed interacting with their 6–8-year-old sons after pleasant and conflictual discussions. After conflictual discussion, fathers showed lower support/engagement toward sons, and coparenting styles were less democratic. Couple negativity was correlated with family negativity, regardless of the topic of discussion, which suggests continuity in the affective quality of the two family subsystems. Mothers' marital satisfaction moderated families' responses to the experimental manipulation. The results provide stronger evidence than previously available of a causal link between conflict and disrupted parenting. Further research is needed to identify which conflict-related disruptions in parenting influence the development of children's problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief report: HIV-exposed newborns show inferior orienting and abnormal reflexes on the Brazelton Scale

Despite radiographic complete remission after standard induction therapy, 75% of SCLC patients will have tumor in the resected specimen. This and the high rate of local recurrence indicates that surgery may assume a greater role in the future if better control can be obtained for distant disease and local relapse thus becomes the mode of death.     

Effects of mother's parenting practices on child internalizing trajectories following partner violence.

Studies of children's functioning following exposure to a traumatic event rarely have investigated change over the weeks following the event, but examining recovery in the short aftermath of a traumatic event is important for understanding vulnerability to subsequent disorder, as well as the potential utility of preventive interventions. Data are reported from a short-term longitudinal study of 35 mother-child dyads over 14 weeks following exposure to an incident of severe intimate partner violence. Using a developmental-ecological framework, we proposed that maternal parenting practices would be associated with children's recovery, and that maternal distress would be associated with her parenting practices. Consistent with hypotheses, observed parenting practices at baseline predicted the trajectory of children's self-reported internalizing problems over the study period. Maternal mental health problems were associated with child depression symptoms, but not with overall child internalizing symptoms. Parenting was not associated with maternal mental health symptoms. Further studies should pay closer attention to the role of parenting in children's adjustment in the aftermath of a traumatic event. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of deficient reporting on meta-analysis: A conceptual framework and reanalysis.

Presents a framework for studying the influence of reporting quality on meta-analytic results in which 3 sources of reporting deficiency are identified: quality (adequacy) of publicizing, quality of macrolevel reporting, and quality of the review process in a different way. To assess the influence of reporting quality empirically, 25 reports were sampled from the psychotherapy meta-analysis reported by M. L. Smith et al (1980) and recorded by the present authors. Two sources of information pertinent to reporting quality were established: interrater reliabilities and confidence judgments. Reanalyses incorporating reliability corrections and confidence judgments suggested that deficient reporting injects considerable noise into meta-analytic data and can lead to spurious conclusions. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of family and marital psychotherapies: A meta-analysis.

This meta-analysis of 163 randomized trials (including 59 dissertations) examines a number of questions not studied in previous syntheses. These include differences in outcome associated with different theoretical orientations, differences between marital and family therapies versus individual therapies, the clinical significance of therapy outcome, differences between marital versus family therapies in both outcomes and problems treated, and the effects of various substantive and methodological moderators of therapy outcome. The review concludes with some observations about the methodological status of this literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marriage and the parenting alliance: longitudinal prediction of change in parenting perceptions and behaviors

The study evaluates how marriage and the parenting alliance affect parenting experiences over time. Couples (N = 79) with school-age children who have mental retardation completed self-report and observational measures of marriage, the parenting alliance, and parenting attitudes and behaviors at 2 periods, 18-24 months apart. Longitudinal structural equation modeling demonstrated significant effects of marital quality on changes over time in self-reports of perceived parenting competence for both the mothers and the fathers, and in observed negative mother-child interactions. Also, in all cases, the parenting alliance mediated the effects of marriage on parenting experiences. There was little evidence of reciprocal causation in which parenting variables predicted change in the quality of marriage and the parenting alliance. Interactions involving child age suggested that teenagers as opposed to younger children were more reactive to negative features of their parents' marital functioning and parenting alliance. Implications are discussed regarding stable but negative marital functioning and regarding possible differences in mothers' and fathers' parenting in the context of marital distress.     

The incidence of dementia: a meta-analysis

OBJECTIVE: To carry out a meta-analysis of the age-specific incidence of all dementias, including AD and vascular dementia. BACKGROUND: Several meta-analyses have been carried out on dementia prevalence, but none on its incidence. METHODS: We used loess-curve fitting to analyze data from 23 published studies reporting age-specific incidence data. RESULTS: The incidence of both dementia and AD rose exponentially up to the age of 90 years, with no sign of leveling off. The incidence rates for vascular dementia varied greatly from study to study, but the trend was also for an exponential rise with age. There was no sex difference in dementia incidence (p = 0.21), but women tended to have a higher incidence of AD in very old age, and men tended to have a higher incidence of vascular dementia at younger ages. East Asian countries had a lower incidence of dementia than Europe (p = 0.0004), and also tended to have a lower incidence of AD. CONCLUSIONS: The incidence of dementia rises exponentially to the age of 90 years. Any sex differences are small, and incidence is lower in East Asia than in Europe.