Parenting-STAIR Modular for Military Fathers and OCONUS Families

Condition(s) studied

Investigational drug(s) / intervention(s)

Parenting-STAIR Modular (PSTAIR-M): 12-16 PSTAIR-M treatment sessions (approximately 12-16 weeks).

Treatment as Usual (TAU): Weekly treatment sessions of an established EBT. The total number of sessions/weeks will be determined by the EBT and clinic protocols.

Study summary

The goal of this clinical trial is to learn if a family-based treatment called Parenting-STAIR-Modular (PSTAIR-M) can help military parents recover from trauma, strengthen emotion regulation skills, and improve parent-child relationships. Participants will be trauma-exposed active-duty Service Members (SM) or their spouses who screen positive for PSTD and/or depression, and one identified child (ages 2-10).

The main questions it aims to answer are: 1) Does PSTAIR-M reduce parental PTSD and depression symptoms, lower parenting stress, and improve child behavior compared to treatment-as-usual?; and 2) Is PSTAIR-M feasible and acceptable when delivered to military families stationed overseas?

Researchers will compare PSTAIR-M to treatment-as-usual (TAU) to see if PSTAIR-M leads to greater improvements in parental PTSD, depression, parenting stress, emotion regulation, child maltreatment risk, and child behavior than usual care.

Participants will: 1) attend 12-16 weekly, 1-hour online treatment sessions with their assigned clinicians, 2) complete three 1-hour online assessments administered by research staff, 3) engage with their child in three 15-30-minute online, observed play sessions, 4) have assessments and observed play sessions audio and video recorded.

Eligibility

Primary outcome measure(s)

• Post-traumatic stress disorder (PTSD) Checklist 5 — Four assessment timepoints: pre-treatment (baseline), mid-treatment (after session 11, approximately 11 weeks after baseline), post-treatment (approximately 17 weeks after baseline), and 6-month follow-up (approximately 41 weeks after baseline).
  The PCL-5 will be used to assess severity and change in PTSD symptoms. The PCL-5 is a 20-item self-report measure with strong evidence of reliability and convergent validity. Participants indicate the degree to which they have been bothered by problems related to a traumatic experience in the past month (e.g., "repeated, disturbing dreams of the stressful experience"; "feeling very upset when something reminded you of the stressful experience") on a 5-point Likert scale (0=not at all; 1=a little bit; 2=moderately; 3=quite a bit; 4=extremely). Summed responses yield a continuous score ranging from 0 to 80; higher scores indicate greater symptom severity.
• Patient Health Questionnaire-9 (PHQ-9) — Four assessment timepoints: pre-treatment (baseline), mid-treatment (after session 11, approximately 11 weeks after baseline), post-treatment (approximately 17 weeks after baseline), and 6-month follow-up (approximately 41 weeks after baseline).
  The PHQ-9 will be used to assess severity and change in depressive symptoms. The PHQ-9 is a 9-item self-report measure with strong evidence of reliability and predictive and convergent validity. Participants indicate how often they have been bothered by particular problems within the past two weeks (e.g., "feeling down, depressed, or hopeless"; "poor appetite or overeating") on a 4-point Likert scale (0=not at all; 1=several days; 2=more than half the days; 3=nearly every day). Summed responses yield a continuous score ranging from 0 to 27; higher scores indicate greater symptom severity.
• Adult Adolescent Parenting Inventory-version 2 (AAPI-2) — Three assessment timepoints: pre-treatment (baseline), post-treatment (approximately 17 weeks after baseline), and 6-month follow-up (approximately 41 weeks after baseline).
  The AAPI-2 will be used to measure child-maltreatment risk. The AAPI-2 is a 40-item self-report measure with strong psychometric properties and predictive validity. Participants indicate how much they agree or disagree with statements about parenting and raising children (e.g., "Time-out is an effective way to discipline children") on a 5-point Likert scale (SD=Strongly disagree, D=Disagree, U=Uncertain, A=Agree, SA=Strongly agree). AAPI-2 is scored using a stencil to assign each answer a number; summed numbers for five parenting categories are converted into standard scores that are plotted on a profile chart to show risk for abusive or neglectful parenting behavior.

Trial sites (6)

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