Parent-Child Memory Study: Improving Future Thinking Among Mothers

Official title

Parent-Child Memory Study: Improving Future Thinking Among Mothers From a Traditionally Underserved Community to Reduce Harsh Parenting and Improve Child Outcomes - A Randomized Controlled Trial

Overview

Parents of children from impoverished communities are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including suicidal ideation and attempts. One mechanism linking low resource environments and maladaptive parenting strategies is maternal delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical means) relative to larger, but delayed rewards (like improving the parent-child relationship). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of maternal delay discounting to inform broader public health efforts aimed at improving adolescent mental health outcomes in traditionally underserved communities.

Detailed description

Harsh parenting is associated with serious and costly mental health problems among youth, including substance use, mood disorders, and suicidal ideation and behaviors. Of concern, these parenting practices are most common among families from impoverished communities; however, many behaviorally-based parenting interventions do not take into account the unique mechanisms linking environmental disadvantage to parenting approaches. While the causes of harsh parenting are complex and varied, one such mechanism may be parents' tendencies to prioritize immediate rewards (such as stopping a child's misbehavior via physical punishment like spanking and hitting) relative to larger, but delayed rewards (including improved parent-child relationship quality), known as delay discounting.

The aims of the current study are to conduct a Stage 1 parent-child dyad randomized control trial (RCT) (n = 72) examining the effectiveness of a brief, episodic future thinking (EFT) intervention in a community setting serving low-income mothers and additional implementation data. Participants will be randomized to receive either Episodic Future Thinking (EFT) or Episodic Recent Thinking (ERT) intervention arms. This case series will examine the efficacy of episodic future thinking (EFT) compared to episodic recent thinking (ERT) to target reduction of parenting-related delay discounting. Outcomes will evaluate the effect of EFT on reducing maternal delay discounting and harsh parenting and improving child clinical outcomes.

Interventions

• Behavioral Episodic Future Thinking (EFT)
  The adapted episodic future thinking (EFT) intervention will focus on generation of vivid, substance-free, rewarding events that could happen in the future with their children.
• Behavioral Episodic Recent Thinking (ERT)
  In the episodic recent thinking (ERT) condition, the participant will instead describe in vivid details events that have occurred in the recent past.

Primary outcome measures

• Change in Monetary Choice Questionnaire [Time frame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9]
• Change in Consideration of Future Consequences Scale Score [Time frame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9]

Secondary outcome measures (2)

• Change in Alabama Parenting Questionnaire Score [Time frame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9]
• Change in Emotion Regulation Checklist [Time frame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9]

Eligibility criteria

Parent Inclusion Criteria:

• A mother and or grandmother from the Flint area with a child/grandchild between the ages of 5-10 who can provide legal consent for that child
• Self-report that they have consistent contact with the child/grandchild
• Willing to participate in the study
• Able to participate in written assessments and an intervention conducted in English
• Have a working cell phone that can receive and send text messages and be willing to receive/send text messages as part of the study
• Have a phone or device that's able to use video conferencing software if interested in virtual participation

Parent Exclusion Criteria:

• Self-disclosed active suicidality/homicidality
• Self-disclosed current bipolar disorder, schizophrenia, or psychosis
• Self-reported current and ongoing involvement with child protective services

Child Inclusion Criteria:

• Children must be between the ages of 5-10 and have a mother/grandmother willing to provide consent for their participation
• Willing to participate in parent-child observation sessions
• Elementary proficiency in English
• Willing to participate in study surveys

Child Exclusion criteria:

• Self-disclosed active suicidality/homicidality
• Self-disclosed current bipolar disorder, schizophrenia, or psychosis

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Prevention

Study locations

United States · 1 center

• Mothers of Joy Institute for Parenting and Family Wellness, Inc — Flint

Publications

• Felton JW, Collado A, Cinader M, Lejuez CW, Chronis-Tuscano A, Yi R. Exposure to maternal depressive symptoms and growth in adolescent substance use: The mediating role of delay discounting. Dev Psychopathol. 2021 Oct;33(4):1279-1289. doi: 10.1017/S0954579420000486. PMID 32519638
• Dassen FC, Houben K, Jansen A. Time orientation and eating behavior: Unhealthy eaters consider immediate consequences, while healthy eaters focus on future health. Appetite. 2015 Aug;91:13-9. doi: 10.1016/j.appet.2015.03.020. Epub 2015 Mar 23. PMID 25814191
• Felton JW, Collado A, Ingram KM, Doran K, Yi R. Improvement of Working Memory is a Mechanism for Reductions in Delay Discounting Among Mid-Age Individuals in an Urban Medically Underserved Area. Ann Behav Med. 2019 Oct 7;53(11):988-998. doi: 10.1093/abm/kaz010. PMID 30955043
• Lin H, Epstein LH. Living in the moment: effects of time perspective and emotional valence of episodic thinking on delay discounting. Behav Neurosci. 2014 Feb;128(1):12-9. doi: 10.1037/a0035705. PMID 24512061
• Moreland, A.M., Felton, J.F., Hanson, R.F., Jackson, C., & Dumas, J.E. (2016). The relation between parenting stress and parenting locus of control: Mechanisms of change in parenting interventions. Journal of Child and Family Studies, 25, 2046-2054.
• Snider SE, DeHart WB, Epstein LH, Bickel WK. Does delay discounting predict maladaptive health and financial behaviors in smokers? Health Psychol. 2019 Jan;38(1):21-28. doi: 10.1037/hea0000695. Epub 2018 Nov 26. PMID 30474996
• Stein JS, Wilson AG, Koffarnus MN, Daniel TO, Epstein LH, Bickel WK. Unstuck in time: episodic future thinking reduces delay discounting and cigarette smoking. Psychopharmacology (Berl). 2016 Oct;233(21-22):3771-3778. doi: 10.1007/s00213-016-4410-y. Epub 2016 Aug 23. PMID 27553824

Identifiers

NCT: NCT06145919 · NHRCT: 16828-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗