of the preventive interventions described in this report are conceptually relevant to members of the armed forces and their families. However, consideration of how these interventions could be used in the military context, given differences in service systems and many other aspects of military and civilian life, is beyond the scope of this report.

Family Interventions That Span Developmental Periods

Such family situations as mental illness, divorce, death, and abuse can affect family functioning and contribute to MEB disorders. Selective interventions to help families deal with these adversities and prevent negative outcomes among children have been developed and tested. Interventions designed for families dealing with parental depression are discussed in Chapter 7.

Family Disruption Due to Divorce or Parental Death

Compared with adolescents in two-parent homes, those with divorced parents exhibit higher levels of mental, emotional, and behavioral problems and lower levels of success in developmental tasks in childhood and adolescence; this increased risk persists into adulthood (Amato and Soboleski, 2001; Amato and Keith, 1991a, 1991b). Parental death is also associated with multiple problems in childhood and adulthood, including more symptoms of depression and anxiety and higher rates of depression and posttraumatic stress disorder (Cerel, Fristad, et al., 2006; Gersten, Beals, and Kallgren, 1991; Kendler, Gardner, and Prescott, 2002; Melhem, Walker, et al., 2008).


Preventive Interventions for Divorcing Families. A number of prevention programs focus on improving outcomes for children who experience parental divorce (Braver, Griffin, and Cookston, 2005; Emery, Sbarra, and Grover, 2005; Grych and Fincham, 1992; Haine, Sandler, et al., 2003; Lee, Picard, and Bain, 1994; Pedro-Carroll, 2005; Sobolewski and King, 2005; Wolchik, Sandler, et al., 2005). Many of these programs work with parents during and after the divorce or target changing the divorce process. At least two programs with positive results work with the mother during and after the divorce to deal with the stressors involved: the Parenting Through Change (PTC; Forgatch and DeGarmo, 1999) program and the New Beginnings Program (Wolchik, Sandler, et al., 2007). A randomized controlled trial of the PTC program demonstrated reductions in coercive parenting, antisocial behavior, and internalizing behavior at 30-month follow-up and reductions in delinquency at 36-month follow-up (DeGarmo, Patterson, and Forgatch, 2004; Martinez and Forgatch, 2001; Patterson, DeGarmo, and Forgatch,



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