Amy M Smith Slep

• Ph.D.
• New York University

Over fifteen percent of the global population experiences dental fear, and although evidence-based treatments exist, adoption of these treatments is almost non-existent. Informed by our prior research examining barriers to adopting face-to-face behavioral treatments in dental operatories, this study examined dentists’ responses to three stepped-car...

Despite expanded mental health services and outreach within the military, most active-duty members who endorse mental health problems do not seek services. Little is known about why this is the case, but cognitions may play a key role. In this study, cognitions relevant to service seeking were compared among three subgroups of active-duty members:...

NORTH STAR is a community-based prevention assessment, planning, and implementation framework for military communities. It was developed and tested at the installation level in a randomized controlled trial, with encouraging findings. However, in that trial, a third of installations in the NORTH STAR condition failed to implement action plans. In t...

The need for standardized criteria in partner and child maltreatment response systems is critical for providing fair decisions, allocating family support, producing reliable research findings, and aiding prevention efforts, among other tasks. The primary goal of this study was to replicate Heyman and Slep’s (2009a) study—whether maltreatment incide...

Objectives Although several brief cognitive behavior therapy (CBT)-based treatments for dental fear have proven efficacious, these interventions remain largely unavailable outside of the specialty clinics in which they were developed. Leveraging technology, we sought to increase access to treatment for individuals with dental fear through the devel...

Background: With an estimated global prevalence rate of over 30%, dental fear is a ubiquitous public health phenomenon. Dental fear’s adverse effects on patient oral health and quality of life are well established; the stresses and financial repercussions it can pose to providers are increasingly recognized. Although dental fear is highly treatable...

Linkages among psychological health problems, intimate relationship distress, and suicide risk have been widely studied, but less is known about how these factors interact, especially in military populations. With steady increases in suicide rates among active military and post-service members (SMs), it is critical to better understand the relation...

It is well-established that rates of interpersonal violence (IV; physical and emotional intimate partner violence [IPV], non-consensual sexual contact [NCSC], and stalking) peak at 18–24 years of age. Most emerging-adult IV research has been conducted with college samples, making increased risk for IV in college a widely held, but perhaps unjustifi...

Adverse childhood experiences (ACEs) have been consistently associated with worse physical and mental health outcomes in adulthood (Felitti et al., 1998; Merrick et al., 2019) as well as higher risk for relationship dysfunctions (Khalifian et al., 2022; Wheeler et al., 2019) including intimate partner violence (IPV; Spencer et al., 2022). In the pr...

Despite the repeal of "Don't Ask, Don't Tell" (DADT) over a decade ago, military processes and policies continue to function as significant structural and institutional barriers to research aimed at optimizing resources for military couples and families with marginalized sexual identities. Such research is essential given the apparent mental health...

Introduction The Office of the Secretary of Defense and each of the services have made an unprecedented commitment to the prevention of sexual assault and related behavioral health phenomena. Indeed, the Department of Air Force has selected, in some cases tailored, and disseminated a wide array of evidence-based preventative programs, policies, and...

Despite a half‐century of scholarship devoted to explicating and disrupting the intergenerational transmission of family violence, it remains a prominent and destructive social force in the United States. Theoretical models have posited a variety of historical and concurrent risk and protective factors implicated in the trajectory from childhood vi...

Tools that assess school supports for highly mobile, military-connected students are lacking. This study describes the development and preliminary validation of the Inventory of School Supports-Parent Report (ISS-PR). Participants were 433 parents (74% female; 62.5% White, 12% Black, 6.5% Asian, 5.5% Pacific Islander, 4% Native American, and 9.5% b...

Parental help-seeking preferences may help explain the treatment gap in child mental health. This study examined mothers’ and fathers’ help-seeking behaviors for child mental health to further understand their individual preferences for treatment. A total of 394 mothers and fathers completed questionnaires assessing the types of help sought for men...

Objective: Interpersonal partner violence (IPV) is a pervasive social and public health problem worldwide. In the context of the response by the World Health Organization to this issue, proposals were developed to improve the usefulness of International Classification of Diseases (ICD-11) descriptions for helping clinicians to reliably identify rel...

This study describes the development of a 12-item inventory of school supports for military-connected (MC) children. Participants were 444 students (grades 3 or 5) with an active-duty military parent (48% female; 57.3% White, 10.7% Black, 6.2% Native American, 5% Asian, 3.3% Pacific Islander, 17.5% bi/multiracial; 19% Latinx). Youth completed the I...

Objectives: U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions...

Introduction Excessive gambling can cause substantial biopsychosocial problems (e.g., difficulties with finances, relationships, mental, and physical health). For military Service Members, it can also result in security clearance denial or revocation, failure to achieve promotions, and premature career termination. Recent congressional mandates hav...

Purpose/Objectives A patient‐centered care (PCC) paradigm undergirds modern dental education. PCC is particularly relevant in the management of patient dental fear. The aims of this study were three‐fold: (a) to examine the preliminary psychometric properties of an author‐designed survey administered to explore dental fear knowledge and perceptions...

The U.S. Department of Defense (DoD) aims to prevent suicide, harassment, sexual assault, and partner and child maltreatment by implementing evidence-based behavioral health interventions (EBIs). However, sustaining EBI implementation over time and with fidelity to result in meaningful impacts is a tremendous challenge. We interviewed 35 military l...

Using a normative US sample of 477 mothers of 6‐ to 24‐ month‐old children, we explored the relations among toddlers’ physical aggression, child temper loss, and parent‐child conflict to gain a better understanding of how aggression develops from infancy to toddlerhood. An inventory of specific aggressive acts was subject to factor analysis to test...

Understanding the extent to which youth and families experienced COVID-related stress requires accounting for prior levels of stress and other associated factors. This is especially important for military families, which experience unique stressors and may be reluctant to seek outside help. In this prospective study, we examined the role of pre-pan...

Coercive conflicts between parents and children and between couples are implicated in the pathogenesis of a variety of psychological and physical health problems. Despite its seeming importance to population health, there are no widely available, easy-to-use methods with demonstrated efficacy to engage coercive conflict and reduce it. Identifying a...

Introduction As suicides among military personnel continue to climb, we sought to determine best practices for supporting military mental health clinicians following patient suicide loss (i.e., postvention). Materials and Methods We conducted a scoping review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyse...

We conducted an observational study of a collection of interactive processes known as “demand‐withdraw” in relation to adolescent dating aggression. Couples (N = 209) aged 14–18 years participated in a challenging observational laboratory assessment to measure demands (i.e., pressures for a change), as well as demand → partner withdraw and demand →...

Commonly used scales of psychological intimate partner violence (ψIPV) for adolescents may not include sufficient items to measure adequately different forms of ψ aggressive behaviors. They may also characterize as harmful ψ aggressive behaviors occurring in non-conflictual or joking contexts. The current study examined a new scale, the Relationshi...

Despite evidence that parents' physical aggression abuse has long-lasting negative consequences, information about the true population prevalence of aggression and physical abuse is limited. We have even less information about how parental aggression and abuse vary by child age, parent gender, and how that aggression and abuse might be clustered wi...

Psychological maltreatment (PM) of children has been difficult to define and even more challenging to operationalize consistently. This fact contributes to child PM being under-recognized and under-addressed by professionals that interact with children with mental health, behavioral, and developmental issues; and by systems such as child welfare, c...

For decades, researchers, interventionists, and the lay public have subscribed to the notion that couples low in relationship satisfaction and/or experiencing psychological, physical, or sexual intimate partner violence (IPV) have communication skills deficits. In contrast, experimental studies of communication have concluded that differences were...

Two studies examined the impact of the implementation of the Field-tested Assessment, Intervention-planning, and Response (FAIR) system, a system-level intervention for determining whether allegations of family maltreatment meet threshold for abuse or neglect, on alleged recidivism. Data were collected at the 10 U.S. Army installations with the lar...

This study investigates associations between (a) relationship satisfaction and intimate partner violence (IPV: psychological, physical, and sexual) and (b) observed couple communication behavior. Mixed-sex couples ( N = 291) were recruited via random digit dialing. Partners completed the Quality of Marriage Index (Norton, 1983), the Revised Conflic...

Introduction: Psychological problems and family maltreatment are significant public health problems. Although research focuses almost exclusively on either individual psychological problems or family maltreatment, there is substantial co-occurrence of these problems. Similarly, intervention services are often "siloed": individuals with mental heal...

In a study of conflict recovery and adolescent dating aggression, 14‐ to 18‐year‐old couples (N = 209 dyads) participated in a 1‐hr observational assessment. Negative behavior was observed during conflict‐evoking “hot” tasks and in a “cooldown” task. Physical and psychological dating aggression were assessed via questionnaires. Negative behavior me...

Reports an error in "Self-report measures of coercive process in couple and parent-child dyads" by Danielle M. Mitnick, Michael F. Lorber, Amy M. Smith Slep, Richard E. Heyman, Shu Xu, Lisanne J. Bulling, Sara R. Nichols and J. Mark Eddy (Journal of Family Psychology, 2021[Apr], Vol 35[3], 388-398). In the original article, the full acknowledgment...

Although many evidence-based interventions are well-established, our understanding of how to effectively implement and sustain those interventions in real-world settings is less well understood. We investigated predictors of implementation and reach in a randomized controlled trial of the NORTH STAR prevention system. One-third of U.S. Air Force (A...

Family violence is a major public health concern, impacting millions each year. Only a small portion of family violence gets reported to police or comes to the attention of child protective agencies. Importantly, different types of maltreatment frequently co-occur within the family constellation, and this co-occurrence has often been overlooked. Wh...

Marital dysfunction in military samples demands special scrutiny because of its concurrent and prospective linkages with a broad spectrum of mental and physical health disorders, as well as its demonstrated adverse impact on military readiness. Although previous research has shown higher risk for marital distress and divorce among female service me...

The effects of family maltreatment on the military are far-reaching and well documented, with implications that include the deterioration of mission readiness and an increase in distractibility for all involved. Congress has mandated each service agency to take steps in preventing partner and child maltreatment, including outreach – enlisting milit...

To inform interpersonal models of intimate partner violence (IPV), the present study examines patterns of vocally encoded emotional arousal during the conversations of mixed-gender couples who reported on the extent of physical and psychological IPV and degree of relationship satisfaction (N = 149). All couples completed two problem-solving discuss...

Introduction: Military leaders are concerned that active duty members' fear of career impact deters mental health (MH) treatment-seeking. To coalesce research on the actual and perceived consequences of MH treatment on service members' careers, this systematic review of literature on the U.S. Military since 2000 has been investigating the followin...

This study examined whether violations of partner expectations-and attributions and perceptions of these violations-are associated with relationship satisfaction across the transition to parenthood. First-time parents (N = 99) mixed-sex couples completed mail-in packets during pregnancy (Time 1; T1) and when their babies were 3-5 months old (Time 2...

Intimate partner violence (IPV) is a serious public health problem associated with increased risk of developing mental health conditions. Assessment of IPV in mental health settings is important for appropriate treatment planning and referral; however, lack of training in how to identify and respond to IPV presents a significant barrier to assessme...

Providing high-quality and cost-effective services in family and mental health treatment programs is difficult. There is an elusive balance between (a) maximizing patients served and positive patient outcomes and (b) minimizing provider burnout and turnover. Agencies often implicitly assume that all cases require equivalent provider time and effort...

Introduction The U.S. Air Force (USAF) conducted a program of research to develop and disseminate reliable and valid criteria for partner and child maltreatment (comprising abuse [physical, emotional/psychological, and sexual] and neglect). These criteria are now used in all branches of the U.S. military. The U.S. Army was the first service outside...

Background. This study examined the impact of the implementation of the Field-tested Assessment, Intervention-planning, and Response (FAIR) system for maltreatment determination on two measures recidivism of family maltreatment. Methods. The 10 U.S. Army installations with the largest caseloads participated. Data were collected when Family Advocacy...

We tested hypotheses about moment-to-moment interpersonal influences on anger during couples' conflict, and the association of those anger dynamics with relationship satisfaction and intimate partner violence (IPV). Displayed anger was coded from laboratory observations of cohabiting couples (N = 197); experienced anger was assessed via a video-rec...

To examine the concordance between patients’ experience and expression of unpleasant emotions in a health care context, 21 patients presenting to a university dental clinic were observed for expressed unpleasant emotions and patients provided the intensity of their experienced unpleasant emotions. We found low convergence between experience and exp...

Introduction We evaluated the effectiveness of New Orientation for Reducing Threats to Health from Secretive-problems That Affect Readiness (NORTH STAR), a community assessment, planning, and action framework to reduce the prevalence of suicidality, substance problems, intimate partner violence, and child abuse. Materials and Methods One-third of...

Child maltreatment and intimate partner abuse determinations often include judgments (e.g., severity) that go beyond whether or not the allegations are founded. Severity ratings inform multiple stakeholders (e.g., researchers, policymakers, clinicians, supervisors) and response pathways (e.g., “differential response” to child maltreatment). However...

This chapter provides an overview of empirically supported intervention and prevention programs for child maltreatment. For each intervention and prevention program, we outline the content and delivery of the program, review the empirical support for the program, and discuss any cross‐cultural evaluations or adaptations to the program. In addition...

If high-conflict family environments are cariogenic across cultures, and can be studied in cultures where both these environments and cariogenic dental practices are particularly prevalent, this would afford the opportunity to examine how these two pathways of risk might interact, laying the stage for culturally competent, integrated prevention eff...

Dysfunctional conflict resolution behaviors in couples have been long recognized as markers of relationship maladjustment and are, consequently, frequent targets of couple therapy. The process of flooding may play a role. Flooding is the subjective sense of being overwhelmed by the partner’s negative affect, which is perceived as unexpected and int...

This chapter provides an overview of empirically supported intervention and prevention programs for child maltreatment. For each intervention and prevention program, we outline the content and delivery of the program, review the empirical support for the program, and discuss any cross‐cultural evaluations or adaptations to the program. In addition...

We evaluated the effectiveness of NORTH STAR, a community assessment, planning, and action framework to reduce the prevalence of several secretive adult problems (hazardous drinking, controlled prescription drug misuse, suicidality, and clinically significant intimate partner violence and child abuse [both emotional and physical]) as well as cumula...

The U.S. Preventive Services Task Force has recommended that clinicians screen patients for intimate partner violence (IPV). This article aims to develop and test the first screeners for clinically significant physical and psychological IPV (i.e., acts meeting criteria in the International Classification of Diseases (11th ed.; ICD-11; World Health...

One of the most influential behavioral models of family conflict is G. R. Patterson's (1982) coercive family process theory. Self-reports for behaviors related to coercion (e.g., hostility toward a family member) abound; however, there are no self-report measures for coercive process itself, which is, by definition, a dyadic process. Operationaliza...

The degree to which individual self-rated physical health and concordance of self-rated physical health between partners are associated with relationship satisfaction was examined in a community sample of 399 couples with children. Couples completed self-report assessments of physical health (general health and physical functioning) and relationshi...

Objective To examine couple and parenting outcomes from an American version of Couple CARE for Parents (CCP) in low‐income, unmarried couples. Background We adapted an evidence‐based, flexibly delivered program for use with low‐income, unmarried couples, for whom the outcome literature is scarce. Method Couples (N = 443) were recruited from mater...

Intimate partner violence (IPV) is a global public health problem that has been shown to lead to serious mental health consequences. Due to its frequent co-occurrence with psychiatric disorders, it is important to assess for IPV in mental health settings to improve treatment planning and referral. However, lack of training in how to identify and re...

Family violence research has been plagued with inconsistencies in terms, definitions, and thresholds for intervention. Efforts to provide a normed standard for what constitutes intimate partner violence, child abuse, and neglect have clashed with attempts to recognize the impact of cultural variability on the experiences of family maltreatment. Thi...

Participation rates in couple relationship education (CRE) programs for low-income couples are typically low. We examined predictors of session attendance and early dropout (i.e., dropout after 1 session) among a sample of low-income, unmarried parents of a newborn (N = 467 couples) enrolled in an evidence-based CRE program. Predictors included dem...

Objective: Differentiating suicide attempters from suicide ideators has been named a critical suicidology frontier (Klonsky & May, 2013). Per Bronfenbrenner's (1977, 1994) ecological systems theory, risk/protective factors from four ecological levels (individual, family, workplace, and community) were used to predict last year suicide attempt stat...

This study explored whether individual differences in self-reported emotional flooding were associated with observational behaviors and experienced and displayed anger during a 10-min problem solving discussion. A sample of 233 married or cohabiting couples, comprising 4 groups (distressed with intimate partner violence [IPV], distressed/nonIPV, sa...

Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) and International Classification of Diseases-11th Revision (ICD-11; proposed) now include criteria for clinically significant (a) intimate partner violence (IPV) and neglect and (b) child abuse and neglect. However, existing measures of IPV and child abuse do not allow for...

Noxious family environments are associated with a wide range of adverse child outcomes. In order to prevent couple and parent-child relationship problems, a number of programs have been developed for couples with newborns. The current paper describes a program of research evaluating the American version of couple CARE for parents of newborns. This...

Effective, accessible prevention programs are needed for adults at heightened risk for intimate partner violence (IPV). This parallel group randomized controlled trial examines whether such couples receiving the American version of Couple CARE for Parents of Newborns (CCP; Halford et al. 2009) following the birth of a child, compared with controls,...

Objective: To investigate age-related trends in physically aggressive behaviors in children before age 2 years. Study design: A normative US sample of 477 mothers of 6- to 24-month-old children reported on the frequency of 9 interpersonally directed aggressive child behaviors, and hurting animals, in the past month. Results: Almost all (94%) o...

Recently in this journal, Weeland et al. (2018) published a thought-provoking article reporting moderating effects of children's serotonin transporter-linked polymorphisms ( 5-HTTLPR ) on negative parenting during prevention with the Incredible Years series. Participants were parents and young children of 387 families enrolled in the Observational...

Cambridge Core - Social Psychology - The Cambridge Handbook of Violent Behavior and Aggression - edited by Alexander T. Vazsonyi

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Dis...

Objectives: We sought to identify subgroups of individuals based on patterns of psychological health problems (PH; e.g., depressive symptoms, hazardous drinking) and family maltreatment (FM; e.g., child and partner abuse). Method: We analyzed data from very large surveys of United States Air Force active duty members with romantic partners and c...

Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials—with 2 meta-analyses finding strong average effect sizes (d > 1)—CBT has received almost no dissemination beyond the specialty clinics that tested...

This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associat...

Past research on the relation between hostility in intimate relationships and adiposity has yielded mixed findings. The present study investigated whether the association between relationship hostility and adiposity is moderated by people’s biological reactions to couple conflict. Cohabiting adult couples (N = 117 couples) engaged in two conflict i...

In the present investigation, we studied the development of 6 physically aggressive behaviors in infancy and toddlerhood, posing 3 questions (a) How do the prevalences of individual physically aggressive behaviors change from 8, 15, and 24 months? (b) Are there groups of children who show distinctive patterns in the way individual physically aggres...

In the present investigation, we studied the development of six physically aggressive behaviors in infancy and toddlerhood, posing three questions (1) How do the prevalences of individual physically aggressive behaviors change from 8, 15, and 24 months? (2) Are there groups of children who show distinctive patterns in the way individual physically...

The longitudinal course of the psychological health (PH) of United States Air Force (USAF) base communities in relation to risk and demographic factors was studied over a 5-year period. PH (clinically significant hazardous drinking, prescription drug misuse, depressive symptoms, suicidal thoughts and behaviors, intimate partner violence [IPV] and c...

Effective community-based prevention requires an understanding of risk and protective factors in the population of interest. This article consolidates myriad risk and protective factor studies on family violence, alcohol abuse, and suicidality investigating various ecological levels (individual, family, workplace, and community) in random populatio...

Objective: Investigate (1) the association of child adiposity with parent-to-child and parent-to-parent hostility, (2) the mediation of these associations by dietary behaviours and (3) moderation by gender. Design: One hundred thirty-five couples with 6- to 14-year-old children completed measures of emotional and physical aggression, overreactive d...

In the present investigation we consider and explain an apparent paradox in the measurement of corporal punishment with the Parent-Child Conflict Tactics Scale (CTS-PC): How can it have poor internal consistency and still be reliable? The CTS-PC was administered to a community sample of 453 opposite sex couples who were parents of 3- to 7-year-old...

Objective: Investigate (1) the association of child adiposity with parent-to-child and parent-to-parent hostility, (2) the mediation of these associations by dietary behaviours, and (3) moderation by gender. Design: One hundred thirty-five couples with 6- to 14-year-old children completed measures of emotional and physical aggression, overreactive...

Prepublication manuscript.In the present investigation we consider and explain an apparent paradox in the measurement of corporal punishment with the Parent-Child Conflict Tactics Scale (CTS-PC): How can it have poor internal consistency and still be reliable? The CTS-PC was administered to a community sample of 453 opposite sex couples who were pa...

This chapter considers the child within the context of the family unit and explores the co-occurrence of physical intimate partner abuse (IPV) with child physical abuse (CPA). It presents an overview of the co-occurrence rates, effects on the child, risk factors and theoretical explanations for this overlap and the implications this evidence has fo...

Despite significant research on parental emotion, parents’ regulation of their own emotions during discipline encounters is an understudied topic. Progress in this area of inquiry would be enhanced by the development of valid measures of emotion regulation. The present article describes an evaluation of such a measure, the revised Parental Emotion...

Research has garnered support for a systemic view of factors affecting child dental caries that accounts for the influence of social factors such as the family environment. Our previous work has demonstrated the association between mother-to-father emotional aggression and child caries. The present study builds on these results by evaluating pathwa...

Military deployment can create significant relationship strain. Although most couples navigate the challenges of deployment successfully, this period may render some couples more vulnerable to adverse relationship outcomes such as infidelity due to a convergence of factors including geographic separation and reduced emotional and physical intimacy....

Purpose: The prevalence and correlates of dental fear have been studied in representative population studies, but not in patients presenting for dental treatment. We hypothesized that dental fear among patients presenting at a large, urban college of dentistry would be similar to that of the population (e.g. 11% high dental fear, 17% to 35% modera...

How do military and civilian families compare with respect to maltreatment? This question has always been of interest, but interest has peaked in the context of the recent wars. This chapter reviews the literatures on (1) prevalence of different forms of maltreatment among military families and comparing military and civilian families, (2) risk fac...

Although a substantial proportion of service members returning from a combat deployment report individual emotional and behavioral disorders as well as intimate relationship difficulties, previous studies indicate that only a minority actually seek mental health services. Little is known about factors that predict help-seeking in this population. W...

Parents who are overwhelmed by the intensity and aversive nature of child negative affect - those who are experiencing flooding - may be less likely to react effectively and instead may focus on escaping the aversive situation, disciplining either overly permissively or punitively to escape quickly from child negative affect. However, there are no...