Parent-Child Memory Study: Improving Future Thinking Among Mothers

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

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.

Study Overview

• Status: Recruiting
• Conditions: Behavior, Health
• Intervention / Treatment: Behavioral: Episodic Future Thinking (EFT); Behavioral: Episodic Recent Thinking (ERT)

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.

• Study Type: Interventional
• Enrollment (Estimated): 144
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Julia Felton, PhD; Phone Number: 704-995-7832; Email: Jfelton4@hfhs.org

Study Locations

• United States
  • Michigan
    • Flint, Michigan, United States, 48503
      • Recruiting
      • Mothers of Joy Institute for Parenting and Family Wellness, Inc
      • Contact: Shearese Stapleton

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Parent Inclusion Criteria:

1. 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
2. Self-report that they have consistent contact with the child/grandchild
3. Willing to participate in the study
4. Able to participate in written assessments and an intervention conducted in English
5. 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
6. Have a phone or device that's able to use video conferencing software if interested in virtual participation

Parent Exclusion Criteria:

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

Child Inclusion Criteria:

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

Child Exclusion criteria:

1. Self-disclosed active suicidality/homicidality
2. Self-disclosed current bipolar disorder, schizophrenia, or psychosis

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Episodic Future Thinking (EFT); Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. The participant will be asked to discuss their relationship with their child and to give examples of both positive and negative parenting from their personal experience. The "peer mother" will then ask the participant to think about their long-term parenting goals and will discuss how to create a vivid event that will be easy to remember. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, participants are asked to engage in messaging that will prompt them to think about future events.	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.
Active Comparator: Episodic Recent Thinking (ERT); In the episodic recent thinking (ERT) condition, the participant will be asked to discuss their relationship with their child and to give examples of both positive and negative parenting from their personal experience. The "peer mother" will then ask the participant to think about the present and discuss how to focus on the present. Two positive recent events and two negative recent events will be used to create ERT scenes for the parent to envision their current relationship with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, participants will receive messages over the course of two weeks helping parents to focus on recent events with their child.	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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Monetary Choice Questionnaire	The Monetary Choice Questionnaire (MCQ) is a 27-item binary-choice task, which asks participants to select between two hypothetical monetary amounts: a smaller reward available immediately (e.g. $49 today) or a larger reward available after a delay (e.g. $60 in 89 days). The measure is scored to derive a discounting rate k, with larger values reflecting more problematic rates of discounting. Because k distributions are typically skewed, post-hoc natural logarithmic transformations will be performed, which have been shown to approximate normal distributions. The MCQ has been shown to have strong psychometric properties among adults and correlates with real rewards, as well as real-world risk behaviors.	Baseline, Intervention, Week 2, Month 3, Month 6, Month 9
Change in Consideration of Future Consequences Scale Score	The Consideration of Future Consequences Scale1 (CFCS-14) is a 14-item self-report questionnaire that assesses active consideration of longer-term implications of an individual's actions. Lower scores on the CFCS-14 are associated with a greater focus on immediate needs and have been found to be associated with less engagement in health behaviors1819 and greater substance use. The measure has been used extensively among adult samples and demonstrates strong reliability and validity. Research suggests modest but significant correlations with the MCQ. Change in CFCS-14 score is measured by comparing scores at the post-intervention assessment timepoints with baseline scores.	Baseline, Intervention, Week 2, Month 3, Month 6, Month 9

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Emotion Regulation Checklist	Parents will report on children's emotion regulation using the Emotion Regulation Checklist (ECR). The ECR includes 24 items that yield two subscales: (1) lability/negativity and (2) emotion regulation. The measure is widely used and validated for parent-report of older children and young adolescents.	Baseline, Intervention, Week 2, Month 3, Month 6, Month 9
Change in Alabama Parenting Questionnaire Score	Parents will report on their parenting styles and behavior using the Alabama Parenting Questionnaire (APQ). The APQ consists of five subscales that yield two broadband "positive" and "negative" parenting factors. The measure is widely used and validated among parenting populations. 42 items are ranked on a scale of 1-5 and scores are computed for each subscale (with possible scores ranging from 3-15 for corporal punishment to 10-50 for longer subscales including parental monitoring and involvement). Higher scores reflect greater levels of each subscore domain.	Baseline, Intervention, Week 2, Month 3, Month 6, Month 9

Collaborators and Investigators

• Sponsor: Henry Ford Health System
• Collaborators: Michigan State University; University of Kansas; University of Maryland, College Park

Publications and helpful links

General Publications

• 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.
• 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.
• 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.
• 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.
• 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.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): February 6, 2024
• Primary Completion (Estimated): August 31, 2025
• Study Completion (Estimated): August 31, 2025

Study Registration Dates

• First Submitted: November 17, 2023
• First Submitted That Met QC Criteria: November 17, 2023
• First Posted (Actual): November 24, 2023

Study Record Updates

• Last Update Posted (Actual): May 14, 2025
• Last Update Submitted That Met QC Criteria: May 12, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Keywords: delay discounting; episodic future thinking; parent-child relations; low resource; episodic recent thinking; Flint, Michigan; special play time
• Other Study ID Numbers: NHRCT: 16828-01

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No