Determinants of seeking timely and necessary pediatric care

Ninety mothers were interviewed in a pediatrician’s waiting room about their reasons for seeking care. We compared their answers, and the pediatrician’s judgment of the visit’s necessity and timeliness to a model which distinguishes appraisal, illness, and utilization stages in seeking medical treatment. Clearly defined symptoms and the use of few home treatments predicted a more rapid assessment that one’s child was ill. No factors predicted how quickly a mother would decide that her child needed professional care, nor how rapidly she would then seek that care. The pediatrician judged visits to be necessary when the child had many physical symptoms, pain, and/or fever, and when the child’s mother was employed. He judged visits to be delayed for mothers who reported that cost of treatment may influence their decisions to seek care. He indicated that only 39% of the visits were both necessary and on time. We discuss ways to encourage appropriate utilization of pediatric visits.     

Current and Past Maternal Depression, Maternal Interaction Behaviors, and Children’s Externalizing and Internalizing Symptoms

Relations among past maternal depressive disorder, current depressive symptoms, current maternal interaction behaviors, and children's adjustment were examined in a sample of 204 women and their young adolescent offspring (mean age = 11.86, SD = 0.55). Mothers either had (n = 157) or had not (n = 57) experienced at least one depressive disorder during the child's life. Mothers and children participated in a problem-solving task, video-taped for later coding. Mothers with current depressive symptoms and those with histories of chronic/severe depressive disorders displayed fewer positive behaviors toward their children; mothers with current depressive symptoms also showed more negative behaviors with their children. The relation between mothers' depression history and their behavior during the interaction with their child was partially mediated by mothers' current mood state. Moreover, high levels of maternal negativity and low levels of positivity during the problem-solving task were related to children's externalizing problems. Maternal positivity partially mediated the relation between maternal depression and children's externalizing symptoms. These findings highlight the importance of providing parenting interventions for depressed mothers.     

Relationships Among Paternal Involvement and Young Children's Perceived Self-Competence and Behavioral Problems

We examined the relationships of father involvement to young children's perceived self-competence and fathers' and mothers' perceptions of their children's internalizing and externalizing behavioral problems. The results indicated that mothers in families in which father involvement is high may have a more positive outlook regarding their child's behavior than do mothers in families in which father involvement is low. Fathers who were highly involved indicated their children have more behavior problems than fathers who were not highly involved. High father involvement was associated with increased children's feelings of paternal acceptance, a factor that plays a role in the development of self-concept and esteem.     

Parenting cognitions and treatment beliefs as predictors of experience using behavioral parenting strategies in families of children with attention-deficit/hyperactivity disorder

We tested a model of mothers' parenting efficacy and attributions for child ADHD behaviors as predictors of experiences with behavioral treatment. The model proposed that mothers' beliefs regarding the acceptability and effectiveness of behavioral strategies would intervene between mothers' cognitions about parenting and child behavior and their treatment experiences. Participants were 101 mothers of 5- to 10-year-old children (82% male) with ADHD. Mothers reported their parenting efficacy and attributions for child behavior, and then received a single session of treatment teaching 2 behavior management strategies. Then, mothers reported their beliefs regarding the acceptability and effectiveness of these strategies. A follow-up phone interview 1 week later assessed mothers' experiences in using the behavioral strategies. The overall model fit the data. Attributions of child ADHD behavior as more pervasive, enduring, and within the child's control were related to seeing behavioral treatment as more acceptable, but neither attributions nor treatment acceptability predicted treatment experience. However, mothers with higher parenting efficacy viewed the behavioral strategies as more likely to be effective, and this pathway significantly predicted positive treatment experience. Implications for understanding the variables that contribute to parental decision-making and treatment participation for childhood ADHD are considered.     

Role of Parenting Relationship Quality in Communicating about Maternal BRCA1/2 Genetic Test Results with Children

It is known that many mothers rapidly share the results of their BRCA1/2 genetic testing with their children, especially adolescent children. What is less known is the extent to which these mothers may engage fathers in a discussion concerning genetic counseling and the anticipated disclosure of genetic test results to children, or seek shared decision making in this context. This short communication addresses this issue by first examining mothers' and fathers' discussions concerning a research study of family communication. In our view, this conversation likely served as a precursor to, and proxy indicator of, maternal receptivity to partner input regarding the genetic counseling/testing-results disclosure process. We further evaluated how the quality of the parenting relationship is associated with mothers' decisions to include or not include the child's father in this study. Finally, this report addresses potential ways in which the genetic counselor may be able to facilitate parental communication regarding the evolving process of disclosure of genetic information to children and adolescents.     

Self-fulfilling prophecies: the synergistic accumulative effect of parents' beliefs on children's drinking behavior

This research examined whether mothers' and fathers' beliefs about their children's alcohol use had cumulative self-fulfilling effects on their children's future drinking behavior. Analyses of longitudinal data acquired from 115 seventh-grade children and their mothers and fathers were consistent with synergistic accumulation effects for negative beliefs: Parents' beliefs predicted the greatest degree of confirmatory behavior from children when both mothers and fathers overestimated their children's alcohol use. Results did not support synergistic accumulation effects for positive beliefs: Children's predicted future alcohol use was similar regardless of whether one parent or both underestimated their child's alcohol use. These findings suggest that the generally small self-fulfilling effects reported in the literature may underestimate the power of negative self-fulfilling prophecies to harm targets because studies have not taken into consideration the possibility that negative self-fulfilling prophecies may be more likely than positive ones to accumulate across multiple perceivers.     

父母婚姻质量与儿童行为问题的追踪研究：儿童努力控制的调节作用

本研究采用母亲报告法,对474名学前儿童进行了为期一年的追踪研究,考察完整家庭中父母婚姻质量对儿童行为问题的影响,以及儿童努力控制的调节作用。结果表明:(1) 父母婚姻质量对学前儿童的外显和内隐行为问题均有即时的负向预测作用;(2) 儿童的努力控制对其当前、后期的外显和内隐行为问题均有负向预测作用;(3) 第一年儿童的努力控制对父母婚姻质量与儿童行为问题之间关系的调节作用成立。     

The impact of mothers' gender-role stereotypic beliefs on mothers' and children's ability perceptions.

The focus of this study is the relation between mothers' gender stereotypic beliefs, their perceptions of their children's abilities, and their children's self-perceptions in 3 activity domains. Approximately 1,500 mothers and their 11- to 12-year-old children responded to questions about the children's abilities in the math, sports, and social domains. It was predicted that mothers' beliefs about their children would be moderated by their gender stereotypic beliefs about the abilities of female and male people in general. As predicted, path analyses revealed that mothers' gender stereotypic beliefs interact with the sex of their child to influence their perceptions of the child's abilities. Mothers' perceptions, in turn, mediate the influence of past performance on children's self-perceptions in each domain.     

Relationship between a history of consistent maternal employment and depression in young adults

Research on the correlates of maternal employment has yielded inconsistent results. In this study, 79 male and 120 female undergraduates with mothers who had been employed from the students' infancy through their adolescence scored higher on the Beck Depression Inventory-II than those whose mothers had not been employed. This relationship between children's depressive symptoms and mothers' employment history was not evident among young adults whose mothers' employment was perceived to be financially unnecessary.     

Mothers' Overreactive Discipline and Their Encoding and Appraisals of Toddler Behavior

The relations of observed overreactive discipline with mothers' tendencies to notice negative, relative to positive, child behavior (preferential negative encoding), and mothers' negative appraisals of neutral and positive child behavior (negative appraisal bias), were examined in mothers of toddlers. The mothers rated both their own children's and unfamiliar children's behavior. Negative appraisal bias with respect to mothers' own (but not unfamiliar) children was related to mothers' overreactivity, independent of child misbehavior. Overreactivity was not related to mothers' preferential negative encoding either of their own or of unfamiliar children's behavior. However, in the case of mothers' own children, preferential negative encoding moderated the relation between negative appraisal bias and overreactive discipline, such that the negative appraisal bias-overreactivity relation was significant only in the context of high preferential negative encoding.     

Community violence, family conflict, and preschoolers' socioemotional functioning

This study examined the relations among family conflict, community violence, and young children's socioemotional functioning and explored how children's social cognition and mothers' psychological functioning may mediate the outcomes associated with this exposure. Mothers of 431 Head Start preschoolers completed questionnaires about their family demography, exposure to community violence, family conflict, and children's distress symptoms. Children were administered a social cognition assessment, and teachers rated their behavior. Results showed that mothers' reports of children's co-witnessing of community violence were positively associated with police department crime rates, children's distress symptoms, and teachers' ratings of aggression. A path analysis revealed that children's social awareness and mothers' depressive symptoms partially mediated the effects of community violence and family conflict on outcomes for children.     

Presenting problems and assigned diagnoses among young Latino children with disruptive behaviors

It is unclear whether the behaviors that alert families to the need for services are those that classify children for the diagnoses they receive. This study describes the behaviors that Latina mothers from Cuba, Puerto Rico, and the Dominican Republic report to have induced them to seek services for their young children. Both qualitative and quantitative analyses were used. Results indicated that mothers most frequently cited behaviors that fell in the categories of Hyperactivity, Aggression/Temper Tantrums, and School Complaints as reasons for help seeking. Whereas aggression and self-injurious acts were most alarming to mothers, School Complaints appeared to be a strong motivator for help seeking. Children whose mothers cited school behavior as a reason for help seeking had significantly poorer global functioning and presented significantly higher care giving demands than peers. In addition, their mothers reported significantly more disciplinary laxity than the mothers of peers without School Complaints. Maternal narratives of children's behaviors moderately concurred with assigned diagnoses. Mothers overlooked inattentive behaviors in children with ADHD and reported much more aggression and oppositionality than might be expected from the number of diagnoses of ODD that were assigned.     

Parenting Disruptive Preschoolers: Experiences of Mothers and Fathers

This study examined parental functioning and interactions with young children with Oppositional Defiant Disorder (ODD), with emphasis on differences between mothers and fathers in their responses to their child and in their unique contributions to the prediction of child disruptive behavior. Participants were 53 3- to 6-year olds with ODD who presented for treatment with two parents. Mothers reported more severe disruptive behavior and higher parenting stress than fathers. During parent-child interactions, mothers showed more responsiveness than fathers, even though children were more compliant during interactions with fathers. Regression analyses showed that fathers' parent-related stress was predictive of both mothers' and father's reports of disruptive child behavior; mothers' marital satisfaction was predictive of behavioral observations of child compliance with both mothers and fathers. This study revealed several important differences in the experiences of mothers versus fathers of disruptive children and indicates the importance of including the father in the child's assessment and treatment.     

Mothers' insightfulness regarding their infants' internal experience: relations with maternal sensitivity and infant attachment

This study examined the associations among mothers' insightfulness into their infants' internal experience, mothers' sensitivity to their infants' signals, and infants' security of attachment to their mothers. The insightfulness of 129 mothers of 12-month-old infants was assessed by showing mothers 3 videotaped segments of observations of their infants and themselves and interviewing them regarding their infants' and their own thoughts and feelings. Interviews were classified into 1 insightful and 3 noninsightful categories. Mothers' sensitivity was assessed during play sessions at home and at the laboratory, and infant-mother attachment was assessed with the Strange Situation. Mothers classified as positively insightful were rated as more sensitive and were more likely to have securely attached children than were mothers not classified as positively insightful. Insightfulness also accounted for variance in attachment beyond the variance explained by maternal sensitivity. These findings add an important dimension to research on caregiving, suggesting that mothers' seeking of explanations for the motives underlying their infants' behavior is related to both maternal sensitivity and infant attachment.     

Maternal depressive symptomatology and child behavior: transactional relationship with simultaneous bidirectional coupling

The present study investigated reciprocal relationships between adolescent mothers and their children's well-being through an analysis of the coupling relationship of mothers' depressive symptomatology and children's internalizing and externalizing behaviors. Unlike studies using discrete time analyses, the present study used dynamical systems to model time continuously, which allowed for the study of dynamic, transactional effects between members of each dyad. Findings provided evidence of coupling between maternal depressive symptoms and children's behaviors. The most robust finding was that as maternal depressive symptoms became more or less severe, children's behavior problems increased or decreased in a reciprocal manner. Results from this study extended upon theoretical contributions of such authors as Richters (1997) and Granic and Hollenstein (2003), providing empirical validation from a longitudinal study for understanding the ongoing, dynamic relationships between at-risk mothers and their children.     

The relation between young children's cognitive role-taking and mothers' preference for a conflict-inducing childrearing method

In this study, we examined children's cognitive role-taking in relation to their mothers' choices of techniques to solve domestic dilemmas involving children's misbehavior, social skills, and logical reasoning. Results showed that a mother's preference for the childrearing strategy known as distancing, which uses a Socratic or dialectical inquiry to create cognitive conflict in the child, bore a significant association to her child's advancement in cognitive role-taking skill. This finding is discussed in relation to theories of cognitive development that postulate that mental conflict or tension stimulates cognitive growth. Practical factors that might inhibit mothers from making effective use of the distancing technique are also considered.     

Moderating Effects of Mothers' Attribution on the Relationships Between Their Affect and Parenting Behaviors and Children's Aggressive Behaviors

We examined Bugental's (1987) transactional model in the context of the relationships between aggressive children and their mothers. Based on Bugental's model, it was hypothesized that mothers who possessed the attributional style of low self-control and high child-control over hypothetical child care failure were more likely to manifest negative affect and negative parenting behaviors toward their child, only when their child is aggressive. Children's aggressive behavior was assessed via mothers' and teachers' ratings. Sixty-six children and their mothers served as subjects. Our results provided support for mothers' negative affect when using teachers' rating of children's aggressive behaviors only. Possible explanations for the differential results obtained using mothers' and teachers' ratings of children's aggressive behaviors were discussed.     

Children’s Affect Expression and Frontal EEG Asymmetry: Transactional Associations with Mothers’ Depressive Symptoms

Although parents and children are thought to influence one another's affect and behavior, few studies have examined the direction of effects from children to parents, particularly with respect to parental psychopathology. We tested the hypothesis that children's affective characteristics are associated with the course of mothers' depressive symptoms. Children's affect expression was observed during a series of mother-child interaction tasks, and children's resting frontal electroencephalogram (EEG) asymmetry was assessed in a psychophysiology laboratory. Mothers' depressive symptoms were assessed at two time points, approximately one year apart, at the mother-child interaction visits. Depressive symptoms increased over time for mothers with a history of childhood-onset depression whose children exhibited right frontal EEG asymmetry. Depressive symptoms were associated with high child negative affect at both time points for mothers whose children exhibited right frontal EEG asymmetry. Cross-lagged models with a subset of participants provided some evidence of both parent-to-child and child-to-parent directions of effects. Findings suggest that akin to other interpersonal stressors, children's affective characteristics may contribute to maternal depressive symptoms.     

Contextual determinants of mothers' interventions in young children's peer interactions

In this study, the role of context in mothers' interventions in their preschool children's peer relationship problems was investigated. Event theme (aggression, peer rebuff, or initiating play), the child's role in the event (actor or target), the child's age and sex, and the mother's emotional reaction were examined as predictors of the extent to which mothers (N = 71) said they would discuss peer relationships, encourage peer interaction, and use power assertion in response to a series of videotaped vignettes depicting common peer relationship problems. Mothers suggested using more discussion in aggressive situations and more encouragement in initiating play situations. Mothers said they would use more power assertion when the child was the actor (i.e., provocateur), rather than the target, in an aggressive situation. Findings are discussed in terms of (a) the importance of considering context in understanding how mothers intervene in their children's peer relationships and (b) the need to examine moderators of cross-contextual consistency in mothers' interventions.     

Parent Cognitions as Predictors of Child Treatment Response in Attention-Deficit/Hyperactivity Disorder

Using a subsample of 105 children and their parents (100 mothers, 57 fathers) from the Multimodal Treatment Study of Children with ADHD (the MTA), the value of parents' baseline cognitions as predictors of children's treatment outcome at 14 months was examined. Measures of parents' cognitions about themselves, their ADHD children, and their parenting, as well as a self-report measure of dysfunctional discipline were included. Both mothers' and fathers' self-reported use of dysfunctional discipline predicted worse child treatment outcome. Low self-esteem in mothers, low parenting efficacy in fathers, and fathers' attributions of noncompliance to their ADHD child's insufficient effort and bad mood also were associated with worse child treatment outcome. All of these predictive relations were obtained even after MTA treatment effects had been taken into account. Secondary analyses indicated that mothers had a more external locus of control, lower self-esteem, lower parenting efficacy, and a greater tendency to attribute noncompliance to their ADHD child's bad mood than did fathers.