Parenting Stress and Childhood Psychopathology: An Examination of Specificity to Internalizing and Externalizing Symptoms

The purpose of this study was to examine if specificity exists between three factors of parenting stress (i.e., parental distress, parent–child (PC) dysfunctional interactions, and difficult child) and childhood internalizing and externalizing symptoms. The incremental validity of parenting stress beyond parental psychopathology was also examined. The sample was drawn from families of children aged 5–17 (N = 300), who sought treatment for their child from a community mental health clinic. Results indicated that the PC dysfunctional interactions factor showed specificity to internalizing symptoms when controlling for parental psychopathology. Parental distress did not show specificity or incremental validity and the difficult child factor was associated with both internalizing and externalizing symptoms when controlling for parental psychopathology. The influence of age, gender, and ethnicity on these associations is also presented, and findings are discussed in terms of how the results add to understanding the specific relations between parenting stress and child and adolescent symptoms.     

Co-occurring Mental Health Problems and Peer Functioning Among Youth with Attention-Deficit/Hyperactivity Disorder: A Review and Recommendations for Future Research

It is well established that children and adolescents with attention-deficit/hyperactivity disorder (ADHD) frequently experience co-occurring mental health problems in addition to difficulties in their peer relationships. Although substantial research has focused on the extent to which peer functioning contributes to subsequent co-occurring mental health problems, much less research has considered how co-occurring mental health problems affect peer functioning domains. Therefore, the purpose of this review is to examine the effect of co-occurring mental health problems on the peer functioning of youth with ADHD. The impact of co-occurring externalizing (i.e., oppositional defiant disorder, conduct disorder) and internalizing (i.e., anxiety, depression) symptoms are reviewed, with a focus on whether these co-occurring symptoms exacerbate, attenuate, or have no effect across peer domains of social skills/competence, peer status, and friendship among youth with ADHD. Drawing from a developmental psychopathology framework, this review then draws attention to relevant causal processes and developmental cascades (including social-cognitive, affective, and family and parenting factors) in offering promising avenues for future work.     

Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD

We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.     

Moderators of informant agreement in the assessment of adolescent psychopathology: extension to a forensic sample

A well-documented finding in developmental psychopathology research is that different informants often provide discrepant ratings of a youth's internalizing and externalizing problems. The current study examines youth- and parent-based moderators (i.e., youth age, gender, and IQ; type of psychopathology; offense category; psychopathic traits; parental education, income, and stress) of informant discrepancies in a sample of young offenders and compares the utility of youth and caregiver reports against relevant clinical outcomes. Results indicate that gender moderated the discrepancy between informant reports of somatic complaints, while parenting stress moderated the discrepancies across reports of internalizing and externalizing psychopathology. Variables unique to the forensic context (e.g., offense category) were found to moderate cross-informant discrepancies in reports of internalizing and externalizing psychopathology. Further, youth self-reports of internalizing symptoms predicted a clinician-generated diagnosis of a mood disorder, while caregiver reports of aggressive behaviors predicted the presence of an externalizing diagnosis. Results highlight the importance of assessing informant agreement in the context of forensic assessment and raise questions surrounding the optimal use of informant data in this setting.     

Internal and External Validity of Self-Report and Parent-Report Measures of Sluggish Cognitive Tempo in South Korean Adolescents

This study evaluated the internal and external validity of self-report and parent-report measures of sluggish cognitive tempo (SCT) in South Korean adolescents. Adolescents (N =?469, ages 13–17 years; 50.2% boys) completed self-report measures of SCT and attention-deficit/hyperactivity disorder inattention (ADHD-IN) in addition to measures of internalizing and externalizing psychopathology, social problems, and grades. Parents rated adolescents on SCT, ADHD-IN, internalizing and externalizing psychopathology, and social problems. Using adolescent self-report, 11 of 15 SCT symptoms showed convergent and discriminant validity with ADHD-IN. Using parent-report, all 15 SCT symptoms showed convergent and discriminant validity with ADHD-IN. For within source analyses, SCT showed unique and stronger associations than ADHD-IN with internalizing psychopathology whereas ADHD-IN showed unique and stronger associations than SCT with externalizing psychopathology. SCT and ADHD-IN showed similar unique associations with social problems, whereas ADHD-IN was more strongly related than SCT to grades. Across source analyses also supported the differential unique associations of SCT and ADHD-IN with internalizing and externalizing psychopathologies. This study provides initial evidence for the internal and external validity of SCT with South Korean adolescents, extending support for the transcultural validity of SCT to the important developmental period of adolescence.

     

Resilient Adolescent Adjustment Among Girls: Buffers of Childhood Peer Rejection and Attention-Deficit/Hyperactivity Disorder

Examined a risk-resilience model of peer rejection and attention-deficit/hyperactivity disorder (ADHD) in a 5-year longitudinal study of 209 ethnically and socioeconomically diverse girls aged 6-13 at baseline and 11-18 at follow-up. Risk factors were childhood ADHD diagnosis and peer rejection; hypothesized protective factors were childhood measures of self-perceived scholastic competence, engagement in goal-directed play when alone, and popularity with adults. Adolescent criterion measures were multi-informant composites of externalizing and internalizing behavior plus indicators of academic achievement, eating pathology, and substance use. ADHD and peer rejection predicted risk for all criterion measures except for substance use, which was predicted by ADHD only. ADHD and peer rejection predicted lower adolescent academic achievement controlling for childhood achievement, but they did not predict adolescent externalizing and internalizing behavior after controlling for baseline levels of these constructs. Regarding buffers, self-perceived scholastic competence in childhood (with control of academic achievement) predicted resilient adolescent functioning. Contrary to hypothesis, goal-directed play in childhood was associated with poor adolescent outcomes. Buffers were not found to have differential effectiveness among girls with ADHD relative to comparison girls.     

共情与青少年内外化问题的关系及影响机制

内外化问题是青少年最常见的心理行为问题,共情与青少年内外化问题具有重要联系,但以往研究青少年内外化问题的时候不注重共情不同成分的区分;即使区分了共情的不同成分,认知共情和情绪共情作为共情的不同成分和内外化问题的关系仍旧存在一定争议,且共情对内外化问题影响的机制鲜有探讨。本文首先综述了认知共情和情绪共情与青少年内外化问题的关系,并借助共情的发生过程（自我-他人模型）理论、发展过程（风险性发展模型）理论和相关神经生理因素,为理解共情对青少年内外化问题的影响机制提供了解释。未来研究可明确共情的定义,发展更生态化的测评方式,并进一步探索影响因素及机制,结合和关注个体特点、特殊群体及文化背景,以便为揭示共情与青少年内外化问题构建更系统的理论。     

Externalizing Outcomes of Youth with and without ADHD: Time-Varying Prediction by Parental ADHD and Mediated Effects

Although parental attention-deficit/hyperactivity disorder (ADHD) is a risk factor for multiple negative youth outcomes, it is unknown how change in parental ADHD symptoms over time affects change in child ADHD symptoms; moreover, mediators of these predictions are largely unknown. Parents of 230 5–10 year-old children (68 % male) with (n = 120) and without ADHD (n = 110) were followed prospectively for 6–7 years across three separate waves. Parents self-reported their ADHD and depression symptoms and similarly rated offspring ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms; youth self-reported their substance use. Temporally-ordered mediators consisted of parental expressed emotion (EE), derived from the Five Minute Speech Sample, and self-reported positive and negative parenting behavior. Controlling for key demographics and parental depression symptoms, increasing parental ADHD symptoms were a time-varying predictor of worsening youth ADHD and ODD, although it was unrelated to change in CD and alcohol/substance use. Next, although EE facets (i.e., criticism, emotional over-involvement) did not mediate these predictions, negative parenting behavior significantly mediated predictions of youth ADHD (and marginally in predictions of ODD) from parental ADHD symptoms. These quasi-experimental findings suggest that parental ADHD symptoms are a potential unique causal risk factor for offspring ADHD and ODD; also, preventing negative parenting behavior secondary to parental ADHD symptoms is critical to improve trajectories of youth ADHD and ODD. We consider parental ADHD symptoms and family factors underlying emergent externalizing problems utilizing a developmental psychopathology framework, including implications for intervention and prevention.     

Self-control,parenting, and problem behavior in early childhood: A multi-method,multi-informant study

BackgroundEarly childhood self-control and parenting are suggested to play key roles in the development of child problem behavior. The current study aims to 1) replicate earlier work by examining the unique and combined effects of child self-control and parenting on child problem behavior and 2) extend earlier work by including both mother and father reports.MethodsData were used from 107 Dutch families: mothers, fathers, and their two-year old child. Child self-control was measured using both father’s and mother’s reports of effortful control and with an observed behavioral task (i.e., gift-in-bag task). Similarly, parenting (i.e., emotional availability and discipline) and child problem behavior (i.e., externalizing and internalizing problems) were measured by using both father’s and mother’s reports.ResultsChild self-control reported by fathers and mothers, but not observed self-control, was related to fewer externalizing and (mother-reported) internalizing problems. Paternal emotional availability showed a modest association with fewer child externalizing problems, maternal emotional availability was related to fewer internalizing problems. Finally, there was an interaction between father- (but not mother) reported self-control and paternal emotional availability in the prediction of child internalizing problems. No main or interaction effect was revealed for discipline.ConclusionFindings confirm prior work on self-control, parenting, and child problem behavior. Most importantly however, the current study adds to the literature by highlighting the need for additional research including maternal as well as paternal data. Specifically, insight in the unique role of fathers may shed light on aspects of child adjustment not covered by mother reports alone.     

Impact of Behavioral Inhibition and Parenting Style on Internalizing and Externalizing Problems from Early Childhood through Adolescence

Behavioral inhibition (BI) is characterized by a pattern of extreme social reticence, risk for internalizing behavior problems, and possible protection against externalizing behavior problems. Parenting style may also contribute to these associations between BI and behavior problems (BP). A sample of 113 children was assessed for BI in the laboratory at 14 and 24 months of age, self-report of maternal parenting style at 7 years of age, and maternal report of child internalizing and externalizing BP at 4, 7, and 15 years. Internalizing problems at age 4 were greatest among behaviorally inhibited children who also were exposed to permissive parenting. Furthermore, greater authoritative parenting was associated with less of an increase in internalizing behavior problems over time and greater authoritarian parenting was associated with a steeper decline in externalizing problems. Results highlight the importance of considering child and environmental factors in longitudinal patterns of BP across childhood and adolescence.     

Exposure to Violence and Socioemotional Adjustment in Low-Income Youth: An Examination of Protective Factors

Using a sample of 391 low-income youth ages 13–17, this study investigated the potential moderating effects of school climate, participation in extracurricular activities, and positive parent–child relations on associations between exposure to violence (i.e., witnessing violence and violent victimization) and adolescent socioemotional adjustment (i.e., internalizing and externalizing problems). Exposure to violence was related to both internalizing and externalizing problems. High levels of participation in extracurricular activities and positive parent–child relations appeared to function as protective factors, weakening the positive association between exposure to violence and externalizing problems. Contrary to prediction, school climate did not moderate associations between exposure to violence and socioemotional adjustment. Further, none of the hypothesized protective factors moderated the association between exposure to violence and internalizing problems.     

The Association of Parent Mindfulness with Parenting and Youth Psychopathology Across Three Developmental Stages

The primary purpose of the current study was to test a model examining the process by which parent dispositional mindfulness relates to youth psychopathology through mindful parenting and parenting practices. The universality of the model across youth at three developmental stages was examined: young childhood (3–7 years; n?=?210), middle childhood (8–12 years; n?=?200), and adolescence (13–17 years; n?=?205). Overall, participants were 615 parents (55 % female) and one of their 3-to-17 year old children (45 % female). Parents reported on their dispositional mindfulness, mindful parenting, positive and negative parenting practices and their child’s or adolescent’s internalizing and externalizing problems. Consistent findings across all three developmental stages indicated that higher levels of parent dispositional mindfulness were indirectly related to lower levels of youth internalizing and externalizing problems through higher levels of mindful parenting and lower levels of negative parenting practices. Replication of these findings across families with children at different developmental stages lends support to the generalizability of the model.     

Explaining the Asian American Youth Paradox: Universal Factors versus Asian American Family Process Among Filipino and Korean American Youth

This study used longitudinal survey data of Filipino American and Korean American youth to examine ways in which universal factors (e.g., peer antisocial behaviors and parent–child conflict) and Asian American (AA) family process variables (e.g., gendered norms) independently and collectively predict grade point average (GPA), externalizing, and internalizing problems. We aimed to explain the “Asian American youth paradox” in which low externalizing problems and high GPA coexist with high internalizing problems. We found that universal factors were extensively predictive of youth problems and remained robust when AA family process was accounted for. AA family process also independently explained youth development and, in part, the AA youth paradox. For example, gendered norms increased mental distress. Academic controls did the opposite of what it is intended, that is, had a negative impact on GPA as well as other developmental domains. Family obligation, assessed by family-centered activities and helping out, was beneficial to both externalizing and internalizing youth outcomes. Parental implicit affection, one of the distinct traits of AA parenting, was beneficial, particularly for GPA. This study provided important empirical evidence that can guide cross-cultural parenting and meaningfully inform intervention programs for AA youth.     

The Co-Development of Parenting Stress and Childhood Internalizing and Externalizing Problems

Although the detrimental influence of parenting stress on child problem behavior is well established, it remains unknown how these constructs affect each other over time. In accordance with a transactional model, this study investigates how the development of internalizing and externalizing problems is related to the development of parenting stress in children aged 4–9. Mothers of 1582 children participated in three one-year interval data waves. Internalizing and externalizing problems as well as parenting stress were assessed by maternal self-report. Interrelated development of parenting with internalizing and externalizing problems was examined using Latent Growth Modeling. Directionality of effects was further investigated by using cross-lagged models. Parenting stress and externalizing problems showed a decrease over time, whereas internalizing problems remained stable. Initial levels of parenting stress were related to initial levels of both internalizing and externalizing problems. Decreases in parenting stress were related to larger decreases in externalizing problems and to the (stable) course of internalizing problems. Some evidence for reciprocity was found such that externalizing problems were associated with parenting stress and vice versa over time, specifically for boys. Our findings support the transactional model in explaining psychopathology.     

ODD dimensions, ADHD, and callous-unemotional traits as predictors of treatment response in children with disruptive behavior disorders

To answer several questions pertinent to DSM-V, the authors examined the predictive validity of pretreatment oppositional defiant disorder (ODD) dimensions, attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits in relation to several treatment outcomes in 177 children diagnosed with ODD or conduct disorder (CD). Multiple informants completed diagnostic interviews and rating scales at 6 assessment points (pretreatment to 3-year follow-up) to document emotional and behavioral outcomes. After controlling for pretreatment CD, the ODD dimension of hurtfulness was related to treatment-resistant CD, delinquent behaviors, and externalizing problems. In contrast, the ODD dimension tapping irritability was associated with treatment-resistant ODD, internalizing problems, and global functional impairment following treatment. Whereas pretreatment ADHD was associated with posttreatment ODD and social problems, it was unrelated to posttreatment CD symptoms and diagnosis. Contrary to predictions, CU traits were unrelated to any posttreatment outcomes after controlling for other covariates. These findings remained after controlling for measures of pretreatment global functional impairment.     

Maladaptive personality traits and psychopathology in childhood and adolescence: the moderating effect of parenting

This study examines child and adolescent psychopathology from a maladaptive trait perspective, incorporating both parental and child ratings of parenting as a moderator of the personality-psychopathology association. Hierarchical moderated regression analyses were conducted on a combined sample of referred and nonreferred children and adolescents (N=862, parental ratings of parenting and N=396, child ratings of parenting). The results indicated positive main effects of maladaptive traits on externalizing and internalizing problems, and positive main effects of parental negative control on externalizing problems. Significant interactions were found for Disagreeableness and Emotional Instability with parental Negative Control and for Disagreeableness x Positive Parenting in explaining externalizing problems. The discussion focuses on the contribution of these findings to a better understanding of the trait-psychopathology relationship at young age.     

Response Inhibition and Measures of Psychopathology: A Dimensional Analysis

On the basis of Quay's (1988a, 1988b, 1993, 1997) model in which the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS) are linked to various forms of child psychopathology, predictions were made regarding the relation between inhibitory control and two dimensions of psychopathology: externalizing and internalizing behavior. Inhibitory control was measured using two versions of Logan and Cowan's stop signal paradigm (1984; Logan, Cowan, & Davis, 1984; Osman, Kornblum, & Meyer, 1986, 1990). The primary outcome measure for the stop tasks was stop signal reaction time (SSRT) which measures the latency of the inhibition process. A positive relationship was predicted for externalizing behavior, whereas a negative relationship was predicted for internalizing behavior. A total of 42 non-clinical elementary school children, in the age range of 6 to 12 years, participated in the study. Externalizing behavior was positively related to response inhibition. Symptoms of ADHD seem to be better at predicting inhibitory functioning than symptoms of aggressive behavior disorders. Some support was found for a negative relation between internalizing behavior and inhibitory control. These findings support Quay's model and the discriminant validity of inhibitory control with regard to externalizing and internalizing behavior.     

Irritability and Limited Prosocial Emotions/Callous-Unemotional Traits in Elementary-School-Age Children

Affective traits, including irritability and limited prosocial emotions/callous-unemotional traits (LPE/CU), each explain significant variance in youth conduct problems but few studies have examined these constructs simultaneously. This study examined whether irritability, LPE/CU, or their combination explained significant variance in measures of internalizing or externalizing psychopathology, aggression, peer problems, impairment, or parenting. Participants were 219 elementary-school-age children, including 178 with attention-deficit/hyperactivity disorder, oppositional defiant disorder, and/or conduct disorder and 41 typically developing children. Results of analyses showed that irritability and LPE/CU had significant and sometimes unique associations with measures of child behavior, impairment, and parenting. There was also evidence that the interaction between irritability and LPE/CU was significantly associated with aggression and impairment. These findings suggest that irritability and LPE/CU should be examined together when assessing and treating conduct problems in youth.     

Response inhibition and measures of psychopathology: a dimensional analysis.

On the basis of Quay's (1988a, 1988b, 1993, 1997) model in which the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS) are linked to various forms of child psychopathology, predictions were made regarding the relation between inhibitory control and two dimensions of psychopathology: externalizing and internalizing behavior. Inhibitory control was measured using two versions of Logan and Cowan's stop signal paradigm (1984; Logan, Cowan, & Davis, 1984; Osman, Kornblum, & Meyer, 1986, 1990). The primary outcome measure for the stop tasks was stop signal reaction time (SSRT) which measures the latency of the inhibition process. A positive relationship was predicted for externalizing behavior, whereas a negative relationship was predicted for internalizing behavior. A total of 42 non-clinical elementary school children, in the age range of 6 to 12 years, participated in the study. Externalizing behavior was positively related to response inhibition. Symptoms of ADHD seem to be better at predicting inhibitory functioning than symptoms of aggressive behavior disorders. Some support was found for a negative relation between internalizing behavior and inhibitory control. These findings support Quay's model and the discriminant validity of inhibitory control with regard to externalizing and internalizing behavior.     

Common and specific correlates of preadolescent internalizing and externalizing psychopathology

The specificity of various child characteristics and environmental correlates of childhood internalizing and externalizing problems was examined using both cross-sectional and longitudinal analyses (from ages 2-3 and 4-5 years) in a general population sample of 10-11-year-olds. Specificity was defined according to a between-subjects and a within-subjects method, using parent and teacher reports of psychopathology. Temperamental withdrawal, parental internalizing psychopathology, and early single parenthood (for girls) were identified as correlates that are specific for internalizing problems, whereas temperamental high general activity level was identified as externalizing-specific. Further, parenting stress, poor school results (only for boys), and stressful life events (only for girls) were found to be common correlates of psychopathology. Research implications regarding the findings and the use of a within-subjects method are discussed.