Childhood Irritability: Predictive Validity and Mediators of Adolescent Psychopathology

Despite its transdiagnostic significance, there is modest evidence with respect to the predictive validity of childhood irritability, especially across developmental periods; similarly, little is known about explanatory factors underlying these predictions. This study had two goals: (1) to test the predictive validity of childhood irritability with respect to adolescent internalizing and externalizing problems, controlling for baseline ADHD and related psychopathology and (2) to test theoretically-derived family (i.e., parenting behavior, parenting stress) and social (i.e., peer status, social skills) constructs as explanatory factors of adolescent psychopathology. Two hundred thirty ethnically diverse (51.5% White) 5–10-year-old youth (32% female) with (n?=?121) and without (n?=?110) ADHD completed three separate laboratory-based assessments across six to seven years. Temporally-ordered predictors, putative mediators, and psychopathology outcomes were assessed using multiple informants (i.e., parent, teacher, youth) and methods (i.e., structured interviews, normed rating scales). Controlling for demographic factors, clinical correlates, and baseline psychopathology, childhood irritability uniquely predicted adolescent externalizing problems, but not internalizing problems. Next, analyses revealed that low social skills partially explained predictions of adolescent internalizing problems. However, family or social factors did not underlie predictions of adolescent externalizing problems. These preliminary findings support the predictive validity of childhood irritability with respect to early adolescent externalizing problems and implicate low social skills as a potentially unique mediator of internalizing outcomes. Intervention-induced improvements in social skills may minimize emergent psychopathology initiated by significant childhood irritability.

     

Modeling relations between hassles and internalizing and externalizing symptoms in adolescents: a four-year prospective study

This study examined the relations between hassles and internalizing and externalizing symptoms across 4 years in adolescents who varied with regard to their risk for psychopathology. The sample comprised 240 adolescents assessed in 6th, 7th, 8th, and 9th grades regarding their level of peer and academic hassles and internalizing and externalizing symptoms. Structural equation modeling was used to construct latent variables of hassles and internalizing and externalizing syndromes. Results varied by informant about the teens' symptoms. For adolescent report, the stress exposure model fit the data best for internalizing syndromes; that is, higher levels of stressors predicted significantly higher levels of self-reported symptoms 1 year later. For mother report of adolescents' symptoms, the stress generation model fit the data best for both internalizing and externalizing syndromes; that is, higher levels of adolescents' internalizing and externalizing symptoms, as reported by their mothers, significantly predicted higher levels of hassles 1 year later.     

Parenting and Preschoolers' Symptoms as a Function of Child Gender and SES

ABSTRACT

Improving parental discipline practices is a central target of behavioral parent training programs, but little research has examined how discipline varies as a function of gender. Based on the assumption that socialization practices might be related to gender differences in psychopathology, we examined relations between parenting and problem behaviors in children. We predicted that parents would be overreactive toward children displaying symptoms inconsistent with gender stereotypes and lax towards those with gender stereotype-consistent behavior. Parents of 112 preschool-aged children reported on their children's externalizing and internalizing symptoms, and their own lax and overreactive parenting. As hypothesized, internalizing symptoms in girls and externalizing symptoms in boys predicted lax parenting, while externalizing behaviors in girls and internalizing symptoms in boys were associated with overreactive parenting. Exploratory analyses suggest that relations differed somewhat as a function of sociocultural status, pointing to the need for future studies to consider social context.     

An Examination of Gender Differences in Adolescent Adjustment: The Effect of Competence on Gender Role Differences in Symptoms of Psychopathology

Numerous studies have documented gender differences in psychopathology; girls generally report more internalizing symptoms and boys generally report more externalizing symptoms. These gender differences are partially accounted for by the gender-typed personality characteristics of boys and girls. This study was designed to investigate how gender roles influence symptoms of psychopathology by examining the mediating effects of self- and peer-rated competencies. Using a multiple regression approach to path analysis with a sample of primarily White, middle-class high school students, gender roles significantly predicted symptoms of psychopathology and mediated the gender differences in those symptoms. In addition, the adolescents' self- and peer-rated competence in various domains helped to explain the effect of gender roles on symptoms of psychopathology. Specifically, self-rated social attractiveness and global self-worth fully mediated the relation between instrumentality (i.e., masculinity) and internalizing symptoms. Global self-worth and both self- and peer-rated achievement/conduct partially mediated the relation between expressivity (i.e., femininity) and externalizing symptoms. Practical and theoretical implications are discussed.     

Mental Health Problems of Displaced War-Affected Adolescents in Northern Uganda: Patterns of Agreement Between Self and Caregiver Assessment

We evaluate caregiver and adolescent concordance on adolescent mental health severity in war-affected Northern Uganda. Data were collected from 628 caregiver-adolescent dyads in two internally displaced persons’ camps. Internalizing and externalizing-type mental health problems were assessed using locally-developed scales. To evaluate concordance, mean caregiver and adolescent scores on each scale were compared using Pearson’s correlation coefficients and within-pair-differences were compared by subtracting caregiver from adolescent responses and using t tests to assess whether these differed from 0. Mental heath problem type and youth/caregiver gender and age were investigated as potential indicators of group differences. Adolescents consistently rated their problems as more severe for internalizing problems and less severe for externalizing problems compared with caregivers. Mothers’ reports exhibited better concordance for internalizing problems while fathers’ and other caregivers’ exhibited better concordance of externalizing problems. Results suggest researchers and program implementers need to be aware of respondent differences when planning studies and services.     

Measuring Relational Aggression in Middle Childhood in a Multi-Informant Multi-Method Study

Relational aggression includes behaviors intended to damage the social status and relationships of others. Recent work has demonstrated problematic outcomes for both aggressors and victims. These behaviors have been associated with psychopathology, including early borderline personality pathology. Despite the importance in better understanding these behaviors, numerous questions remain regarding the validity of different informants and methods for assessing relational aggression. In a community-based sample of 330 families evenly split by child gender (50.3% female), relational aggression data was assessed via multiple informants (mother, father, and self) and multiple methods (questionnaire and interview). The results suggest that mothers and fathers show higher agreement for girls’ relational aggression than for boys’ and that the presence of gender differences depends on the method of measurement. In addition, both mothers and fathers reports of relational aggression uniquely predicted internalizing behaviors, externalizing behaviors, and social problems, with fathers’ reports emerging as a particularly robust predictor. Relational aggression scores accounted for a greater amount of predicted variance in externalizing behaviors than in the other two domains. Results are discussed in the context of the utility of multiple informants and the conceptualization of relational aggression in a broader externalizing psychopathology framework.     

Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar psychosocial outcomes as CD. However, relatively little work has examined whether forms of psychopathology (e.g., externalizing and/or internalizing disorders) mediates the relationship between youth CD and adult psychosocial outcomes. The present study examined associations between youth CD and adult psychosocial outcomes and sought to identify forms of psychopathology that may potentially mediate this relationship. Participants completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Analyses found that most domains of adult psychosocial functioning were associated with youth CD. Adult antisocial behavior was the only form of psychopathology predicted by CD. Adult antisocial behavior appeared to mediate the relationship between CD and marital status, life satisfaction, and being in jail and partially mediated the relationship between CD and family support and global functioning. These data suggest that reducing the progression to adult antisocial behavior may improve multiple psychosocial outcomes among those with a history of CD.     

HPA-Axis Activation as a Key Moderator of Childhood Trauma Exposure and Adolescent Mental Health

Individual differences in a child’s sensitivity to stress may influence whether youth exposed to trauma develop symptoms of psychopathology. We examined the interaction between HPA-axis reactivity to an acute stressor and exposure to different types of childhood trauma as predictors of mental health symptoms in a sample of youth. Youth (n?=?121, ages 9–16; 47% female) completed a standardized stress task, including 5 post-stress salivary cortisol samples. Parents also completed the Child Behavior Checklist as a measure of child internalizing and externalizing symptoms in the past month, and completed the Early Trauma Inventory (ETI) as a measure of their child’s trauma exposure. More emotional abuse and non-intentional trauma were associated with greater internalizing symptoms. Youth exposed to physical abuse who demonstrated slower HPA-axis reactivity had elevated internalizing and externalizing symptoms. Youth exposed to emotional abuse or non-intentional traumatic events who demonstrated faster HPA-axis reactivity had elevated internalizing and externalizing symptoms. Profiles of exaggerated or attenuated HPA-axis reactivity to acute stress may be risk factors for psychopathology in children facing different stressful social environments.     

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.     

Organizational social context and psychopathology of youth in residential care: The intervening role of youth–caregiver relationship quality

Drawing on an ecological approach with multiple informants, this study investigated the mediating role of youth–caregiver relationship quality in associations between different features of residential care settings' organizational social context and youth's psychopathology. Participants were 378 youth aged between 12 and 25 years old, and 54 caregivers aged between 24 and 57 years old, from 29 generalist residential youth care settings in Portugal. Given the hierarchical structure of data, analyses were performed using multilevel modeling. Results revealed that organizational social contexts characterized by higher levels of engagement, stress, and centralization, as perceived by the caregivers, were associated with lower levels of youth's externalizing problems (e.g., aggressive behavior and delinquency), reported by the caregivers, via better youth–caregiver relationship quality, perceived by the youth in care. These findings highlight the relevance of creating an organizational social context in residential care settings that supports caregivers in establishing high-quality relationships with the youth in care, thereby promoting their mental health. This study contributes to the clarification of conflicting findings in previous studies of this field, by offering further empirical investigation of these issues.     

The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a meta-analysis

In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition).     

Factors Associated with Psychological Maladjustment of Mexican Adolescents Living in Poverty

The objectives of this study were to test the replicability of the Youth Self-Report structure in Mexican adolescents living in poverty; to determine gender and rurality differences in internalizing and externalizing problems; and to identify predictors of internalizing and externalizing problems. Data were collected from a probabilistic sample of households that are beneficiaries of the Oportunidades program, including the heads of those households, their spouses and their adolescent children. The self-reports of parents and children were analyzed using structural equation modeling. Results confirmed the Youth Self-Report structure in Mexican adolescents, and indicated higher levels of emotional disorders in females, higher levels of behavioral disorders in males, and higher levels in all the Youth Self-Report scales in rural adolescents. Internalizing and externalizing problems were mediated by the presence of loneliness, oppositional behavior and stress, through which the model’s other latent variables exerted indirect influence on the determination of youth psychopathology.     

Examination of consistency of adolescent and parent reports across several psychosocial constructs

This study investigated the consistency of discrepancy scores between adolescent and parent reports across several psychosocial constructs (adolescent internalizing, externalizing, emotion regulation difficulties, parent rewarding responses to adolescent emotions, and parent depressive symptoms). Sixty‐two adolescents (67.7% females; 76.7% African American) and one of their parents participated. Most of the associations among discrepancy scores were equivalent. There was one instance in which the association among two discrepancy scores (youth internalizing and externalizing) was stronger than the others and one instance in which the association was weaker than the others (youth internalizing and parent rewarding). These results suggest that discrepancies between adolescent and parent reports are not necessarily a stable characteristic of the dyad and depend on the construct under consideration.     

Testing Informant Discrepancies as Predictors of Early Adolescent Psychopathology: Why Difference Scores Cannot Tell You What You Want to Know and How Polynomial Regression May

Multiple informants commonly disagree when reporting child and family behavior. In many studies of informant discrepancies, researchers take the difference between two informants’ reports and seek to examine the link between this difference score and external constructs (e.g., child maladjustment). In this paper, we review two reasons why difference scores cannot serve as unambiguous predictors of outcomes. Further, we use polynomial regression analyses to both test the validity of difference scores and provide a more direct test of the hypothesis that discrepancies in parent and child reports predict child psychopathology. Data from 218 parent-adolescent dyads (M adolescent age?=?11.5 years, 51 % female; 49 % European American, 47 % African American) were used to predict adolescent-reported antisocial behavior and depression from parent and adolescent reports of parent-adolescent conflict, parental knowledge, parental acceptance, adolescent rule-breaking behavior, and adolescent pubertal development. Results demonstrate that analyses using difference scores do not provide valid tests of the utility of informant discrepancies in predicting adolescent psychosocial maladjustment. However, interaction terms in polynomial regression analyses provide evidence that informant discrepancies predict child psychopathology. Parent-adolescent informant discrepancies predict adolescent psychopathology but researchers should avoid using difference scores to measure informant discrepancies. Polynomial regression analyses provide more comprehensive and accurate tests of whether informant discrepancies predict child and adolescent psychopathology.     

Predictive Value of Informant Discrepancies in Reports of Parenting: Relations to Early Adolescents’ Adjustment

Research has demonstrated a lack of agreement between parent and child reports across a range of parent and child variables. These discrepancies hinder the interpretation of research findings as well as diagnostic and treatment decisions in clinical practice. The current study examined the hypothesis that discrepancies between parent and child reports of parenting can be useful as predictors of future child outcomes. The participants included 559 early adolescents and their primary caregivers (79% African American, 21% Caucasian). Both respondents provided information on parental nurturance, harsh discipline and inconsistent discipline. A year later, information of adolescents’ internalizing problems, externalizing problems, and social competence was collected. Structural equation modeling revealed that parent-child discrepancies in parenting reports could be explained by a latent factor which was a significant predictor of child internalizing problems and social competence, but not of externalizing problems, after adjusting for initial internalizing and externalizing problems. The three models applied across gender and ethnicity.     

Are discrepancies among child,mother, and father reports on children's behavior related to parents' psychological symptoms and aspects of parent-child relationships?

Examined whether parents' symptoms and qualitative and quantitative aspects of parent–child relationships make unique contributions to mothers' and fathers' reports of, and mother–child, father–child, and father–mother discrepancies on, children's behavior. Participants were 100 children, aged 10–12, and their mothers and fathers. Parents' symptoms and parent–child relationships made unique contributions to both parents' ratings of externalizing behavior. Although parent–child relationship variables were related to both parents' ratings of internalizing behavior, only parents' symptoms made unique contributions. On mother–child and father–child discrepancies, differences emerged between mother and father, and internalizing and externalizing behaviors. Both fathers' and mothers' symptoms contributed to father–mother discrepancies on both behavior types, with parent–child relationships contributing unique variance to discrepancies on internalizing behavior. Results highlight the importance of each informant's symptoms and relationship variables in understanding informant discrepancies.     

Linking dimensions and dynamics in psychopathology research: An example using DSM-5 instruments

The DSM-5 includes two measures to assess dimensions of personality pathology (Personality Inventory for DSM-5; PID-5) and cross-cutting symptoms of psychopathology (DSM-5 Cross-cutting Symptom Measure; CCS). Few studies have evaluated these measures in an ecologically valid context. Participants (N = 248, student sample) completed self-report versions of the DSM-5 measures, and then completed a two-week daily diary of internalizing and externalizing outcomes. The CCS scales evidenced convergent and discriminant validity with these outcomes, PID-5 Negative Affectivity and Detachment were related to internalizing outcomes, and PID-5 Antagonism was related to externalizing outcomes. We also demonstrated the benefit of linking static dimensions to temporally-dynamic processes by examining how PID-5/CCS dimensions moderated the within-person associations among daily cognitive distortions and internalizing and externalizing outcomes.     

Exposure to Bullying and General Psychopathology: A Prospective,Longitudinal Study

Although there is mounting evidence that the experience of being bullied associates with both internalizing and externalizing symptoms, it is not known yet whether the identified associations are specific to these symptoms, or shared between them. The primary focus of this study is to assess the prospective associations of bullying exposure with both general and specific (i.e., internalizing, externalizing) factors of psychopathology. This study included data from 6,210 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Child bullying was measured by self-report at ages 8 and 10 years. Child psychopathology symptoms were assessed by parent-interview, using the Development and Well-being Assessment (DAWBA) at ages 7 and 13 years. Bullying exposure significantly associated with the general psychopathology factor in early adolescence. In particular, chronically victimized youth exposed to multiple forms of bullying (i.e., both overt and relational) showed higher levels of general psychopathology. Bullying exposure also associated with both internalizing and externalizing factors from the correlated-factors model. However, the effect estimates for these factors decreased considerably in size and dropped to insignificant for the internalizing factor after extracting the shared variance that belongs to the general factor of psychopathology. Using an integrative longitudinal model, we found that higher levels of general psychopathology at age 7 also associated with bullying exposure at age 8 which, in turn, associated with general psychopathology at age 13 through its two-year continuity. Findings suggest that exposure to bullying is a risk factor for a more general vulnerability to psychopathology.

     

Cross-setting consistency in early adolescent psychopathology: deviant friendships and problem behavior sequelae

This study examines adult reports of externalizing and internalizing psychopathology at home and school in a sample of 224 high-risk adolescent boys and girls (average age 12 years). Four groups of young adolescents were defined, based on the consistency of the teacher and parent Child Behavior Checklist reports: normal, internalizing, externalizing only, and comorbid. Group comparisons revealed the comorbid and externalizing groups were more engaged in a deviant peer group and were observed in higher levels of deviancy training with their friends, compared to other young adolescent groups. In general, elevated levels of arrest, drug use, and sexual promiscuity were associated with cross-setting consistency in externalizing disorders. Comorbid youth, however, showed the highest levels of sexual promiscuity in middle adolescence, compared to all other groups. These findings are consistent with a developmental account of adolescent maladjustment and suggest that emotional disturbance in early adolescence might exacerbate youth vulnerability, especially to deviancy training within friendships.     

Friends’ Knowledge of Youth Internalizing and Externalizing Adjustment: Accuracy,Bias, and the Influences of Gender,Grade, Positive Friendship Quality,and Self-Disclosure

Some evidence suggests that close friends may be knowledgeable of youth’s psychological adjustment. However, friends are understudied as reporters of adjustment. The current study examines associations between self- and friend-reports of internalizing and externalizing adjustment in a community sample of fifth-, eighth-, and eleventh-grade youth. The study extends prior work by considering the degree to which friends’ reports of youth adjustment are accurate (i.e., predicted by youths’ actual adjustment) versus biased (i.e., predicted by the friend reporters’ own adjustment). Findings indicated stronger bias effects than accuracy effects, but the accuracy effects were significant for both internalizing and externalizing adjustment. Additionally, friends who perceived their relationships as high in positive quality, friends in relationships high in disclosure, and girls perceived youths’ internalizing symptoms most accurately. Knowledge of externalizing adjustment was not influenced by gender, grade, relationship quality, or self-disclosure. Findings suggest that friends could play an important role in prevention efforts.