Relation Between Parent Psychiatric Symptoms and Youth Problems: Moderation through Family Structure and Youth Gender

Links between parents’ psychiatric symptoms and their children’s behavioral and emotional problems have been widely documented in previous research, and the search for moderators of this association has begun. However, family structure (single versus dual-parent households) has received little attention as a potential moderator, despite indirect evidence that risk may be elevated in single-parent homes. Two other candidate moderators—youth gender and age—have been tested directly, but with inconsistent findings across studies, perhaps in part because studies have differed in whether they used youth clinical samples and in which informants (parents vs. youths) reported on youth problems. In the present study, we examined these three candidate moderators using a sample of exclusively clinic-referred youths (N?=?333, 34 % girls, aged 7–14,) and assessing youth problems through both parent- and youth-reports. Both family structure and youth gender emerged as robust moderators across parent and youth informants. Parent symptoms were associated with youth internalizing and externalizing problems in single-parent but not dual-parent homes; and parent symptoms were associated with youth internalizing problems among boys, but not girls. The moderator findings suggest that the risks associated with parent psychopathology may not be uniform but may depend, in part, on family structure and youth gender.     

Utilization of Individual versus Family Therapy Among Adolescents with Severe Emotional Disturbance

Service utilization patterns among children with severe emotional and/or behavioral disturbances are described for 89 children and families, interviewed at two time points across a 6-month period. Children received a greater number of individual therapy sessions than family therapy sessions, and children significantly decreased their levels of internalizing and externalizing behaviors. Family therapy was associated with decreases in internalizing behaviors when children reported outcomes. Individual therapy was not associated with changes in either internalizing or externalizing behaviors regardless of reporter. Symptom severity did not dictate whether children were provided individual or family therapy. Recommendations for individualized treatment plans are offered.     

流动儿童的问题行为与人格、家庭功能的关系

以北京市806名流动儿童和319名城市儿童为被试,采用问题行为问卷、小五人格问卷和家庭功能问卷,考察流动儿童问题行为的特点及其与城市儿童的差异,并探讨人格和家庭功能对流动儿童问题行为的影响。结果发现:(1)流动儿童内、外化问题行为的自我报告率分别达到了31.0%2、0.1%,与城市儿童相比,流动儿童的内化问题行为较为突出。(2)人格的情绪性、开放性显著正向预测流动儿童的内化问题题行为,外向性、家庭功能的亲密度显著负向预测其内化问题行为,情绪性、开放性显著正向预测流动儿童的外化问题行为,宜人性、谨慎性、亲密度显著负向预测外化问题行为。(3)人格在家庭功能的亲密度与内化问题行为之间起部分中介作用,在亲密度与外化问题行为之间起完全中介作用。     

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.     

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.     

Family Instability and Child Maladjustment Trajectories During Elementary School

This study examines the relation between family instability and child maladjustment over a 6-year period in 369 children from four communities. Measures were collected annually from kindergarten through fifth grade. In associative growth curve models, family instability trajectories predicted children's externalizing and internalizing behavior trajectories during this time period. High levels of family instability also incrementally predicted the likelihood of meeting criteria for a DSM IV diagnosis during elementary school, above and beyond prediction from earlier measures of maladjustment. However, the timing of family instability had a different effect on externalizing versus internalizing disorders. In general, stronger relations were found between family instability and externalizing behaviors relative to internalizing behaviors, although children with comorbid disorders experienced the highest levels of family instability.The Conduct Problems Prevention Research group is comprised of Karen L. Bierman (Pennsylvania State University), John D. Coie (Duke University), Kenneth A. Dodge (Duke University), E. Michael Foster (Pennsylvania State University), Mark Greenberg (Pennsylvania State University), John E. Lochman (University of Alabama), Robert J. McMahon (University of Washington), and Ellen E. Pinderhughes (Tufts University)     

A Cross-Domain Growth Analysis: Externalizing and Internalizing Behaviors During 8 Years of Childhood

In a sample of 405 children assessed in kindergarten through the seventh grade, we determined the basic developmental trajectories of mother-reported and teacher-reported externalizing and internalizing behaviors using cross-domain latent growth modeling techniques. We also investigated the effects of race, socioeconomic level, gender, and sociometric peer-rejection status in kindergarten on these trajectories. The results indicated that, on average, the development of these behaviors was different depending upon the source of the data. We found evidence of the codevelopment of externalizing and internalizing behaviors within and across reporters. In addition, we found that African-American children had lower levels of externalizing behavior in kindergarten as reported by mothers than did European-American children but they had greater increases in these behaviors when reported by teachers. Children from homes with lower SES levels had higher initial levels of externalizing behaviors and teacher-reported internalizing behaviors. Males showed greater increases in teacher-reported externalizing behavior over time than did the females. Rejected children had trajectories of mother-reported externalizing and internalizing behavior that began at higher levels and either remained stable or increased more rapidly than did the trajectories for non-rejected children which decreased over time.     

The Role of Family Income Dynamics in Predicting Trajectories of Internalizing and Externalizing Problems

Economic disparities in children’s behavioral functioning have been observed in prior research. Yet, studies have ignored important perspectives from developmental psychopathology and have not delineated how aspects of income dynamics (i.e., cumulative family income versus income volatility) differentially relate to behavior problems. To address these limitations, the current study examined how both cumulative income and income volatility predict trajectories of children’s internalizing and externalizing problems from kindergarten through fifth grade in a nationally representative sample of 10,900 children (51.4 % male). Results showed four distinct trajectories of internalizing problems and five distinct externalizing trajectories. Family income dynamics were related to trajectory group membership. Specifically, increased cumulative income decreased risk of membership in mid-increasing and mid-stable internalizing groups, and children whose families experienced multiple waves of income loss were 2.4 times as likely to be in the mid-increasing group instead of the low-stable group. With respect to externalizing, higher cumulative income increased the likelihood of belonging in the group exhibiting stably low externalizing problems. Experiencing income loss increased the risk of belonging in the trajectory group exhibiting chronically high externalizing behaviors. These results enhance our knowledge of the role of family income in the development of behavior problems.     

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.     

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.

     

Family Conflict Moderates the Relation Between Negative Mood and Youth Internalizing and Externalizing Symptoms

Higher negative (or lower positive) mood is associated with internalizing and externalizing problems among some, but not all youth, suggesting that contextual factors may influence these temperament-symptom relations. Family conflict also is associated with internalizing and externalizing problems, although it is unclear whether family conflict influences the relation between negative mood and symptoms. To address this gap, we examined whether family conflict moderates the relations between temperamental negative mood and internalizing and externalizing symptoms. Participants were 775 youth (69?% male, 76?% Caucasian). Mothers and youth completed questionnaires when youth were ages 10–12 (time 1) and 12–14 (time 2). When exposed to higher family conflict at time 1, children higher in negative mood experienced higher time 2 internalizing and externalizing problems than children lower in negative mood. When exposed to lower family conflict, children’s internalizing and externalizing symptom levels were similar regardless of their levels of negative mood. Findings suggest that interventions aimed at reducing youth’s risk for internalizing and externalizing symptoms should address conflictual interactions within the larger family system, particularly among youth with higher negative mood.     

The Third Rail of Family Systems: Sibling Relationships, Mental and Behavioral Health, and Preventive Intervention in Childhood and Adolescence

Sibling relationships are an important context for development, but are often ignored in research and preventive interventions with youth and families. In childhood and adolescence, siblings spend considerable time together, and siblings’ characteristics and sibling dynamics substantially influence developmental trajectories and outcomes. This paper reviews research on sibling relationships in childhood and adolescence, focusing on sibling dynamics as part of the family system and sibling influences on adjustment problems, including internalizing and externalizing behaviors and substance use. We present a theoretical model that describes three key pathways of sibling influence: one that extends through siblings’ experiences with peers and school, and two that operate largely through family relationships. We then describe the few existing preventive interventions that target sibling relationships and discuss the potential utility of integrating siblings into child and family programs.     

Adverse Life Events, Coping and Internalizing and Externalizing Behaviors in Urban African American Youth

African American youth residing in low income urban neighborhoods are at increased risk of experiencing negative life events in multiple domains, increasing their risk for internalizing and externalizing behaviors. However, little is known about youth’s differential responses to life event stress, or protective processes and coping strategies for urban African American youth exposed to adverse life events. Thus, the present study examined whether variability in predominantly low income, urban African American youth’s responses to life event stress are accounted for by the type of life event experienced or the type of coping strategies used. Participants were a community sample of 353 urban African American youth (52.8 % girls; age range 8–12 years) who participated in the Multiple Opportunities to Reach Excellence (MORE) Project. Youth reported about their experiences with adverse life events, coping strategies, and internalizing and externalizing symptoms. Results indicated that violent life events were uniquely associated with externalizing behavior, while discrimination and economic stress were uniquely associated with internalizing behavior. The utility of coping strategies varied by gender, such that avoiding problems was protective for girls who experienced violent life events, but not for boys. For boys, exposure to violence was significantly positively associated with externalizing symptoms regardless of the amount of avoiding problems coping used. Findings suggest that interventions to develop coping strategies may need to be gender-specific as well as tailored for the types of stressors common for low income urban youth.     

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.     

The Contributions of Child Behavioral Functioning and Parent Distress to Family Functioning in Pediatric Inflammatory Bowel Disease

The objective of this study was to examine the relative contributions of both parental and adolescent functioning to family functioning in adolescent patients with inflammatory bowel disease (IBD) and their families. Participants were 45 adolescents (27 male, 18 female) 13-17?years old (M?=?15.41?years, SD?=?1.32) with IBD and their parents. Families completed measures of patient behavioral functioning and depression, parent distress and family functioning. Disease severity assessments were completed via data provided by patients' gastroenterologists. Results indicated that parent-reported patient behavioral problems accounted for a significant 26% of variance in family functioning. Post-hoc analysis revealed that externalizing behavior problems accounted for the majority of this variance compared to internalizing behavior problems. These results suggest that externalizing problems may have a more significant impact on these families than previous research indicates. Moreover, externalizing behaviors may significantly impact family adaptation and should be taken into consideration during routine clinical care. Further research is needed to replicate and expand upon these findings.     

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.     

Children Exposed to the Arrest of a Family Member: Associations with Mental Health

The arrest of a parent or other family member can be detrimental to children’s health. To study the impact of exposure to the arrest of a family member on children’s mental health and how said association may change across developmental periods, we examined baseline data for children (birth through 11 years) entering family-based systems of care (SOC). Children exposed to the arrest of a family member had experienced significantly more 5.38 (SD = 2.59) different types of potentially traumatic events (PTE) than children not exposed to arrest 2.84 (SD = 2.56). Multiple regression model results showed that arrest exposure was significantly associated with greater behavioral and emotional challenges after controlling for children’s age, gender, race/ethnicity, household income, caregiver’s education, parenting factors, and other PTE exposure. Further analyses revealed differences in internalizing and externalizing behaviors associated with arrest exposure across developmental levels. This study highlights some of the mental health challenges for children exposed to the arrest of a family member, while adding to our knowledge of how such an event affects children across different developmental periods. More trauma-informed, developmentally appropriate systems need to be in place at all levels to assist children and families experiencing arrest.     

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems

The stepfamily literature is replete with between‐group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well‐being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent–child, parent–child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent–child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent–child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.     

行为抑制性、母亲养育方式和学步儿问题行为的关系

采用实验室观察及问卷法,考察学步儿行为抑制性、母亲养育方式和问题行为的关系。结果发现:(1)行为抑制性正向预测内隐问题行为;母亲拒绝正向预测外显问题行为;母亲保护担忧负向预测外显问题行为。(2)性别能调节母亲养育方式与问题行为之间的关系,母亲鼓励独立负向预测男孩内隐问题行为;母亲拒绝正向预测女孩内隐问题行为;保护担忧负向预测男孩外显问题行为;母亲惩罚正向预测男孩外显问题行为。     

Urban youth disruptive behavioral difficulties: exploring association with parenting and gender

The current study will examine behavioral difficulties among a sample of African American urban youth who were exposed to violence. Possible gender differences in disruptive behavioral difficulties, as well as possible associations between parental practices, family relationships, and youth disruptive behavioral difficulties are examined. A secondary data analysis from baseline data for 125 African American urban mothers and their children collected as part of a large-scale, urban, family-based, HIV prevention research study was analyzed. Findings reveal that externalizing behavioral problems in youth are associated with exposure to violence. Girls displayed significantly higher levels of externalizing behavioral difficulties than boys. Mothers' parenting practices and family relationships were associated with youths' externalizing behavior problems. Implications for interventions to reduce youths' exposure to violence and to develop gender sensitive interventions for youth and supportive interventions for their parents are discussed.