Child and parent evaluations of depression and aggression in psychiatric inpatient children

This investigation examined the agreement between children and their parents on measures of depression and aggression. A total of 120 inpatient children (ages 7–13) and their mothers and fathers independently completed self-report and interview measures that focused on the children's dysfunction. Children and their parents differed in their ratings of each symptom area, with children providing significantly less severe ratings than their parents. Children who met DSM III criteria for major depression or conduct disorder were significantly higher in their ratings of depression and aggression than children without these diagnoses, as reflected in both child and parent ratings. Child and parent ratings correlated in the low to moderate range on measures of children's symptoms, whereas mother and father ratings correlated in the moderate to high range. The correspondence between children and parents did not vary as a function of symptom area (depression and aggression) or assessment format (self-report and interviews). The results suggest that children are able to rate the severity of their dysfunction, although they tend to provide lowerbound estimates than do their parents.     

Children's antisocial behavior, mental health, drug use, and educational performance after parental incarceration: a systematic review and meta-analysis

Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental incarceration, including traumatic separation, loneliness, stigma, confused explanations to children, unstable childcare arrangements, strained parenting, reduced income, and home, school, and neighborhood moves. Children of incarcerated parents often have multiple, stressful life events before parental incarceration. Theoretically, children with incarcerated parents may be at risk for a range of adverse behavioral outcomes. A systematic review was conducted to synthesize empirical evidence on associations between parental incarceration and children's later antisocial behavior, mental health problems, drug use, and educational performance. Results from 40 studies (including 7,374 children with incarcerated parents and 37,325 comparison children in 50 samples) were pooled in a meta-analysis. The most rigorous studies showed that parental incarceration is associated with higher risk for children's antisocial behavior, but not for mental health problems, drug use, or poor educational performance. Studies that controlled for parental criminality or children's antisocial behavior before parental incarceration had a pooled effect size of OR = 1.4 (p < .01), corresponding to about 10% increased risk for antisocial behavior among children with incarcerated parents, compared with peers. Effect sizes did not decrease with number of covariates controlled. However, the methodological quality of many studies was poor. More rigorous tests of the causal effects of parental incarceration are needed, using randomized designs and prospective longitudinal studies. Criminal justice reforms and national support systems might be needed to prevent harmful consequences of parental incarceration for children.     

Agreement of mothers' and teachers' hyperactivity ratings with scores on drug-sensitive psychological tests

Hyperactivity ratings were obtained from parents and teachers for 45 hyperactive children. The children were also given several psychological tests. Teachers' ratings, but not parents' ratings, were negatively correlated with performance on the psychological tests that require sustained attention and on which performance is improved by stimulant drugs. This pattern of correlations was interpreted as evidence that teachers, but not parents, have an opportunity to observe children performing daily tasks that require sustained attention.     

A meta-analytic review of the influence of pediatric cancer on parent and family functioning.

This study used meta-analytic methods to compare the functioning of parents of children with cancer to parents of physically healthy children or normative samples. A meta-analysis using fixed effects, weighted least squares methods was conducted on 29 studies examining psychological distress and marital and family functioning among parents of children with cancer. Mothers and fathers of children newly diagnosed with cancer reported significantly greater distress than comparison samples. Mothers reported greater distress than fathers up to 12 months postdiagnosis. Mothers of children with cancer reported higher levels of family conflict than mothers of healthy children. Findings suggest that pediatric cancer impacts parents' perceptions of self- and family functioning, especially within the 1st year following diagnosis.     

Development of consensus about child oppositional behavior: Increased convergence with entry into school

This study examines the relation between parent and teacher ratings of oppositional behaviors in children from kindergarten to second grade. One cross-sectional sample of 85 boys in kindergarten, first, and second grade was assessed for problem behavior on the basis of reports from the children, parents, teachers, and trained observers. The second sample consisted of parent and teacher ratings of both boys and girls in a longitudinal design at 5 and 7 years of age. Results from both studies indicate that agreement does increase around the time of the child's transition into school and that each informant influences the ratings of the others over time.     

Multiple attachment relationships within families: mothers and fathers with two young children

Security of attachment between mothers and fathers and their 2 children was examined in 41 maritally intact families. Strange Situation assessments of attachment security for the younger children (mean age = 1 year 10 months), Attachment Q-sort ratings of the older children (mean age = 4 years 8 months), and ratings of parental caregiving behavior of both children were obtained. Younger and older children developed concordant attachments to both parents. Parents were consistent in their caregiving behavior toward their 2 children. However, parents were not congruent in their attachment to their 2 children. Associations were found between maternal caregiving and attachment only in the younger group. The results support the idea that parental caregiving behavior accounts for only modest portions of the variance in attachment security; evolving attachments integrate developmental inputs from the children and the caregivers in the network of early family relationships.     

The unique impact of parent training for separation anxiety disorder in children

This investigation examined the preliminary efficacy of an integrated cognitive-behavioral parent-training protocol for six families of separation-anxious children (7 to 10 years of age) using a multiple baseline design across participants. Although families were assessed on child, parent, and clinician ratings at pre- and posttreatment as well as 6-month follow-up, only parents received education and training. Although the parent-training protocol was largely effective and treatment gains were maintained at 6-month follow-up, only those child participants whose parents experienced clinically significant improvement on parental process measures (i.e., enhanced efficacy or satisfaction, reduced stress) achieved high end-state functioning. Implications regarding the importance of individualized family-based interventions for treating anxious youth are discussed.     

Significance of Childhood Conduct Problems to Later Development of Conduct Disorder Among Children With ADHD: A Prospective Follow-Up Study

This study investigates whether low to moderate levels of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) behaviors contribute to the development of clinically diagnosed CD in adolescence, in children with attention deficit hyperactivity disorder (ADHD). Participants were 207 White boys (ages 6-12) with ADHD free of conduct disorder diagnoses. Parent and teacher ratings were obtained. Participants were assessed at mean age 18 by clinicians blind to childhood status. A non-ADHD group (recruited in adolescence) was also studied. ODD behavior ratings did not predict CD in adolescence, whereas CD behavior ratings did. No single ODD or CD behavior predicted adolescent outcome. ADHD probands with very low ratings (Not at all, Just a little) by parents and teachers on all CD behaviors were still at significantly increased risk for CD in adolescence, compared to non-ADHD controls. The same relationships were found between childhood ODD and CD behaviors, and antisocial personality disorder in adulthood (mean age, 25). We conclude that childhood ADHD is a developmental precursor of later antisocial disorder, even in the absence of comorbid ODD or CD in childhood. However, low levels of CD-type problems are not innocuous, because they predict later CD among children with ADHD without comorbid CD.     

Maternal and Paternal Perceptions of Social Competence in Children and Adolescents

We examined maternal and paternal perceptions of social competence in children and adolescents. One hundred forty-seven parents rated scenarios depicting children who varied in age, gender, and social competence. Parents also completed questionnaires assessing the amount of time they spend with their own children, their gender identity, their psychological symptoms, and their affectivity. Results indicated that the amount of time parents spend with their own children was related to maternal and paternal ratings, whereas affectivity was related to paternal ratings. In contrast, parents’ gender identity and psychological symptoms were unrelated to their ratings of social competence. Finally, there was an interaction between parent gender and the level of social competence depicted in the scenarios they rated, suggesting that there were differences in maternal and paternal ratings. These findings emphasize the importance of examining the perceptions of both mothers and fathers when assessing social competence in children and adolescents.     

Parent-child interactions during joint engagement with touchscreen technology: A comparison of younger versus older toddlers

With a plethora of touchscreen apps aimed at young children, parents are receiving mixed messages about the appropriateness of such technology for their toddlers. The American Academy of Pediatrics (2016) advises limited engagement with digital media for this age group and encourages parents to co-engage with children when they are using screens. However, very little is known about parent-child interaction in the context of joint engagement with digital screen media in the toddler years. This study observed 56 toddlers (M = 32.5 months old; 53 % female) and a parent (52 mothers; 4 fathers) performing a 3-minute drawing task on a touchscreen tablet (digital condition), and on an Etch-A-Sketch (non-digital condition) using a repeated measures design. Observations were analysed using global ratings of dyadic interaction, comparing warmth, cooperation and conflict between digital and non-digital conditions. A mixed MANCOVA analysis, controlling for levels of daily usage of touchscreens, revealed lower levels of parent-child cooperation and warmth in the digital condition compared to the non-digital condition. In addition, there was a main effect of age with younger dyads displaying less cooperation overall, particularly in the digital condition where interactions were also less warm. Results suggest that co-engaging with digital technology can be a challenging and potentially emotionally charged context for both parents and young children. Younger toddlers, especially, may be more likely to experience less cooperative interactions when co-engaging with digital technology with a parent. Results are discussed in relation to developmental differences between 2- and 3-year olds, and the need for more nuanced guidance for parents supporting young children’s interaction with digital media.     

Reliable Ratings or Reading Tea Leaves: Can Parent,Teacher, and Clinician Behavioral Ratings of Preschoolers Predict ADHD at Age Six?

To assess the relative ability of parent, teacher, and clinician behavioral ratings of preschoolers to predict ADHD severity and diagnosis at 6 years of age. Hyperactive/inattentive preschoolers [N?=?104, 75 % boys, Mean (SD) age?=?4.37 (0.47) years] were followed over 2 years (mean?=?26.44 months, SD?=?5.66). At baseline (BL), parents and teachers completed the ADHD-RS-IV and clinicians completed the Behavioral Rating Inventory for Children following a psychological testing session. At age 6, [Mean (SD) age?=?6.62 (0.35) years], parents were interviewed with the K-SADS-PL; teachers completed the ADHD-RS-IV; and laboratory measures of hyperactivity, impulsivity, and inattention were obtained from children. Hierarchical logistic and linear regression analyses examined which combination of BL ratings best predicted 6-year-old ADHD diagnosis and severity, respectively. At age 6, 56 (53.8 %) children met DSM-IV criteria for a diagnosis of ADHD. BL ratings from parent/teacher/clinician, parent/teacher and parent/clinician combinations significantly predicted children who had an ADHD diagnosis at age 6. Parent and clinician, but not teacher, behavior ratings were significant independent predictors of ADHD diagnosis and severity at 6-years-old. However, only clinician reports of preschoolers’ behaviors predicted laboratory measures of over-activity and inattention at follow-up. Cross-situationality is important for a diagnosis of ADHD during the preschool years. Among parents, teachers and clinicians, positive endorsements from all three informants, parent/teacher or parent/clinician appear to have prognostic value. Clinicians’ ratings of preschoolers’ inattention, impulsivity and hyperactivity are valid sources of information for predicting ADHD diagnosis and severity over time.     

Events of parental divorce: Stressfulness ratings by children,parents, and clinicians

The stressfulness, for the "typical" child, of 62 events that occur to children of divorce was rated by children of divorce (n = 58), their custodial parents (n = 58), and clinicians (n = 50). In addition, a larger group of children (n = 123) rated the goodness or badness of the events that had happened to them. The rank orderings of the mean stress ratings for the typical child made by children, parents, and clinicians were highly correlated. However, when the absolute stress value of the events was compared across raters, children rated 10 events as significantly less stressful than did parents (p less than .05); parents' and clinicians' ratings differed for 9 events, parents rating 7 as less stressful (p less than .05). Children rated 19 events as less stressful than did clinicians (p less than .05). The rank ordering of the children's mean ratings of events actually experienced correlated highly with the rank orderings of the children's mean ratings of the negative events for the typical child.     

Evaluation of a preventive intervention for a self-selected subpopulation of children

Evaluated an experimental preventive intervention developed for children who perceived their parents as problem drinkers. The 8-session program was designed to improve children's coping, self-esteem, and social competence, and modify alcohol expectancies which were specified as mediators of the effects of parental alcohol abuse on child mental health. Participants were 271 self-selected 4th-, 5th-, and 6th-grade students in 13 schools. The children were randomly assigned to treatment or delayed treatment conditions and the program was given to three successive cohorts of students. A meta-analysis across three different cohorts indicated significant program effects to improve knowledge of the program content and the use of support- and emotion-focused coping behaviors for the full sample. A slightly stronger range of effects was found for a high-risk subsample. This research was funded by the National Institute of Mental Health Grant P50-MH39246 to support a Preventive Intervention Research Center and Prevention Training Grant T32-MH18387-02.     

Stability of Values of Junior High School Pupils and Their Parents Over Two Years

97 parent-daughter pairs and 80 parent-son pairs were administered a value-orientation instrument when the children were in junior high school and again 2 years later. Girls became more concerned with what they could give of themselves in their eventual work. Girls' parents began to stress home-making qualities. Boys became less concerned with the more tangible rewards of work and more concerned with utilizing their capabilities. Boys' parents rated all the values more important than did their sons. Boys and their parents evidenced more disagreement regarding values than did girls and their parents. However, when focusing on the most important value, there is considerable agreement between children and parents. Parents have remained consistent in their value ratings over the 2 years while children have changed their ratings in the direction of the values their parents hold for them. The children of parents who have changed their value ratings were not different from children of parents who remained consistent in the ratings. Nor were children who changed their value ratings different from those whose values were stable.     

Swedish norms for the Strengths and Difficulties Questionnaire for children 3–5 years rated by parents and preschool teachers

The Strengths and Difficulties Questionnaire (SDQ) is a widespread tool for assessing behavior problems in children and adolescents. Despite being investigated thoroughly concerning both validity and reliability, peer reviewed studies that provide norms, especially for preschool children, are lacking. This paper provides Swedish norms using data from a large community sample of children aged 3–5, based on mothers’, fathers’, and preschool teacher’s ratings. Preschool teachers’ ratings were generally lower than parents’ ratings, which contradicts some previous studies. Differences between girls and boys were found, suggesting that boys display higher levels of behavior problems. Lower parental education and country of origin outside of Sweden were also associated with more difficulties. Cut-offs are presented for each age group, gender and rater category. Population-specific norms and percentile cut-offs provided in this study facilitate identifying children in need of interventions in paediatric care and enable cross-country comparisons of children’s mental health problems.     

Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment

Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.     

Behavioral Versus Nonbehavioral Guided Self-Help for Parents of Children With Externalizing Disorders in a Randomized Controlled Trial

Self-help interventions for parents, which have a behavioral basis, are considered to be an effective treatment option for children with externalizing disorders. Nonbehavioral approaches are widely used but have little empirical evidence. The main objective of this trial was to compare the efficacy of a behavioral and a nonbehavioral guided self-help program for parents. Families of children (aged 4–11 years) diagnosed with attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) were randomized to either a behavioral or a nonbehavioral guided self-help program including 8 parenting booklets and 10 counseling telephone calls. The analyses considered the ratings of 5 informants: blinded clinician, therapist, participant, (her or his) partner, and teacher. Of the 149 families randomized to treatment (intention-to-treat sample [ITT]), 110 parents completed the intervention (per-protocol sample [PP]). For the 4 primary outcome measures (blinded clinician- and participant-rated ADHD and ODD) at post-assessment, the analysis revealed a treatment advantage for the behavioral group in blinded clinician-rated ODD symptoms (ITT: d = 0.37; PP: d = 0.35). Further treatment differences, all in favor of the behavioral group (ITT and PP), were detected in therapist ratings (i.e., ODD) and participant ratings (e.g., parental self-efficacy [only PP], negative parenting behavior, parental stress). In both samples, no differences were found at post-assessment for ratings of the partner and the teacher, or at the 12-month follow-up (only participant ratings available). Behavioral guided self-help shows some treatment advantage in the short term. No superiority over nonbehavioral therapy was detected 12 months after treatment termination.     

Social perspective-taking and teacher ratings of peer interaction in hyperactive boys

Hyperactive and matched control boys at two age levels were compared on teacher ratings of peer interaction and three measures of social perspective-taking. The teachers' ratings of peer interaction discriminated between the hyperactive children and their controls. In addition, a significant interaction effect indicated that teachers rated the older hyperactive group as more deviant with peers than both their younger hyperactive counterparts and their age-matched controls. In a structured laboratory setting, the hyperactive children did not differ from control children on the three measures of social perspective-taking. The perspective-taking measures did, however, show differences across age groups. Implications for treatment are examined.The research reported in this paper is based on master's thesis submitted to the Graduate Faculty of Arts and Sciences of the University of Pittsburgh by the first author. The authors are indebted to Dr. C. Keith Conners for his assistance in recruiting hyperactive subjects and to Drs. Alex Siegel and Carl Barenboim for their critical evaluations regarding this investigation. Appreciation is expressed to the staff, teachers, parents, and students of the Forest Grove Elementary School for their cooperation.