Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.     

Prioritizing Parental Worry Associated with Duchenne Muscular Dystrophy Using Best-Worst Scaling

Duchenne muscular dystrophy (DMD) is a progressive, fatal pediatric disorder with significant burden on parents. Assessing disease impact can inform clinical interventions. Best-worst scaling (BWS) was used to elicit parental priorities among 16 short-term, DMD-related worries identified through community engagement. Respondents viewed 16 subsets of worries, identified using a balanced, incomplete block design, and identified the most and least worrying items. Priorities were assessed using best-worst scores (spanning +1 to ?1) representing the relative number of times items were endorsed as most and least worrying. Independent-sample t-tests compared prioritization of parents with ambulatory and non-ambulatory children. Participants (n?=?119) most prioritized worries about weakness progression (BW score?=?0.64) and getting the right care over time (BW?=?0.25). Compared to parents of non-ambulatory children, parents of ambulatory children more highly prioritized missing treatments (BW?=?0.31 vs. 0.13, p?<?0.001) and being a good enough parent (BW?=?0.06 vs. ?0.08, p?=?0.010), and less prioritized child feeling like a burden (BW?=??0.24 vs. ?0.07, p?<?0.001). Regardless of child’s disease stage, caregiver interventions should address the emotional impact of caring for a child with a progressive, fatal disease. We demonstrate an accessible, clinically-relevant approach to prioritize disease impact using BWS, which offers an alternative to the use of traditional rating/ranking scales.     

A Psychometric Evaluation of the Behavioral Inhibition Questionnaire in a Non-Clinical Sample of Israeli Children and Adolescents

This study examined the psychometric properties of a Hebrew version of the Behavioral Inhibition Questionnaire (BIQ) in a non-clinical sample of Israeli children and adolescents. We produced a Hebrew translation of the BIQ and collected 227 responses to it from parents of children aged 4–15. Some respondents in the larger sample also completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire (n?=?91) and the Conners’ Abbreviated Parent-Teacher (CONNERS) questionnaire (n?=?39), in addition to the BIQ. Lastly, 21 children of BIQ respondents (aged 8–14) completed a self-report version of the questionnaire. Confirmatory factor analysis (CFA) was performed to assess how well the established six correlated factor model of the BIQ applied to the sample data. The Hebrew BIQ demonstrated good internal consistency (Chronbach’s α?=?.94, n?=?227) and 3 month test–retest reliability, (r?=?.95, p?<?.001, n?=?21). It also showed both convergent validity, as scores on the BIQ were correlated with the SCARED (r?=?.66, p?<?.01. n?=?91), and discriminant validity, as BIQ scores were not correlated with the CONNERS (r?=?.24, n?=?39). Finally, mother reports of BI were significantly correlated to child reports of BI via the BIQ (r?=?.60, p?<?.01, n?=?21). Thus, through this preliminary study we demonstrated that the Hebrew version of the BIQ is an effective tool for screening for BI among Israeli children, making it a useful instrument for future research.     

Early Feeding,Child Behaviour and Parenting as Correlates of Problem Eating

Mealtimes are a common source of stress for families. Examining factors related to problem eating may provide markers by which to identify families requiring assistance and salient targets for treatment. The current study investigated parenting practices and cognitions, generalisation of child behavioural issues, and early feeding history as they relate to problem eating in typically developing young children. We compared a community sample of 105 parents of 1.5–6-year-old children via survey and observation with 96 parents seeking treatment for their child’s problem eating. History of problems with breastfeeding, χ²(1)?=?3.88, p?=?.049, and the transition to solids, χ²(1)?=?7.27, p?=?.007, were more common among problem eaters than comparisons. Problem eaters had a greater number of problem behaviours outside of mealtimes, F(1181)?=?10.88, p?=?.001, though not more frequently than comparisons and not to clinical levels, F(1181)?=?1.81, p?=?.181. Parents of problem eaters reported more unhelpful mealtime parenting strategies, F(1155)?=?22.59, p?<?.001, yet general parenting style was similar by group, F(1187)?=?0.42, p?=?.527. Parents’ cognitions about mealtimes, F(1155)?=?119.81, p?<?.001, including mealtime-specific self-efficacy, F(1155)?=?171.30, p?<?.001, were poorer amongst problem eaters, and were the only factors to predict problem eating in the total sample. General parenting self-efficacy was poorer in parents of problem eaters (Behaviour: F(1187)?=?42.36, p?<?.001; Setting: F(1187)?=?10.64, p?=?.001). Evidence of feeding issues in infancy may support early detection of and intervention for later problem eating. The significance of broader child behaviour is less clear. Parent factors, particularly those specific to mealtimes, and cognitive in nature (including mealtime parenting self-efficacy) clearly differentiated the groups, and represent important targets for intervention.     

Family Exploration: The Contribution of Stability and Change Processes

Building upon the redefinition of exploration as a family process, this study analyses how the processes of family stability and change may favour exploration by members of multiple family relational contexts. Sixty non-clinical family triads (mother, father, child) participated in an experimental observational study and were video-recorded while playing in different interactive configurations. The children (37 females and 23 males) were 4–5 years old (M?=?55 months). The mothers’ ages ranged from 29 to 45 (M?=?38) and the fathers’ ages ranged from 29 to 46 (M?=?39). All the parents were employed and were living together. All participants were Caucasians of Italian nationality. Using the Triadic Interactions Analytical Procedure (TIAP), the family morphostatic processes and the family morphogenetic processes were analysed in relation to the family members’ exploration. Data analyses showed that family stability continual construction (morphostasis) and family change (morphogenesis) involve different interactive and relational dynamics (χ²(8)?=?13.84, p?>?.05; CFI?=?.97, TLI?=?.94, SRMR?=?.06), even if they are intertwined processes (p?<?.001). Both morphostatic and morphogenetic processes were correlated to the level of exploration showed by family members (respectively r?=?.32, p?<?.05, and r?=?.59, p?<?.001), even if the morphogenetic processes had a stronger relation with family exploration (z?=?1.85, p _one-tailed ?<?.05).     

Mother-Child Interactions and Preschoolers’ Emotion Regulation Outcomes: Nurturing Autonomous Emotion Regulation

Emotion regulation is a complex process that begins in infancy and continues through childhood with parents’ support. Early parent-child interactions shape the way children learn emotion management. We took a sociocultural and social learning approach to exploring the specific components of mother-child interactions that are related to mothers’ perceptions of her child’s regulatory ability and the child’s observed emotion regulation. Thirty mothers and their preschool children were recruited from two New England urban areas: one community sample and one head start sample. Dyads engaged in a free play session, children completed an observed compliance task, and mothers completed a set of questionnaires assessing their perceptions of their child’s regulation. Regression analyses revealed that maternal behaviors during free play predicted child’s observed hostility (F _(2,29)?=?3.137, p?<?.05) and mothers’ perceptions of her child’s regulatory ability predicted observed child compliance (F _{(2, 17)}?=?4.990, p?<?.05). Child behaviors during play significantly predicted child’s compliance (F _(3,20)?=?4.722, p?<?.05) and child’s hostility (F _{(1, 26)}?=?9.220, p?<?.001). Maternal modeling and intentional scaffolding as well as perceptions of her child’s regulatory capacity have a powerful impact on her child’s observed regulation. Results indicate that it is particularly important for mothers of preschoolers to support autonomy while guiding socially appropriate behavior. Interventions that target improving mothers’ negative perceptions of their children, educating on appropriate preschool expectations, and facilitating preschoolers’ mature play may help mothers interact with their children in the ways that foster children’s autonomous emotion regulation.     

Differential Effects of Mother’s and Father’s Parenting on Prosocial and Antisocial Behavior: Child Sex Moderating

The current study examined the differential effects of maternal and paternal parenting on prosocial and antisocial behavior during middle childhood, and the moderating role of child sex. Parents of 96 boys and 107 girls (mean age?=?92.42?months, SD?=?3.52) completed different questionnaires to assess parenting and child behavior. All participants were Caucasian from south of Spain. Multiple hierarchical regressions (enter method) were performed to determine significant predictors of prosocial and antisocial behavior. The results showed that maternal and paternal hostility predicted an increase of externalizing problems in boys and girls (p?<?.001 in both sex groups). As well, Warmth/Induction of both parents predicted an increase in adaptive skills in boys and girls (p?<?.001 in both sex groups). On the other hand, differential effects of fathers’ and mothers’ parenting were found: both for boys and girls, maternal inconsistency positively predicted externalizing problems and negatively adaptive skills (p?<?.001 in both sex groups) and paternal overprotection positively predicted externalizing problems and negatively adaptive skills (p?<?.05 in both sex groups). Finally, maternal coercion negatively predicted adaptive skills in boys and girls (p?<?.05 in both sex groups); however, it increased externalizing problems only in girls (p?<?.05), whereas maternal permissiveness only increased these problems in boys (p?<?.01 in both cases). The discussion highlighted the importance of considering both parents’ and children’s sex to further knowledge of parenting styles affecting children’s behaviors.     

Differential Effects of Child Difficulties on Family Burdens across Diagnostic Groups

Children with neurodevelopmental disorders, such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID), have a variety of difficulties that can place considerable strain on their families. This study investigated the nature of family burdens (i.e., financial burden, need for respite, need for counseling, work changes, and care hours) by examining the effects of child characteristics (i.e., age, gender, and severity of condition), family characteristics (i.e., parent role, education, income, and number of children), and child difficulties (i.e., behavioral, adaptive, emotional, social, learning, and communicative). With representative survey data from parents of children with ADHD (n?=?8252), ASD (n?=?1448), or ID (n?=?949), ranging in age from 2 to 17 years old, we used Χ ², binary logistic regression, linear regression, and univariate analyses to answer our research questions. We found that parents of children with ADHD, ASD, and ID experienced different types and amounts of burdens, families of younger children experienced more burden than those of older children, and families with more income or more children experienced fewer burdens. Adaptive and behavioral difficulties had the greatest relative impact on families. Diagnosis moderated almost all of the relationships between child difficulties and family burden. Overall, these results suggest that providing services and supports that are tailored to the specific needs of each child and family will be necessary for enhancing quality of life.     

Relationship between Disabilities and Adoption Outcomes in African American Children

Although many children adopted from the public child welfare system have special needs, little is known about the experiences of African American adopted children with disabilities and their families. The purpose of this study is to explore different categories of disabilities, including chronic health issues; emotional, mental, or behavioral (EMB) disorders; and intellectual or developmental disabilities (IDDs) on adoption outcomes in a sample of African American children. Data were from the Post-Permanency Round II Survey collected in 2008. A random sample of 412 adoptive parents or legal guardians self-reported their children’s disability diagnoses and family caregiving experiences. Hierarchical regression modelling was used to investigate the relationship between child disability and child and parental outcomes. Results indicated that chronic health issues (β?=?.10, p?<?.05), EMB disorders (β?=?.16, p?<?.01), and IDDs (β?=?.12, p?<?.05) were positively associated with parental burden. In addition, asthma (β?=?.10, p?<?.05), from the larger physical health issue category, was also associated with parental burden. However, none of the disability categories was significantly related with caregiver commitment or adoption dissolution. Future research should disentangle the definitions of special needs or disabilities.     

Development and Validation of the Knowledge of Parenting Strategies Scale: Measuring Effective Parenting Strategies

The current study aimed to develop and evaluate a measure of parenting knowledge, the Knowledge of Parenting Strategies Scale (KOPSS); specifically, to establish the scales internal reliability, ensure a clinically appropriate length, provide a community sample for future comparison, demonstrate adequate test–retest reliability and convergent validity, and to compare the scale to dysfunctional discipline styles. A total of n?=?865 parents were involved in the development and evaluation of the scale. In Study 1, data was collected from n?=?229 parents and Rasch analyses revealed seven items did not fit the measurement model. Study 2 involved a further sample of community families (n?=?346) and revealed the scale could be further shortened to 16 items. Study 3 revealed the scale has good test–retest reliability over a one-week period (r?=?.88, p?<?.001). Study 4 demonstrated convergent validity through a comparison to the Knowledge of Effective Parenting Scale (r?=?.583, p?=?.009). Study 5 utilised a sample of community families (n?=?190), revealing the scale was negatively correlated with hostile and lax discipline (r?=??.29, p?<?.001; r?=??.15, p?<?.05). Lastly, Study 6 showed scores on the KOPSS significantly improved following clinic-based and Internet-based Behavioural Parent Training. The KOPSS was found to be a valid and reliable measure of parenting knowledge of effective parenting strategies, which can be used to evaluate knowledge acquisition in parenting programs, and test the role of knowledge in behaviour change.     

Subtypes of Adaptive and Maladaptive Perfectionism in Anorexia Nervosa: Associations with Eating Disorder and Affective Symptoms

Perfectionism is hypothesized to contribute to the etiology of anorexia nervosa (AN). However, there is little research regarding whether individuals with AN can be classified according to maladaptive (e.g., evaluative concerns) and adaptive (e.g., high personal standards) facets of perfectionism that predict distinct outcomes and might warrant different intervention approaches. In this study, a latent profile analysis was conducted using data from adults with AN (n?=?118). Frost Multidimensional Perfectionism Scale (Frost et al. Cognitive Therapy and Research, 14(5), 449–46, 1990) subscales were used to identify subgroups differing according to endorsed perfectionism features (e.g., adaptive and maladaptive perfectionism). Generalized linear models were used to compare subgroups on eating disorder and affective symptoms measured through questionnaire and ecological momentary assessment. Four subgroups were identified: (a) Low Perfectionism; (b) High Adaptive and Maladaptive Perfectionism; (c) Moderate Maladaptive Perfectionism; and (d) High Maladaptive Perfectionism. Subgroups differed on overall eating disorder symptoms (p?<?.001), purging (p?=?.005), restrictive eating (p?<?.001), and body checking (p?<?.001) frequency, depressive (p?<?.001) and anxiety (p?<?.001) symptoms, and negative (p?=?.001) and positive (p?<?.001) affect. The Low Perfectionism group displayed the most adaptive scores and the Moderate and High Maladaptive Perfectionism groups demonstrated the most elevated clinical symptoms. The High Adaptive and Maladaptive Perfectionism group demonstrated low affective disturbances, but elevated eating disorder symptoms. Results support the clinical significance of subtyping according to perfectionism dimensions in AN. Research is needed to determine if perfectionism subtyping can enhance individualized treatment targeting in AN.     

Maltreated Children in Out-of-Home Care: The Relation between Attachment Quality and Internalizing Symptoms

Maltreated children in out-of-home care are at high risk for poor relationships with caregivers (i.e., biological parents and substitute caregivers) and high levels of internalizing symptoms. It is unclear if these poor relationships are related to, and account for a large portion of the variance in maltreated children’s internalizing symptoms, above and beyond maltreatment type and out-of-home care factors. This study examined the relation between attachment quality with both biological parents and substitute caregivers and children’s internalizing symptoms within a sample of 493 maltreated children (aged 9–11; 51.0?% male) recently placed in out-of-home care. A series of hierarchical regression models indicated that greater child-reported attachment quality with both biological parents and substitute caregivers was associated with fewer child-reported anxiety (β?=??.15, p?<?.01; β?=??.29, p?<?.001, respectively) and depression symptoms (β?=??.14, p?<?.01; β?=??.28, p?<?.001, respectively) as well as fewer child internalizing symptoms (β?=??.12, p?<?.05; β?=??.14, p?<?.01, respectively). Attachment quality with the biological parent and substitute caregiver each explained a significant proportion of the variance in children’s internalizing symptoms, above and beyond child demographics, maltreatment type, and out-of-home care variables. The study also examined whether children’s attachment with substitute caregivers moderated the relationship between children’s attachment with biological parents and children’s internalizing symptoms. No statistically significant moderation effects were found. Future clinical work should focus on enhancing attachment quality between children and both biological parents and substitute caregivers, as these relationships appear to individually relate to the children’s internalizing symptomology.     

Examining Parents’ Preferences for Group Parent Training for ADHD When Individual Parent Training is Unavailable

Parent training programs are considered well-established interventions for attention deficit hyperactivity disorder in children as they reduce behavioral impairment, but limited parent engagement decreases service effectiveness. We used a discrete choice experiment to examine how parent preferences for group vs. individual format might influence their participation in Parent training. Parents (N?=?260) seeking mental health services for children with elevated symptoms of attention deficit hyperactivity disorder in Ontario, Canada were participants. They preferred Individual parent training in another study and completed a discrete choice experiment composed of 30 choice tasks measuring Parent training format preference. In this paper, parents’ preferences for alternatives to Individual Parent training, specifically Group Parent training and Minimal Information options, were estimated. Specifically, this study asked “if first choice is unavailable, what is the second choice?” This question is important as many clinics may not be able to offer both group and individual therapy given state funding cuts for youth mental health services. Simulations predicted that 85.8?% of parents who initially preferred Individual Parent training would switch to Group Parent training that included step-by-step solutions to children’s emotional and behavior problems, and the possibility of feeling informed and confident. The remaining 14.2?% of parents preferred Minimal Information; these parents preferred internet services offered conveniently and timely. Findings highlight consideration of less appealing factors that families might trade for more desirable service elements in a cost-restrictive environment.     

The Impact of Ethnicity,Language, and Anxiety on Quality of Life in Children with Cancer

Undergoing cancer treatment significantly impacts quality of life (QOL). This study evaluated the role of anxiety, ethnicity, and language on QOL in children with a cancer diagnosis. Participants included 156 parent–child dyads in 3 groups: English-speaking Hispanic, Spanish-speaking Hispanic, and English-speaking non-Hispanic White. Parents completed measures of self-reported anxiety and their children’s perceived QOL. Children completed self-reported measures of anxiety and QOL. Families in which parents primarily spoke English reported higher parent-reported generic-module QOL (p?=?0.0062), higher parent-reported cancer-specific QOL (p?=?0.004), lower parent trait anxiety (p?=?0.0005)), and lower child trait anxiety (p?=?0.013), compared to families in which parents primarily spoke Spanish. Regression analyses were strongly supportive of a mediational role of parent trait anxiety in the association of ethnicity/language and parent-reported QOL. The results of this study suggest that children of Spanish-speaking parents may be at greater risk of decreased quality of life, as a function of increased parental anxiety.     

Psychometric Properties of the Parenting Sense of Competence Scale in Treatment-Seeking Post-9/11 Veterans

Although evidence suggests deployment-related stress impacts parenting, few measures of parenting competency have been validated in returning post-9/11 veterans. As part of clinical care in a multidisciplinary clinic serving veterans and military families, 178 treatment-seeking OEF/OIF/OND veterans completed measures including the 16-item Parenting Sense of Competence Scale (PSOC), a widely-used measure of parental efficacy and satisfaction; the Family Assessment Device—general functioning subscale; and the depression, anxiety, and stress scale. Utilizing data from an IRB-approved de-identified data repository, we examined the psychometrics and factor structure of the PSOC. According to a proposed clinical cut-off, 10?% of our clinical sample of veterans exhibited low self-confidence in parenting. A confirmatory factor analysis of the 2-factor structure introducing correlated error terms between items 3 and 9, and between items 10 and 11, revealed to be a satisfactory fit to the data (Χ ² /df?=?1.57, RMSEA?=?0.056 [90?% CI 0.039–0.073]; CFI?=?0.928; TLI?=?0.914; SRMR?=?0.055). In addition, the PSOC exhibited good convergent validity with measures of parental distress (r?=??.22, p?<?0.01 with anxiety symptoms, and r?=??.33, p?<?.001 with depressive symptoms) and family functioning (r?=??.53, p?<?.0001), very good temporal stability (r?=?.81, p?<?.0.0001), and excellent internal consistency (α?=?.85). The PSOC exhibited satisfactory psychometric properties in treatment-seeking veterans and may be used by clinicians and researchers to assess parenting sense of competence, including satisfaction and sense of efficacy, in this population.     

The Influences of Parent and Peer Attachment on Bullying

Individuals with secure attachments to parents and peers are less likely to be bullies and victims of bullying. The current study examined the interplay between gender, parent attachment, and peer attachment as factors related to roles (bullying involvement, defending a victim, and outsider) during bullying. One-hundred forty-eight adolescents (M age?=?15.68) completed surveys about parent and peer attachment and roles during bullying. Findings indicated that females were less likely than males to be involved in bullying and were more likely than males to defend a victim or be an outsider (ps?<?.05). Greater attachment security to parents and peers was associated with less involvement in bullying and greater defending of victims (ps?<?.05). Additionally, a significant three-way interaction demonstrated that greater peer attachment security predicted less bullying involvement for those with lower parent attachment security (p?<?.05), but not for those with higher parent attachment security (p?>?.05). However, this was only true for males (p?<?.01). These results indicate that having a secure attachment to peers may be a potential protective factor against bullying involvement for males with insecure attachments to parents. Future research should examine the possible mechanisms involved in the association between attachment and bullying, such as empathy, aggression, or social information processing.     

The Effectiveness of Coping Power Program for ADHD: An Observational Outcome Study

The present study evaluates the implementation of the Coping Power Program (CPP)-Child Component in a group of patients with attention deficit/hyperactivity disorder (ADHD), and explores the effects of this treatment on changes in the primary and associated symptoms of ADHD. A clinical sample of 50 children and preadolescents (8–13 years) with ADHD was involved. The clinical sample was split into a treatment group (TG; N?=?26), which was included in the child training program (CPP), and a control group (CG; N?=?24), which was placed on a waiting list. The Clinical Global Impression-Severity (CGI-S) and the Child Behavior Checklist 6–18 (CBCL 6–18) were assessed at baseline and at the end of treatment. The outcomes were assessed as a CBCL-subscale response rate and a CGI-S shift. Our results showed a significant improvement in children’s global functioning and in emotional and behavioral symptoms. The children in the TG were more likely to shift from a more severe functional impairment class to a less severe one (69.2% of TG vs. 20.8% of CG). Further, the CGI-S scores diminished significantly in the TG (p?<?0.01). There were significant differences in the changes in Social Problems (p?<?0.05), Attention Problems (p?<?0.05) and Rule-Breaking Behavior Scales (p?<?0.05). CPP seemed to be effective in children and adolescents with ADHD without comorbidity for ODD or CD. Our study revealed an improved outcome, not only in the core symptoms of ADHD, but also in global functioning and social adjustment. Possible improvements to the present formulation of CPP-C are discussed.     

Effects of Individual,Peer, and Family Factors on Child Alcohol Abuse in Ukraine

The present study aims to estimate the relationship between child alcohol problems, sociodemographic characteristics, externalizing behavior, parental and peer alcohol use, and family violence by using a cross-sectional community sample of 320 Ukrainian children (9–16 years of age, 50% boys) and their parents. Participants answered questions from the Drinking and Drug History and Current Use Patterns Questionnaire, the Revised Conflict Tactics Scales, the Alabama Parenting Questionnaire, and the Child Behavior Checklist. Fifty-two percent of children reported alcohol use within the past year and 32% experienced alcohol-related problems. The average number of reported alcohol problems was 11.19 (SD?=?63.65). Five robust regression models examined correlates of early problem drinking in Ukraine. The final model indicated older child age (β?=?0.21, p?<?0.001), more symptoms of externalizing behavior (β?=?0.17, p?<?0.01), and higher peer alcohol use (β?=?0.23, p?<?0.001) were significantly and positively associated with child alcohol problems. Results of the final model explained 32% of the variance in child alcohol problems, F(8, 311)?=?10.76, p?<?0.001. In conclusion, the findings suggest that older age, exposure to high-risk alcohol permeated peer environments, impulsivity, and rule-breaking behaviors are linked with the trajectory of early alcohol abuse among Ukrainian children. Mechanisms that reduce the harmful influence of these risk factors on alcohol consumption need to be in place.