Emotional Functioning in Children and Adolescents with Elevated Depressive Symptoms

Difficulties with emotion and its regulation are of central importance to the etiology and course of depression. The current study investigated these constructs in relation to childhood and adolescence by comparing the emotional functioning of 170 9- to 15-year-olds reporting high levels of depressive symptoms (HD) to a matched sample of 170 children and adolescents reporting low levels of depressive symptoms (LD). Compared to LD, HD participants reported significantly greater shame proneness, poorer functioning on emotion regulation competencies (emotional control, self-awareness and situational responsiveness), less healthy emotion regulation strategy use (less reappraisal and greater suppression), and lower levels of guilt proneness. Empathic concern did not differ between the two groups. The findings enhance current knowledge by providing a more comprehensive profile of the emotional difficulties experienced by children and adolescents with elevated depressive symptoms.     

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。     

Family Functioning and Externalizing Behaviour among Low-income Children: Self-regulation as a Mediator

The purpose of this study was to examine self-regulation as a mediator of the relation between family functioning and externalizing behaviour in 731 low-income children (M age = 41 months) across three time points. Specifically, this study focused on whether chaos in the home and positive behaviour support were indirectly related to externalizing problems through their influence on inhibitory control. The primary findings were as follows: (a) chaos in the home at age 3 years was indirectly related to externalizing behaviour at age 5.5 years through children's inhibitory control at age 4 years, and (b) positive behaviour support at age 3 years was indirectly related to externalizing behaviour at age 5.5 years through inhibitory control at age 4 years. Implications of these findings and directions for future research are discussed.     

Family Functioning and Coping Behaviors in Parents of Children with Autism

We analyzed family dynamics and coping behaviors of parents with a child with an autistic spectrum disorder. Previous research suggests that moderate levels of cohesion and adaptability are associated with higher levels of positive coping, and that the more coping strategies a family implements, the greater their satisfaction with family functioning. Using a family systems approach, the relationships among the familial variables of cohesion, adaptability, and social support were evaluated for their contributions to coping in the family unit. We also compared the responses of mothers and fathers. Surprisingly, for these parents of children with autism, those who rated their family as enmeshed implemented more positive coping strategies than did those from other cohesion styles. This finding suggests that the enmeshed style may be more adaptive for a family that encounters extreme challenges. Notably, mothers and fathers agreed on all variables except for perception of social support from family and friends. Mothers perceived more social support from family and friends. The results lead to several interesting suggestions for future research.     

Functional Gastrointestinal Symptoms in Children with Anxiety Disorders

This study examined the incidence and correlates of functional gastrointestinal symptoms in children with anxiety disorders. Participants were 6–13 year old children diagnosed with one or more anxiety disorders (n?=?54) and non-clinical control children (n?=?51). Telephone diagnostic interviews were performed with parents to determine the presence and absence of anxiety disorders in children. Parents completed a questionnaire that elicited information about their child’s gastrointestinal symptoms associated with functional gastrointestinal disorders in children, as specified by the paediatric Rome criteria (Caplan et al., Journal of Pediatric Gastroenterology & Nutrition, 41, 296–304, 2005a). Parents and children also completed a symptom severity measure of anxiety. As expected, children with anxiety disorders were significantly more likely to have symptoms of functional gastrointestinal disorders (FGID), compared to children without anxiety disorders. That is, 40.7 % of anxious children had symptoms of a FGID compared to 5.9 % of non-anxious control children. Children with anxiety disorders were significantly more likely to have symptoms of functional constipation, and showed a trend for a higher incidence of irritable bowel syndrome symptoms compared to non-anxious control children. Furthermore, higher anxiety symptom severity was characteristic of anxious children with symptoms of FGID, compared to anxious children without FGID symptoms and non-anxious control children. Also, children with anxiety disorders, regardless of FGID symptoms, were more likely to have a biological family member, particularly a parent or grandparent, with a gastrointestinal problem, compared to non-anxious control children. The high incidence of FGID symptoms in children with anxiety disorders warrants further research on whether gastrointestinal symptoms reduce following psychological treatments for childhood anxiety disorders, such as cognitive behavioural therapy.     

Psychiatric Symptomatology and Family Functioning in Children and Adolescents with Spina Bifida

The purpose of this study was to (a) examine the occurrence of psychiatric symptomatology in children and adolescents with spina bifida, (b) investigate the relationship between psychiatric features and aspects of disability, and (c) explore the impact of spina bifida and psychiatric status on family functioning. Fifty-four children and adolescents ages 6 to 18 years (M = 12.94, SD = 3.59) were examined. Parents completed the Child Symptom Inventory (CSI) and the Family Assessment Device (FAD). Using the CSI, a psychiatric diagnostic screen, 43% of the sample obtained one, and 13% obtained two or more screening cutoff scores reflective of psychiatric diagnoses. The two most prevalent diagnostic categories were Attention-Deficit/Hyperactivity Disorder (33%) and Oppositional Defiant Disorder (13%). The sample as a whole exhibited elevated levels of clinical symptoms, with internalizing symptoms more prominent than externalizing symptoms. No differences in diagnostic categories or overall symptomatology were found based on age, gender, ambulation status, or lesion level. Overall symptom counts were positively correlated with scales on the FAD reflecting problematic family functioning (.42–.65). Results suggest that psychiatric symptomatology occurs at a high rate in children and youth with spina bifida. Although ADHD was the modal diagnostic category, the sample as a whole exhibited extensive psychiatric symptoms independent of specific diagnostic categories. Psychiatric symptoms were also associated with increased problematic functioning in families.     

Parent-Rated Anxiety Symptoms in Children with Pervasive Developmental Disorders: Frequency and Association with Core Autism Symptoms and Cognitive Functioning

Background In addition to the core symptoms, children with Pervasive Developmental Disorders (PDD) often exhibit other problem behaviors such as aggression, hyperactivity, and anxiety, which can contribute to overall impairment and, therefore, become the focus of clinical attention. Limited data are available on the prevalence of anxiety in these children. We examined frequency and correlates of parent-rated anxiety symptoms in a large sample of children with PDD. Methods The goals of this study were to examine the frequency and correlates of parent-rated anxiety symptoms in a sample of 171 medication-free children with PDD who participated in two NIH-funded medication trials. Twenty items of the Child and Adolescent Symptom Inventory (CASI) were used to measure anxiety. Results Forty three percent of the total sample met screening cut-off criteria for at least one anxiety disorder. Higher levels of anxiety on the 20-item CASI scale were associated with higher IQ, the presence of functional language use, and with higher levels of stereotyped behaviors. In children with higher IQ, anxiety was also associated with greater impairment in social reciprocity. Conclusion Anxiety is common in PDD and warrants consideration in clinical evaluation and treatment planning. This study suggests that parent ratings could be a useful source of information about anxiety symptoms in this population. Some anxiety symptoms such as phobic and social anxiety may be closer to core symptoms of PDD. Further efforts to validate tools to ascertain anxiety are needed, as are studies to empirically test approaches to treat anxiety in PDD.     

Linking Foster Family Characteristics and Mental Health Symptoms of Youth in Care

Youth in foster care are disproportionately at risk for developing internalizing and externalizing problems (Lawrence et al., 2006); however, a history of maltreatment prior to foster care placement does not automatically result in poor mental health outcomes. Among non-foster care youth, the quality of family interactions has been related to adjustment outcomes, such that low family cohesion and high family conflict is associated with poor mental health symptoms (Caples & Barrera, 2006). While little is known about these constructs in foster care placements, they may help explain the variance in internalizing and externalizing problems for youth in foster care. The present study aimed to examine whether characteristics of the foster care environment (i.e., conflict, cohesion) across various placement types (i.e., traditional foster homes, group-care settings) could help explain the link between previous maltreatment exposure and mental health problems. The sample included 178 youth in foster care (M_age?=?15.18, SD?=?1.76) and their foster caregivers living in the Midwest. Youth participants completed self-report measures about prior maltreatment history, current family environment characteristics, and youth internalizing symptoms. Foster caregivers completed measures on current family environment and youth externalizing symptoms. Results indicated that caregiver report, but not youth report, of family cohesion was negatively associated with youth report of internalizing problems. When examining the indirect effects, youth report of family conflict partially accounted for the link between youth self-report of maltreatment and internalizing symptoms (B?=?0.106, 95% CI?=?0.026–0.186). Caregiver report of family conflict fully accounted for the association between youth self-report of maltreatment and caregiver report of youths’ externalizing symptoms (B?=?0.108, 95% CI?=?0.005–0.211). Findings highlight the importance of utilizing multiple informants when measuring foster family environment and suggest that family conflict is particularly salient for the mental health of youth in foster care.

     

Family Mealtimes and Family Functioning

ABSTRACT

This study contributes to the existing research literature by assessing how the frequency of family mealtimes correlates with family communication and life satisfaction. Participants consisted of 50 families from the Southeastern United States. Parent and child participants completed measures assessing frequency of family mealtime, family communication, and family satisfaction. Results indicated that, based on parent-report, the frequency of all family members eating dinner together was significantly and positively correlated with both family communication and family satisfaction. Implications of findings highlight the importance of encouraging regular mealtime interactions among families.     

Family Functioning and Anxiety Symptoms in Adolescents: The Moderating Role of Mindfulness

Journal of Child and Family Studies - Anxiety disorders are one of the most prevalent psychiatric disorders among adolescents and can be associated with long-term adverse outcomes if untreated. Our...     

Executive Functioning and Engagement in Physical and Relational Aggression among Children with ADHD

Although evidence suggests that executive functioning (EF) impairments are implicated in physically aggressive behavior (e.g., hitting) these cognitive impairments have rarely been examined with regard to relational aggression (e.g., gossip, systematic exclusion). Studies also have not examined if EF impairments underlie the expression of aggression in children with attention-deficit/hyperactivity disorder (ADHD) and if child gender moderates risk. Children with and without clinical elevations in ADHD symptoms (N = 124; ages 8–12 years; 48 % male) completed a battery of EF tests. Parent and teacher report of ADHD and oppositional defiant disorder (ODD) symptoms and teacher report of engagement in physical and relational aggression were collected. Models tested the unique association of EF abilities with physical and relational aggression and the indirect effect through the expression of ADHD or ODD behaviors; child gender was also tested as a moderator. EF impairment was uniquely associated with physical aggression, but better EF ability was associated with relational aggression. For boys, poor EF also was indirectly associated with greater physical aggression through the expression of ADHD behaviors. However, ADHD symptoms were unrelated to relational aggression. ODD symptoms also predicted physical aggression for boys but relational aggression for girls. Results suggest that there are multiple and distinct factors associated with engagement in physical and relational aggression and that better EF may actually promote relational aggression. Established models of physical aggression should not be assumed to map on to explanations of relational aggression.     

Self-Reported Depressive Symptoms Have Minimal Effect on Executive Functioning Performance in Children and Adolescents

The relation between mood and executive functioning in children and adolescents has not been previously reported. This study examined the association between self-reported depressive symptoms in both clinical outpatient and psychiatric inpatient samples to the following measures of executive functioning: the Controlled Oral Word Association Test, Animal Naming, Trail Making Test, and Wisconsin Card Sorting Test. Records from children and adolescents aged 7–17 years old with an IQ > 70 were examined. Data were gathered at either an outpatient neuropsychology clinic (n = 89) or an inpatient psychiatric hospital setting (n = 81). Mood was measured with the Children’s Depression Inventory. Generally, statistical associations between self-reported depressive symptoms and executive functioning were small and non-significant. The variance predicted by mood on measures of executive functioning was minimal (generally less than 2 %) for the total sample, the outpatient group, inpatient group, and a subgroup who endorsed elevated mood symptoms. These results suggest that impaired performance on measures of executive functioning in children and adolescents is minimally related to self-reported depressive symptoms.     

Factors Impacting the Mental Health of the Caregivers of Children with Asthma in China: Effects of Family Socioeconomic Status,Symptoms Control,Proneness to Shame,and Family Functioning

Caregiver mental health is widely considered to be an important factor influencing children's asthma symptoms. The present study aimed to examine key factors that contribute to caregiver mental health in pediatric asthma with a Chinese sample. Two hundred participants reported their family socioeconomic status (SES), proneness to shame, asthma symptoms control of their child, family functioning, and their depression and anxiety symptoms. Results suggested that low family SES, low family functioning, and a high level of shame proneness were associated with high levels of anxiety and depression for caregivers. Family functioning mediated the effects of SES and shame on caregiver mental health and also moderated the effects of SES and shame on caregiver depression. This study highlights the importance of reducing experience of shame and enhancing family functioning in families affected by pediatric asthma.     

Family Functioning Assessment in a Community Sample of African American Caregivers and Children

Racial/ethnic minority youth receive approximately half of the mental health services of their non-minority peers. Improved methods for identifying African American families in need of behavioral health services are necessary. The Family Assessment Device and General Functioning subscale have been found to be reliable and able to detect family functioning impairment in a generalized sample, but less is known about the reliability and validity of the assessment with an African American community sample. Data from 53 African American caregiver-child (ages 7–13) dyads was collected including family demographics and the Family Assessment Device General Functioning (FAD_GF) scale. Confirmatory factor analysis was conducted to determine the minimal number of FAD_GF items (12 vs. 6 items) that were valid and reliable. The 12-item FAD_GF and the 6-item scale had acceptable psychometric properties, and the 6-item measure demonstrated improved model fit over the 12-item scale and identified more clinically impaired families (6-item: 28% vs. 12-item: 23%). The 6-item measure of family functioning was more sensitive 12-item FAD_GF. This brief measure may prove useful for identifying and assessing African American families.

     

Parent Ratings of ADHD Symptoms: Differential Symptom Functioning Across Malaysian Malay and Chinese Children

This study examined differential symptom functioning (DSF) in ADHD symptoms across Malay and Chinese children in Malaysia. Malay (N=571) and Chinese (N=254) parents completed the Disruptive Behavior Rating Scale, which lists the DSM-IV ADHD symptoms. DSF was examined using the multiple indicators multiple causes (MIMIC) structural equation modeling procedure. Although DSF was found for a single inattention (IA) symptom and three hyperactivity-impulsivity (HI) symptoms, all these differences had low effect sizes. Controlling for these DSF, Chinese children had higher IA and HI latent factor scores. However the effect sizes were small. Together, these findings suggest adequate support for invariance of the ADHD symptoms across these ethno-cultural groups. The implications of the findings for cross-cultural invariance of the ADHD symptoms are discussed.     

Associations Between Family Environment, Parenting Practices, and Executive Functioning of Children with and Without ADHD

We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported their children as exhibiting greater problems with behavioral control and metacognitive abilities, and described their family environments as less organized and higher in family conflict. Family environment and parenting practices were not correlated with behavioral control or metacognitive abilities in children with ADHD. In children without ADHD, higher levels of family cohesion, organization, and expressiveness, and lower levels of family conflict, were significantly correlated with greater behavioral control. Higher levels of family cohesion and organization were significantly and positively associated with regulation of metacognitive abilities in children without ADHD. In general, aspects of the family environment and parental limit setting appear to be associated with the development of executive functions in children not diagnosed with ADHD; however, family environment and parenting practices were not associated with executive functions in children diagnosed with ADHD.     

Individual and Family Contributions to Depressive Symptoms in African American Children with Sickle Cell Disease

Depressive disorders in children with chronic illnesses have received little attention despite some evidence suggesting that these children experience increased psychological difficulties as a result of their medical condition. Most of the research on depressive disorders among children has been conducted primarily with Caucasian youth, limiting generalizability to ethnically diverse populations. Further, even less research exists on depressive disorders among African American children with Sickle Cell Disease (SCD) and for African American youth from lower socioeconomic status who are at greater risk for depressive disorders. This paper is an extensive review of the major studies conducted on depression and psychosocial aspects of SCD in African American children. The Transactional Stress and Coping model is provided as a conceptual framework. Following the review, clinical and research implications are provided, as well as an illustration of a psychoeducational family intervention with an African American child who has SCD and internalizing behaviors.     

家庭功能与大学生情绪表达性、孤独感的关系

通过问卷调查法和结构方程模型分析技术,探讨家庭功能与大学生情绪表达性、孤独感之间的关系,以及家庭功能的作用机制,即家庭功能能否通过情绪表达影响大学生孤独感。结果发现:(1)家庭功能对大学生情绪表达性、孤独感有显著预测作用,家庭亲密度或适应性水平高的大学生更倾向具有高的情绪表达性,更少的体验到亲情、爱情以及社交孤独感;(2)情绪表达性对大学生社交孤独感具有一定的预测作用,即大学生越乐于表达情绪,其社交孤独感就越少;(3)家庭功能既直接对社交孤独感产生影响,又通过情绪表达性间接影响社交孤独感,即情绪表达性在家庭功能与社交孤独感之间起部分中介作用。     

Goal Effectiveness and Family Functioning

Differentiation of self in Bowen theory includes the effective pursuit of long-term, intrinsic goals while responsibly engaging with one's family and important others. This kind of goal direction is hypothesized to contribute to higher functioning families. Using quantitative and qualitative methods, this longitudinal study tested this hypothesis and found that participants with more goal effectiveness tended to have less symptomatic families of procreation, less increase in family symptomology over the fifteen years of the study, more strength of goal direction over time, and goal direction that was the same as or greater than their parents and siblings.