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

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

Seesaw Discipline: The Interactive Effect of Harsh and Lax Discipline on Youth Psychological Adjustment

Although extant research documents the negative consequences of harsh and lax discipline for youth, little empirical attention has been devoted to understanding the impact when parents utilize both strategies. As such, the current study was designed to explore the interaction of harsh and lax discipline on youth internalizing and externalizing symptoms in three developmental periods (early childhood, middle childhood, and adolescence). Participants were 615 parents (55 % female) and one of their 3–17 year old children (45 % female). Parents provided reports of their harsh and lax parenting tactics as well as offspring internalizing and externalizing symptoms. Multiple linear regression analyses were utilized to examine the relations between the interaction of harsh and lax parenting on youth symptoms. The interaction between harsh and lax discipline was significantly related to youth internalizing, but not externalizing, problems in the both the young and middle childhood samples and marginally significant in the adolescence sample: seesaw discipline—a novel construct indicative of high levels of both harsh and lax discipline—was associated with the highest levels of youth internalizing problems. Parents who engage in seesaw parenting have children and adolescents who are more likely to evidence internalizing symptoms. Such findings may inform prevention and intervention efforts that target dysfunctional discipline.     

The Relationship Between Child-Reported Positive Affect and Parent-Reported Emotional and Behavioral Problems in ADHD Youth

Although the adaptive role of positive affect (PA) in childhood internalizing disorders is well-established, less is known about PA in children with Attention-Deficit/Hyperactivity Disorder (ADHD). In this cross-sectional study, we examined associations between child-reported PA and parent-reported emotional and behavioral problems in youth with ADHD using multiple hierarchical regression analyses. Participants included 848 ethnically diverse youth (253 youth with ADHD, 595 with other or no diagnoses; age range 6.12–19.65) referred for mental health assessments. Study measures included the Child Behavior Checklist (CBCL) and the Positive and Negative Affect Scale for Children (PANAS-C). Results indicated that higher levels of child-reported PA were associated with greater parental reports of total and internalizing problems among youth with ADHD but not in other clinic-referred youth. Specifically, child self-reports of PA were positively associated with parental reports of anxious/depressed and somatic problems in youth with ADHD. In addition, associations between child-reported PA and parent-reported problems differed by type of ADHD comorbidity. Findings suggest that at higher levels, PA in youth with ADHD might exert a paradoxical effect and be a subtle risk factor for or an indicator of parent-reported internalizing problems among youth with ADHD only and youth with ADHD and a comorbid externalizing disorder but not for youth with ADHD and a comorbid internalizing disorder or youth without ADHD. Discrepancies between child-reported PA and parent-reported problems may influence treatment planning and treatment response. Further clinical and theoretical implications for child therapists and parents are discussed.     

Internalizing and Externalizing Problem Behavior: a Test of a Latent Variable Interaction Predicting a Two-Part Growth Model of Adolescent Substance Use

Externalizing symptoms robustly predict adolescent substance use (SU); however, findings regarding internalizing symptoms have been mixed, suggesting that there may be important moderators of the relationship between internalizing problems and SU. The present study used a longitudinal community sample (N?=?387, 55% female, 83% White) to test whether externalizing symptoms moderated the relationship between internalizing symptoms and trajectories of alcohol and marijuana use from early (age 11–12 years old) to late (age 18–19 years old) adolescence. Two-part latent growth models were used to distinguish trajectories of probability of use from trajectories of amount of use among users. Results suggested that externalizing symptoms moderated the association between internalizing symptoms and probability of alcohol, but not marijuana use. The highest probability of alcohol use was observed at high levels of externalizing symptoms and low levels of internalizing symptoms. A negative protective effect of internalizing symptoms on probability of alcohol use was strongest in early adolescence for youth high on externalizing symptoms. Although moderation was not supported for amount of use among users, both domains of symptomology were associated with amount of alcohol and marijuana use as first-order effects. High levels of externalizing symptoms and low levels of internalizing symptoms were associated with high levels of amount of use among users. These findings suggest that developmental models of substance use that incorporate internalizing symptomology should consider the context of externalizing problems and distinguish probability and amount of use.     

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

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

Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD

We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.     

The Association of Parent Mindfulness with Parenting and Youth Psychopathology Across Three Developmental Stages

The primary purpose of the current study was to test a model examining the process by which parent dispositional mindfulness relates to youth psychopathology through mindful parenting and parenting practices. The universality of the model across youth at three developmental stages was examined: young childhood (3–7 years; n?=?210), middle childhood (8–12 years; n?=?200), and adolescence (13–17 years; n?=?205). Overall, participants were 615 parents (55 % female) and one of their 3-to-17 year old children (45 % female). Parents reported on their dispositional mindfulness, mindful parenting, positive and negative parenting practices and their child’s or adolescent’s internalizing and externalizing problems. Consistent findings across all three developmental stages indicated that higher levels of parent dispositional mindfulness were indirectly related to lower levels of youth internalizing and externalizing problems through higher levels of mindful parenting and lower levels of negative parenting practices. Replication of these findings across families with children at different developmental stages lends support to the generalizability of the model.     

When interventions harm. Peer groups and problem behavior.

This article explored developmental and intervention evidence relevant to iatrogenic effects in peer-group interventions. Longitudinal research revealed that "deviancy training" within adolescent friendships predicts increases in delinquency, substance use, violence, and adult maladjustment. Moreover, findings from 2 experimentally controlled intervention studies suggested that peer-group interventions increase adolescent problem behavior and negative life outcomes in adulthood, compared with control youth. The data from both experimental studies suggested that high-risk youth are particularly vulnerable to peer aggregations, compared with low-risk youth. We proposed that peer aggregation during early adolescence, under some circumstances, inadvertently reinforces problem behavior. Two developmental processes are discussed that might account for the powerful iatrogenic effects.     

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.     

Cross-informant consistency in externalizing and internalizing problems in early adolescence

The concept of cross-informant consistency has long been a topic of interest for those involved in assessment of behavior problems in adolescence. The purpose of the present study was to replicate and expand the existing literature by including four informants (mother, father, teacher, and adolescent self-report) and examining correlations among them as well as differences between reporters on an absolute level of both internalizing and externalizing problems. Fifty-two young adolescents (ranging in age from 11 to 15 years) and their mothers, fathers, and social studies teachers participated in the study. The Conduct Disorder subscale, Socialized Aggression subscale, and Anxiety/Withdrawal subscale of the Revised Behavior Problem Checklist were used. Results indicated that teachers showed little agreement with other informants on conduct problems (teachers reporting fewer problems), while parents and adolescents showed significant agreement. Informants showed no agreement on the measure of covert problems (socialized aggression), and all reports showed agreement on internalizing problems (although teachers continued to report fewer problems). Implications for assessment of young adolescents are discussed.This research was supported, in part, by the William T. Grant Foundation and the University of Georgia's Institute for Behavior Research.     

Marital conflict and support seeking by parents in adolescence: empirical support for the parentification construct

Parentification, a parent-child dynamic wherein children come to provide ongoing emotional support for their parents, has been documented extensively in the clinical literature; however, it rarely has been studied systematically. Using a community sample of 83 couples and their adolescent children (mean age = 15.26 years; 52% male, 48% female), the authors linked adolescent self-report of parentification to specific youth and adult behaviors using multiple methods and examined its associations with youth adjustment problems. The parentification measure demonstrated strong internal consistency and 1-year stability. Parentification was associated with marital conflict, youth perceptions of threat, low warmth in the parent-child relationship, and the tendency for youths to intervene in marital conflict. Links were also found with youth reports of internalizing and externalizing behavior and poorer competency in close friendships. These findings thus support the parentification construct and provide evidence that parentification may contribute to poor youth outcomes by burdening children with developmentally inappropriate responsibilities.     

Reducing the Risk of Internalizing Symptoms among High‐risk Hispanic Youth through a Family Intervention: A Randomized Controlled Trial

Familias Unidas is an intervention that has been found to be efficacious in preventing and reducing substance use, sexual risk, and problem behaviors among Hispanic youth. While it does not specifically target youth internalizing symptoms, the intervention works to strengthen parenting and family factors associated with reduced risk of internalizing symptoms (i.e., depression, anxiety symptoms). This study examines the effects of Familias Unidas on internalizing symptoms among high‐risk youth, as well as the role of family level factors in the intervention's effects. A total of 242 12–17‐year‐old Hispanic youth with a history of delinquency and their primary caregivers were recruited from the school and juvenile justice systems, and randomly assigned to the Familias Unidas intervention or community practice control. A linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms from baseline to 6 and 12 months post‐baseline. Results show that the Familias Unidas intervention was more efficacious than control in reducing youth internalizing symptoms. Baseline youth externalizing and internalizing symptoms did not moderate the intervention's effects on the trajectory of youth internalizing symptoms. While parent – adolescent communication did not significantly moderate the intervention's effects, changes in parent – adolescent communication mediated the intervention's effects on internalizing symptoms, showing stronger intervention effects for youth starting with poorer communication. Findings indicate that the Familias Unidas intervention can reduce internalizing symptoms among high‐risk Hispanic youth, and that improving parent – youth communication, a protective family factor, may be one of the mechanisms by which the intervention influences youth internalizing symptoms.     

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 stability of dimensions of behavior in ADHD and normal children over an 8-year followup

The present study reports on standardized behavioral ratings received by a large sample of hyperactive children meeting research diagnostic criteria (n=108) and a community control sample of normal children (n=61) who were followed prospectively over 8 years into adolescence. On some parentreport measures both groups declined in the severity of their behavior problems across time, while on other measures only the hyperactive group declined, but the hyperactives always remained more deviant than the controls at followup. The hyperactives and controls also differed on most teacher and selfreport ratings at followup. The greatest degree of agreement between raters at adolescence was between parent and youth ratings. These results are consistent with previous research demonstrating more deviant scores for hyperactive children than controls on various rating scales at adolescent followup. They also are consistent with research showing significant longitudinal continuity of both internalizing and externalizing behavioral pathology.This research was supported by NIMH gram 42181. We are grateful to Craig S. Edelbrock, Ph.D., for his assistance with the data entry program, and to Ann Edwards and Gerry Gillespie for their assistance in locating subjects.     

Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity

A large body of research has examined the development of internalizing and externalizing symptoms in childhood and early adolescence. Notably, there is significant concomitant impairment associated with early adolescent symptomatology, as well as association of these symptoms with future development of psychopathology, poor physical health, self-destructive thoughts and behaviors, criminal behavior, and HIV risk behaviors. Drawing on negative reinforcement theory, the current study sought to examine the potential role of distress tolerance, defined as the ability to persist in goal-directed activity while experiencing emotional distress, as a potential mechanism that may underlie both internalizing and externalizing symptoms among 231 Caucasian and African American youth (M age = 10.9 years; 45.5% female; 54.5% Caucasian ethnicity). A series of regressions resulted in significant moderated relationships, such that low distress tolerance conferred increased risk for alcohol use among Caucasians, delinquent behavior among African Americans, and internalizing symptoms among females. Clinical implications, including the potential role of negative reinforcement models in early intervention with young adolescents, are discussed.     

Home sweet home(s): parental separations,residential moves,and adjustment problems in low-income adolescent girls

Associations between histories of family disruption (residential moves and separations from parent figures) and adolescent adjustment (including educational, internalizing, externalizing, and sexual behavior outcomes) were examined in a random sample of 267 African American girls from 3 urban poverty neighborhoods. Higher numbers of residential moves and parental separations significantly predicted greater adolescent adjustment problems after household demographic characteristics were controlled. Adolescents' perceptions of their current relationships and neighborhoods were significantly associated with adolescent adjustment but did not mediate the effects of family disruption. Associations between parental separations and adolescent outcomes were strongest for externalizing problems and were found for both male and female caregivers, for long-standing and more temporary caregivers, and for separations in early childhood, middle childhood, and adolescence.     

Marital Conflict as a Mediator of the Longitudinal Connections between Maternal Emotional Distress and Early Adolescent Maladjustment

In this study, we examined the longitudinal relations among maternal emotional distress, marital conflict, and early adolescent externalizing behaviors and internalizing symptoms during the transition to adolescence. 3 years of self-report data were collected from 136 married mothers and their children, beginning when the children were in 5th grade. Structural equations modeling with latent variables were conducted to examine the nature and directionality of paths between constructs. For mothers, results indicated that marital conflict mediated the relation between prior maternal emotional distress and subsequent early adolescent externalizing behaviors and internalizing symptoms. For early adolescents, a mediating pattern was seen only for externalizing behaviors. In testing the reverse pattern of effects for mothers, marital conflict mediated the relation between prior early adolescent externalizing behaviors and subsequent maternal emotional distress whereas only an indirect pattern of effects existed for internalizing symptoms. Thus, we identified dynamic patterns of familial relations that accounted for the diminished well-being of both early adolescents and their mothers, suggesting that prevention and intervention work during the transition to adolescence should focus on multiple components of family functioning.     

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.     

Risk as a Moderator of the Effects of Prevention Programs for Children from Divorced Families: A Six-Year Longitudinal Study

Program by risk interactions were assessed to evaluate whether the long-term effects of two preventive interventions for children from divorced families were moderated by baseline levels of risk. Six-year prospective relations between childhood (ages 9-12) and adolescence (ages 15-19) were examined in 68 children who comprised the control group of a randomized trial. Analyses indicated that two childhood variables predicted multiple adolescent outcomes: environmental stressors and externalizing problems. A risk index composed of these 2 variables was highly predictive of internalizing and externalizing problems, competence, substance use, and mental disorder 6 years later. Analyses of the full sample (N = 218) indicated that program effects were greater for children with higher risk scores and that the programs attenuated the relation between risk and adolescent internalizing and externalizing problems, competence, and mental disorder.     

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.