Neighborhood deprivation affects children's mental health: environmental risks identified in a genetic design

The possibility that neighborhood conditions affect children's development has captured much attention because of its implications for prevention. But does growing up in deprived neighborhoods matter above and beyond a genetic liability to behavior problems, if genetically vulnerable families tend to concentrate in poor neighborhoods? A nationwide study of 2-year-old twins shows that children in deprived neighborhoods were at increased risk for emotional and behavioral problems over and above any genetic liability. Environmental factors shared by members of a family accounted for 20% of the population variation in children's behavior problems, and neighborhood deprivation accounted for 5% of this family-wide environmental effect. The results suggest that the link between poor neighborhoods and children's mental health may be a true environmental effect, and demonstrate that genetic designs are environmentally informative and can be used to identify modifiable risk factors for promoting child health.     

Children's mental health in times of economic recession: replication and extension of the family economic stress model in Finland

This study evaluated the applicability of the family economic stress model (FESM) in understanding the influences of economic hardship on child mental health during a nationwide economic recession in Finland. The information was gathered from 527 triads of 12-year-olds and their mothers and fathers from a population sample. The structural equation models showed that the FESM fit the data well, indicating its generalizability in Finnish society. The results confirmed that a reduction in disposable family income constitutes a risk for child mental health through increased economic pressure and negative changes in parental mental health, marital interaction, and parenting quality. Controlling the children's prerecession mental health substantiated that economic hardship can lead to deterioration in children's mental health. Alternative models based on fully recursive analyses revealed reciprocal influences between parents and their children over time: Children's prerecession mental health problems predicted compromised parenting, which in turn contributed to children's internalizing and externalizing symptoms during the recession.     

Parental corporal punishment predicts behavior problems in early childhood.

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (Research Triangle Institute, 2002), this study examined the impact of corporal punishment (CP) on children's behavior problems. Longitudinal analyses were specified that controlled for covarying contextual and parenting variables and that partialed child effects. The results indicate that parental CP uniquely contributes to negative behavioral adjustment in children at both 36 months and at 1st grade, with the effects at the earlier age more pronounced in children with difficult temperaments. Parents and mental health professionals who work to modify children's negative behavior should be aware of the unique impact that CP likely plays in triggering and maintaining children's behavior problems. Broad-based family policies that reduce the use of this parenting behavior would potentially increase children's mental health and decrease the incidence of children's behavior problems.     

Correlates of household smoking bans in low-income families of children with and without asthma

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.     

Asthma severity, child security, and child internalizing: using story stem techniques to assess the meaning children give to family and disease-specific events

Children with persistent asthma are at increased risk for mental health problems. Although mechanisms of effect are not yet known, it may be that children are less trusting of the family as a source of support and security when they have more severe asthma. This study tested whether asthma severity is related to children's perceptions of insecurity in the family, and whether insecurity is in turn associated with child adjustment. Children (N = 168; mean age = 8 years) completed story stems pertaining to routine family events (e.g., mealtimes) and ambiguous but potentially threatening asthma events such as tightness in the chest. Responses were evaluated for the extent to which appraisals portrayed the family as responding in cohesive, security-provoking ways. Asthma severity was assessed by both objective lung function testing and primary caregiver report. Caregivers reported child symptomatology. Beyond medication adherence, caregiver education, and child age and gender, greater asthma severity predicted more internalizing and externalizing symptoms. Greater asthma severity, assessed using spirometry (but not parent report), was related to less secure child narratives of the family, which in turn related to more child internalizing symptoms. Results suggest that asthma can take a considerable toll on children's feelings of security and mental health. Furthermore, given the difficulty in assessing young children's perceptions, this study helps demonstrate the potential of story stem techniques in assessing children's appraisals of illness threat and management in the family.     

A Teacher-Consultation Approach to Social Skills Training for Pre-Kindergarten Children: Treatment Model and Short-Term Outcome Effects

This study evaluated the post-treatment outcome effects of a classroom-based social skills program for pre-kindergarten children, using a teacher-consultation model. The pre-K RECAP (Reaching Educators, Children, and Parents) program is a semi-structured, cognitive-behavioral skills training program that provides teachers with in-classroom consultation on program implementation and classroom-wide behavior management. Data on children's social skills and behavior problems were collected from parents and teachers at pre- and post-treatment, for 149 children aged 4–5 years (of whom 56% were girls). Significant treatment effects were found for teacher but not parent reports, with treatment group children improving significantly more than comparison group children in their teacher-rated social skills and internalizing and externalizing problems. These results provide some preliminary support for the efficacy of the program on children's social skills and behavior problems, and for a teacher-consultation model for training teachers to implement school-based mental health programs.     

粗暴养育的内涵、影响因素及作用机制

因对儿童青少年身心发展的消极影响, 粗暴养育(harsh parenting)近年来成为养育研究领域的热点。粗暴养育的表现形式主要包括身体攻击、言语攻击、心理攻击以及强迫/控制行为等。影响因素包括个体影响因素和环境影响因素。前者主要包括父母的敌意人格、认知能力不足、消极的被养经历以及儿童的困难型气质和易损基因型等。后者主要包括家庭经济困难和社区处境不利等。粗暴养育引发儿童的内外化问题, 损害其人际功能, 造成生理/神经系统功能紊乱等。未来研究需进一步考察粗暴养育的影响因素(如特殊家庭环境)、表现形式及其负面影响, 加强本土化研究, 重视粗暴养育的预防和干预。     

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

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

Incorporating Multifaceted Mental Health Prevention Services in Community Sectors-of-Care

This article proposes a framework for embedding prevention services into community sectors-of-care. Community sectors-of-care include both formal and grassroot organizations distributed throughout a community that provide various resources and services to at-risk children and their families. Though the child population served by these organizations is often at elevated risk for mental health problems by virtue of children's exposure to difficult life circumstances (poverty, maltreatment, homelessness, domestic violence, etc.) these children face many barriers to accessing evidence-based prevention or treatment services. We review evidence and propose a framework for integrating prevention services into community sectors-of-care that serve high-risk children and families.     

The Role of Maternal Acceptance in the Relation Between Community Violence Exposure and Child Functioning

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that “buffer” or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.     

Family Influences on the Long Term Post-Disaster Recovery of Puerto Rican Youth

This study focused on characteristics of the family environment that may mediate the relationship between disaster exposure and the presence of symptoms that met DSM-IV diagnostic criteria for symptom count and duration for an internalizing disorder in children and youth. We also explored how parental history of mental health problems may moderate this mediational model. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children (N?=?1,886 dyads) were interviewed with the Diagnostic Interview Schedule for Children and other questionnaires in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, parents’ relationship quality and parental mental health. SEM models were estimated for parents and children, and by age group. For children (4–10 years old), parenting variables were related to internalizing psychopathology, but did not mediate the exposure-psychopathology relationship. Exposure had a direct relationship to internalizing psychopathology. For youth (11–17 years old), some parenting variables attenuated the relation between exposure and internalizing psychopathology. Family environment factors may play a mediational role in psychopathology post-disaster among youth, compared to an additive role for children. Hurricane exposure had a significant relation to family environment for families without parental history of mental health problems, but no influence for families with a parental history of mental health problems.     

Accuracy of Informants: Do Parents Think That Mother Knows Best?

A total of 200 mothers and fathers provided their opinions as to the accuracy of mothers, fathers, teachers, children's peers, and children themselves as informants of children's emotional/behavioral problems. The results showed that mothers and fathers had very similar patterns of perceptions of accuracy, although fathers' ratings showed less differentiation between informants than did mothers' ratings. Patterns were very similar for reports on children and adolescents. Overall, mothers were perceived to be more accurate in reporting internalizing problems; mothers and teachers (and fathers to a lesser extent) were perceived to be more accurate in reporting externalizing problems; mothers, fathers, and teachers were seen as more accurate in reporting children's adaptive behaviors, and mothers, fathers, and children were seen as more accurate in reporting family problems. The results are discussed in the context of multiple informants of children's and adolescents' emotional/behavioral problems.     

The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

Family characteristics as mediators of the influence of problem drinking and multiple risk status on child mental health

Structural equation modeling was used to test a theoretical model in which family cohesion and family reframing coping were hypothesized as mediators between family drinking problems, multiple risk factors, negative life events, and child mental health (conduct disorder, depression, anxiety) in two-parent families. Family cohesion mediated the relationships of family drinking problems and negative life events to child conduct disorder and depression. Negative life events mediated the relationships of family drinking problems and family multiple risk to child conduct disorder. Family reframing coping did not function as a mediator nor was it related to child mental health when other factors were considered simultaneously. Results indicate that increasing family cohesion and reducing sources of stress within the family (negative life events) represent promising areas for interventions for children with problem-drinking parents. Work on this study was funded in part by the National Institute for Mental Health Grant 2-P50-MH39246-06 to support a Preventive Intervention Research Center. The authors gratefully acknowledge contributions made by Rita Shell, Marcia Michaels, Joanne Gersten, George Knight, and Carolyn Berg.     

Child of divorce: An overview

Children of divorce represent a diverse population at risk for subsequent psychological problems, whose interests are insufficiently understood or protected by the legal system or the mental health community. Although many children weather the stress of marital breakdown without psychopathological sequelae, a significant number show lasting difficulties. Information concerning the psychological adaptation of these children has increased rapidly during the past decade, but it remains unequel to the task of guiding family policy in this arena. Current knowledge identifies child gender and developmental stage as crucial factors that interact with the chronic stresses of postdivorce family life to produce short-and long-range impediments to the maturation of these vulnerable young people. There is a critical need to facilitate understanding and cooperation between the behavioral sciences and the legal profession on behalf of children in divorced families. The major research tasks relevant to enlightened public policy lie ahead.     

Relating Kindergarten Attention to Subsequent Developmental Pathways of Classroom Engagement in Elementary School

We examine the relationship between children's kindergarten attention skills and developmental patterns of classroom engagement throughout elementary school in disadvantaged urban neighbourhoods. Kindergarten measures include teacher ratings of classroom behavior, direct assessments of number knowledge and receptive vocabulary, and parent-reported family characteristics. From grades 1 through 6, teachers also rated children's classroom engagement. Semi-parametric mixture modeling generated three distinct trajectories of classroom engagement (n?=?1369, 50% boys). Higher levels of kindergarten attention were proportionately associated with greater chances of belonging to better classroom engagement trajectories compared to the lowest classroom engagement trajectory. In fact, improvements in kindergarten attention reliably increased the likelihood of belonging to more productive classroom engagement trajectories throughout elementary school, above and beyond confounding child and family factors. Measuring the development of classroom productivity is pertinent because such dispositions represent precursors to mental health, task-orientation, and persistence in high school and workplace behavior in adulthood.     

父母述情困难与儿童行为问题:父母心境的中介作用

采用整群抽样法选取438名学前儿童及其家长为被试, 通过量表考察父母述情困难、心境与儿童问题行为之间的关系。结果发现:(1)父亲述情困难与儿童焦虑害羞行为显著正相关, 父亲情绪愉悦在其述情困难与儿童焦虑害羞行为之间具有完全中介作用;(2)母亲述情困难与儿童愤怒攻击、焦虑害羞行为显著正相关, 同时母亲的情绪波动在其述情困难与儿童愤怒攻击行为之间起着部分中介作用。研究结果说明述情困难风险较高的父亲, 其情绪愉悦水平也相对较低, 进而导致儿童表现出更多焦虑害羞行为;述情困难风险较高的母亲, 一方面会直接导致儿童表现出较多愤怒攻击与焦虑害羞行为, 另一方面又会通过其情绪波动增加儿童出现愤怒攻击行为的风险。     

Maternal mental health,child care quality,and children's behavior

Moderating effects of non-parental preschool child care quality on the impact of maternal mental health risks on children's behavioral and mental health outcomes were examined. The paper presents data both on the concurrent buffering effects on children at the age of 4 ½ while they are in child care as well as on the longitudinal effects on the children two years later in the first grade. Study participants included 294 mothers, fathers, their children, their children's non-parental caregivers in preschool child care programs and their children's first grade teachers from the Wisconsin Study of Families and Work. Using regression models to examine moderation, we found that in low quality child care, children exposed to elevated maternal depressive symptoms and anger showed more behavioral problems and worse prosocial functioning. In contrast, children in high quality child care did not present higher symptoms in relation to elevated mother mental health risks. Significant moderating effects were found in both concurrent and longitudinal analyses. Results point to potential buffering effects of high quality care for children faced with adverse family factors.     

Early family context and development of adolescent ruminative style: moderation by temperament

We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool (ages 3? and 4? years) and early adolescence (ages 13 and 15 years). Results indicated that family context and child temperament, assessed during the preschool period, were risk factors for a ruminative style in adolescence. Specifically, early family contexts characterised by over-controlling parenting and a family style of negative-submissive expressivity predicted higher levels of later rumination. These associations were moderated by children's temperamental characteristics of negative affect and effortful control. Further, the interaction of these temperament factors exerted an additional influence on later rumination. Implications for prevention and intervention efforts are discussed.