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.     

Cross-Sectional Age Analysis of Sleep Problems in 2 to 17 Year Olds with ADHD Combined,ADHD Inattentive,or Autism

Sleep problems are common in autism and ADHD. No study has compared sleep problems by age in 2 to 17 year olds with autism versus ADHD-Combined versus ADHD-Inattentive type. Mothers rated 1415 youth with autism and 1041 with ADHD on 10 Pediatric Behavior Scale sleep items. Nighttime sleep problems were most severe in autism, followed by ADHD-Combined, and then ADHD-Inattentive. Difficulty falling asleep, restless during sleep, and waking during the night were the most common problems. Adolescents slept more at night than other age groups, and youth who slept more at night were sleepier during the day. Sleep problems declined with age, but correlations were small. In adolescence, 63% with autism, 53% with ADHD-Combined, and 57% with ADHD-Inattentive had difficulty falling asleep. Given that the majority of children in all age groups had one or more sleep problem, developmentally appropriate interventions are needed to address sleep difficulties and limit their adverse effects.

     

Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.     

Urban youth disruptive behavioral difficulties: exploring association with parenting and gender

The current study will examine behavioral difficulties among a sample of African American urban youth who were exposed to violence. Possible gender differences in disruptive behavioral difficulties, as well as possible associations between parental practices, family relationships, and youth disruptive behavioral difficulties are examined. A secondary data analysis from baseline data for 125 African American urban mothers and their children collected as part of a large-scale, urban, family-based, HIV prevention research study was analyzed. Findings reveal that externalizing behavioral problems in youth are associated with exposure to violence. Girls displayed significantly higher levels of externalizing behavioral difficulties than boys. Mothers' parenting practices and family relationships were associated with youths' externalizing behavior problems. Implications for interventions to reduce youths' exposure to violence and to develop gender sensitive interventions for youth and supportive interventions for their parents are discussed.     

Treatment Effects for Common Outcomes of Child Sexual Abuse: A Current Meta-Analysis

The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, inclusion of caregiver) and participant (e.g., age, gender, ethnicity) characteristics. Results indicated that longer interventions were associated with greater treatment gains while group and individual treatments were equally effective. These findings shed new light on treatment effectiveness and provide useful information regarding the conditions under which treatment may be most effective. Future directions for research in this area are discussed.     

Adverse Life Events, Coping and Internalizing and Externalizing Behaviors in Urban African American Youth

African American youth residing in low income urban neighborhoods are at increased risk of experiencing negative life events in multiple domains, increasing their risk for internalizing and externalizing behaviors. However, little is known about youth’s differential responses to life event stress, or protective processes and coping strategies for urban African American youth exposed to adverse life events. Thus, the present study examined whether variability in predominantly low income, urban African American youth’s responses to life event stress are accounted for by the type of life event experienced or the type of coping strategies used. Participants were a community sample of 353 urban African American youth (52.8 % girls; age range 8–12 years) who participated in the Multiple Opportunities to Reach Excellence (MORE) Project. Youth reported about their experiences with adverse life events, coping strategies, and internalizing and externalizing symptoms. Results indicated that violent life events were uniquely associated with externalizing behavior, while discrimination and economic stress were uniquely associated with internalizing behavior. The utility of coping strategies varied by gender, such that avoiding problems was protective for girls who experienced violent life events, but not for boys. For boys, exposure to violence was significantly positively associated with externalizing symptoms regardless of the amount of avoiding problems coping used. Findings suggest that interventions to develop coping strategies may need to be gender-specific as well as tailored for the types of stressors common for low income urban youth.     

Sleep disturbance and neuropsychological function in young children with ADHD

Sleep disturbance, common among children with ADHD, can contribute to cognitive and behavioral dysfunction. It is therefore challenging to determine whether neurobehavioral dysfunction should be attributed to ADHD symptoms, sleep disturbance, or both. The present study examined parent-reported sleep problems (Children’s Sleep Habits Questionnaire) and their relationship to neuropsychological function in 64 children, aged 4–7 years, with and without ADHD. Compared to typically developing controls, children with ADHD were reported by parents to have significantly greater sleep disturbance—including sleep onset delay, sleep anxiety, night awakenings, and daytime sleepiness—(all p ≤ .01), and significantly poorer performance on tasks of attention, executive control, processing speed, and working memory (all p < .01). Within the ADHD group, total parent-reported sleep disturbance was significantly associated with deficits in attention and executive control skills (all p ≤ .01); however, significant group differences (relative to controls) on these measures remained (p < .01) even after controlling for total sleep disturbance. While sleep problems are common among young children with ADHD, these findings suggest that inattention and executive dysfunction appear to be attributable to symptoms of ADHD rather than to sleep disturbance. The relationships among sleep, ADHD symptoms, and neurobehavioral function in older children may show different patterns as a function of the chronicity of disordered sleep.     

Behavioral Sleep Problems in Children and Adolescents

Sleep problems in children and adolescents are common, and they impact multiple domains of child and family functioning. Psychologists have a critical role in the assessment and treatment of sleep problems and are integral to interdisciplinary sleep teams. Certain sleep problems may be related to co-morbid psychological or developmental conditions, and others are considered to be primarily medical, yet behavioral approaches may be applicable. There are also sleep problems considered to be behavioral in etiology (e.g. inadequate sleep hygiene, behavioral insomnia of childhood, nightmares/bad dreams/nighttime fears, delayed sleep phase syndrome, and psychophysiological insomnia). In this article, the assessment of behavioral sleep problems, as well as specific behavioral sleep disorders, and their treatments will be discussed.     

Linking Maternal Socialization of Positive Emotions to Children’s Behavioral Problems: The Moderating Role of Self-Control

Little is known about how parents socialize children’s positive affect regulation during late childhood. Consequently, we examined how mothers’ reported responses to their children’s (aged 7–12 years) positive emotions were linked to children’s behavioral problems and how children’s self-control moderated these associations. Our results indicated that maternal encouragement of positive emotions predicted fewer externalizing behaviors, but only for youth with lower self-control. Maternal explanation about their children’s positive emotions was unrelated to youth’s behavioral problems. Lastly, maternal dismissing responses to their children’s positive emotions (i.e., reprimanding responses and discomfort) were related to more externalizing and internalizing in youth, and these effects were not dependent on the children’s self-control. The current study adds to the limited research on positive affect socialization and offers some evidence that youth’s self-control may serve as a vantage-sensitivity factor in the association between maternal positive affect socialization and youth adjustment.     

Development of an Intervention for Foster Parents of Young Foster Children with Externalizing Behavior: Theoretical Basis and Program Description

Foster parents are often faced with serious externalizing behaviors of their foster child. These behavioral problems may induce family stress and are related to less effective parenting and often increase. Foster children with behavioral problems are also more at risk of placement breakdown. An intervention to support foster parents of young foster children with externalizing behaviors is necessary to improve the effectiveness of foster placements. Based on research on effective parenting interventions and special needs of foster children, a treatment protocol was developed. This paper describes theoretical foundations for the content and form of the intervention and gives an overview of the modular treatment protocol. Preliminary outcomes of this intervention as well as challenges and future developments and research activities are discussed.     

The relationship between automatic thoughts and negative emotions in children and adolescents: a test of the cognitive content-specificity hypothesis

The aim of this study was to test the cognitive content-specificity hypothesis in children and adolescents aged 7-16 years. Participants consisted of a community sample of 200 youth and a clinical sample of 160 youth with anxiety, depressive, or disruptive behavior disorders. Participants completed several self-report measures assessing a wide range of negative beliefs and symptoms of internalizing and externalizing problems. Multivariate analyses examining the interrelationships between beliefs and noncognitive symptoms revealed that thoughts on loss or personal failure were the strongest predictors of depressive symptoms, thoughts on social threat were the strongest predictors of anxiety symptoms, and thoughts on hostility or revenge were the strongest predictors of aggression. Results showed clear evidence of cognitive-affective specificity across both internalizing and externalizing problems in youth.     

Utilization of Individual versus Family Therapy Among Adolescents with Severe Emotional Disturbance

Service utilization patterns among children with severe emotional and/or behavioral disturbances are described for 89 children and families, interviewed at two time points across a 6-month period. Children received a greater number of individual therapy sessions than family therapy sessions, and children significantly decreased their levels of internalizing and externalizing behaviors. Family therapy was associated with decreases in internalizing behaviors when children reported outcomes. Individual therapy was not associated with changes in either internalizing or externalizing behaviors regardless of reporter. Symptom severity did not dictate whether children were provided individual or family therapy. Recommendations for individualized treatment plans are offered.     

Co-Sleeping among School-Aged Anxious and Non-Anxious Children: Associations with Sleep Variability and Timing

Little is known about the co-sleeping behaviors of school-aged children, particularly among anxious youth who commonly present for the treatment of sleep problems. The current study examined the occurrence of co-sleeping in both healthy and clinically anxious children and its associated sleep patterns. A total of 113 children (ages 6–12), 75 with primary generalized anxiety disorder and 38 healthy controls, participated along with their primary caregiver. Families completed structured diagnostic assessments, and parents reported on their child’s co-sleeping behaviors and anxiety severity. Children provided reports of anxiety severity and completed one week of wrist-based actigraphy to assess objective sleep patterns. A significantly greater proportion of anxious youth compared to healthy children co-slept, and greater anxiety severity was related to more frequent co-sleeping. Co-sleeping in anxious youth was associated with a delay in sleep timing and with greater sleep variability (i.e., more variable nightly sleep duration). All analyses controlled for child age, race/ethnicity, family income, and parental marital status. Co-sleeping is highly common in anxious school-aged children, with more than 1 in 3 found to co-sleep at least sometimes (2–4 times a week). Co-sleeping was even more common for youth with greater anxiety severity. Increased dependence on others to initiate and maintain sleep may contribute to poorer sleep in this population via shifted schedules and more variable sleep patterns.     

父母养育压力对儿童问题行为的影响:养育方式的中介作用

本追踪研究旨在考察父母养育压力对儿童问题行为的影响方式是否存在差异。被试为364名。6个月时, 父母报告各自的养育压力;24个月时, 父母报告各自的养育方式;48个月时, 父母分别报告儿童的问题行为。结果发现, 母亲养育压力可直接显著正向预测学前期儿童的外显问题行为;父亲的养育方式在其养育压力与学前期儿童的内隐和外显问题行为之间起到了完全中介作用。这表明, 母亲早期养育压力可直接影响学前期儿童的外显问题行为;而父亲养育压力完全通过其养育方式影响学前期儿童的内隐和外显问题行为, 且严厉起主要作用。     

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.     

The Effects of Family Structure and Family Processes on Externalizing and Internalizing Behaviors of Male and Female Youth: A Longitudinal Examination

The present study examined potential gender differences in the effects of family structure and family processes on externalizing and internalizing behavioral outcomes among youth over time. Using data from waves one through three of the Add Health study, results indicated that the relationship between family structure and family processes on behavioral outcomes varied depending on the specific externalizing or internalizing behavior. Family structure directly influenced three different externalizing behaviors, but indirectly influenced internalizing behaviors through its effect on maternal attachment and to some degree parental permissiveness. The long-term influence of family structure, family processes, and later externalizing and internalizing behaviors is complex. These relationships played out similarly across both male and female youth, suggesting that the effect of living in a single-parent home, subsequent family processes, and individual behavior and well-being may not be different across gender.     

Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review

Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may, therefore, be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3–4 interventions significantly reduced youth internalizing symptoms; 3–5 reduced youth substance use; and 2–3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from?~?15 to 240 min. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people.

     

Self-Regulation Deficits Explain the Link between Reactive Aggression and Internalizing and Externalizing Behavior Problems in Children

Childhood aggression is often associated with significant psychosocial maladjustment; however, adjustment difficulties may vary based on the function of aggression. The present study used the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al. Child Neuropsychology 6:235–238, 2000) to examine whether difficulties in particular domains of self-regulation serve as common mechanisms in the association between reactive (versus proactive) aggression and internalizing or externalizing adjustment problems in clinic-referred children. Reactive aggression was associated with poorer behavioral regulation and metacognition, whereas proactive aggression was not associated with poorer self-regulation. Further, the association between reactive aggression and adjustment problems, both internalizing and externalizing, was accounted for by poorer behavioral regulation and metacognitive skills. Gender, age, ADHD diagnosis, IQ, and psychotropic medication status did not account for the results. These findings suggest that self-regulation skills influence adjustment problems in reactively aggressive youth and may be important targets of intervention for such children.     

睡眠时间参数对学前儿童问题行为的影响:消极情绪性的调节作用

本研究以338名学前儿童为被试,采用母亲报告法探究了学前儿童睡眠时间与问题行为之间的关系,以及儿童消极情绪性的调节作用。结果发现：（1）睡眠总时长对儿童内化和外化问题行为的主效应显著,而睡眠总时长与消极情绪性对儿童内化和外化问题行为的交互作用不显著;（2）夜间睡眠比对儿童内化问题行为的主效应显著,对儿童外化问题行为的主效应不显著;夜间睡眠比与消极情绪性对儿童内化问题行为的交互作用显著,即对高消极情绪性的儿童,夜间睡眠比能够显著负向预测其内化问题行为,而对低消极情绪性的儿童,夜间睡眠比对其内化问题行为的预测并不显著;夜间睡眠比与消极情绪性对儿童外化问题行为的交互作用不显著。     

The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families

Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing.