Parenting Stress,Parenting, and Adolescent Externalizing Problems

Journal of Child and Family Studies - Although the association between parenting stress and child behavioral outcomes is well established, there is limited research with families of adolescents....     

Parenting Stress and Childhood Psychopathology: An Examination of Specificity to Internalizing and Externalizing Symptoms

The purpose of this study was to examine if specificity exists between three factors of parenting stress (i.e., parental distress, parent–child (PC) dysfunctional interactions, and difficult child) and childhood internalizing and externalizing symptoms. The incremental validity of parenting stress beyond parental psychopathology was also examined. The sample was drawn from families of children aged 5–17 (N = 300), who sought treatment for their child from a community mental health clinic. Results indicated that the PC dysfunctional interactions factor showed specificity to internalizing symptoms when controlling for parental psychopathology. Parental distress did not show specificity or incremental validity and the difficult child factor was associated with both internalizing and externalizing symptoms when controlling for parental psychopathology. The influence of age, gender, and ethnicity on these associations is also presented, and findings are discussed in terms of how the results add to understanding the specific relations between parenting stress and child and adolescent symptoms.     

Type A Behavior and Stress in College Males

Substantial inconsistency can be noted among studies that have considered the relationship between Type A status and subsequent cardiac pathology. This erratic prediction pattern could be partially explained by the failure to consider level of stress in Type As, because only Type As that experience excessive and sustained stress should be at special risk. A stress-vulnerability model for young Type A college students was proposed involving selected Type A characteristics and other personality moderator variables serving to elicit, augment, and sustain stress. We considered self-preoccupation as a stress moderator in Type A college males and found evidence that k serves this function. Self-preoccupied Type As reported excessive stress over the previous year, whereas less self-centered Type As did not. Self-preoccupation was of no importance in moderating stress in Type Bs.     

Romantic Contexts, Sexual Behavior, and Depressive Symptoms among Adolescent Males and Females

In order to examine the association between sexual behavior and depressive affect among adolescents, 122 and 219 Israeli adolescents, in two separate studies, reported their romantic and sexual history, the quality of their relationships and level of depressive symptoms. Findings show that a higher level of sexual activity in short-term romantic relationships, which were low in intimacy and authenticity, was related to increased levels of depressive symptoms among females but not among males. In contrast, involvement in stable romantic relationships was not associated with increased depressive affect for either gender. Findings from a 3 month follow-up suggested that it may be that an increased level of depressive symptoms leads adolescent females to become more sexually involved in short romantic encounters.     

Externalizing Behavior Problems and Discipline Revisited: Nonlinear Effects and Variation by Culture,Context, and Gender

Debate continues regarding the magnitude and importance ofparenting effects on the development of children's externalizing behavior problems, in spite of the evidence that environments (as well as genes) contribute to individual differences in these behaviors. Research has demonstrated an association between harsh physical discipline and child aggression and conduct problems, a likely causal mechanism that probably operates as a shared environmental factor. We offer four hypotheses about the relation between discipline practices and child externalizing problems that may resolve some debate and help lead toward a more comprehensive understanding of how and when discipline practices will make a substantial difference: 1. The association between discipline and child aggression includes a nonlinear component. 2. The parent behavior-child behavior link varies across cultural groups. 3. Parental discipline effects on children vary according to the context of the broader parent-child relationship. 4. The discipline effect is maximized in same-gender parent-child dyads. Discussion focuses on the role of children's mental representations of discipline experiences as a mediator of discipline effects, and research implications with respect to sampling, measurement, and analytic strategies are noted.     

班级同学关系与青少年外化问题行为:自尊和亲子亲合的作用

采用问卷法对1694名中学生进行调查,考察自尊在班级同学关系和青少年外化问题行为之间的中介作用,以及该中介过程是否受到亲子亲合（父子亲合和母子亲合）的调节。结果发现：（1）控制性别和年龄之后,班级同学关系对青少年外化问题行为具有显著的负向预测作用;（2）班级同学关系不仅可以直接负向预测外化问题行为,还可以通过自尊间接预测外化问题行为;（3）父子亲合和母子亲合均在班级同学关系与自尊的关系间起调节作用;（4）父子亲合而非母子亲合能够调节班级同学关系对外化问题行为的直接影响。总之,班级同学关系通过自尊的部分中介作用影响青少年的外化问题行为,且父子亲合和母子亲合进一步对该过程起到不同的调节作用。     

An Examination of the Effectiveness of Dialectical Behavior Therapy Skills Groups

This study implemented a multiple‐phase, contrast, single‐case research design to examine the effectiveness of the 4 core dialectical behavior therapy skills group modules in reducing emotion dysregulation. Three participants completed four 6‐week skills modules over 9 months. Examination of calculated estimates of treatment effect indicated that 2 out of the 3 participants experienced meaningful changes in their degree of emotion dysregulation over the course of treatment. Implications for counseling practice are discussed.     

Adolescent Empathy and Prosocial Behavior in the Multidimensional Context of School Culture

The authors investigated whether students' positive perceptions of their high school's culture were associated with higher levels of empathy and prosocial behavior. The authors collected information from 2 samples to ensure a wide range of school culture perceptions. As expected, empathy and prosocial behavior were correlated. As evidence of the validity of the measure of school culture, students in a small alternative school perceived their school culture as more positive than did students in the companion large, traditional high school. More positive perceptions of school culture were associated with higher levels of empathy but not with prosocial behavior. Results were moderated by gender but not by age. Male students with higher levels of emotional concern (one aspect of empathy) perceived peer relationships (one aspect of school culture) to be more positive than did those with lower levels of emotional concern. This study highlights the importance of using multidimensional constructs for school culture and empathy to understand the effects of schooling on youth.     

Moderators of the Dynamic Link Between Alcohol Use and Aggressive Behavior among Adolescent Males

Although longitudinal evidence has linked alcohol use with aggressive behavior during adolescence, most studies have failed to adequately control for the numerous between-individual differences that may underlie this association. In addition, few studies of adolescents have examined whether the nature of the within-individual association between alcohol use and aggression depends on individual and contextual factors. To address these limitations, this study examined the association between within-individual changes in alcohol use and aggressive behavior across adolescence and determined whether impulsive behavior, positive attitudes toward violence, violent peers, neighborhood crime, and race moderated this association. Data from 971 adolescent males assessed annually from ages 13 to 18 were analyzed using a within-individual regression panel model that eliminated all stable between-individual factors as potential confounds. Findings indicated that within-individual increases in alcohol use quantity from one’s own typical levels of drinking were concurrently associated with within-individual increases in aggressive behavior, and vice versa. However, increases in alcohol were more strongly linked to increases in aggressive behavior among boys with attitudes favoring violence and those who lived in high-crime neighborhoods. The association between alcohol and aggressive behavior was similar for White and Black young men. Interventions designed to reduce aggressive behaviors should consider targeting not only alcohol use, but also individual and environmental risk factors that contribute to this link.     

Family Functioning, Self-Concept, and Severity of Adolescent Externalizing Problems

We investigated direct and shared effects of family functioning and self-concept on the severity of adolescent externalizing problems in a sample of 224 clinically referred adolescents. Structural equation modeling (SEM) revealed strong, direct relationships between problem behaviors and both family functioning and self-concept. Using R. M. Baron and D. A. Kenny's (1986) and G. N. Holmbeck's (1997) criteria for testing mediation in SEM, family functioning partially mediated the relationship between self-concept and problem behaviors. A moderation model, testing the relationship between externalizing problems and the interaction between family functioning and self-concept, did not yield a significant effect. Our findings indicate that self-concept and family functioning exert direct and shared effects on externalizing problems and suggest that interventions for clinically referred adolescents should target both the individual adolescent and his/her family.     

Gender Specific Effect of Psychological Stress and Cortisol Reactivity on Adolescent Risk Taking

The purpose of this study was to evaluate how psychological stress, gender and cortisol response to stress relate to risk behavior among 132 14–18 year old adolescents. Participants completed a laboratory based risk task prior to and immediately after a computerized psychological stress task, and salivary cortisol was collected from pre-stress to 60 min following initial stress exposure. Results indicate that adolescent boys (n?=?59) and girls (n?=?73) demonstrate different patterns of risk taking (RT) in response to stress, such that boys evidenced an increase in RT following stress exposure, whereas girls evidenced a decrease in RT. In addition, a gender by cortisol interaction demonstrated that for boys, both a smaller total cortisol output (AUCg) and peak cortisol response to stress (PC) was associated with greater stress-induced RT. Both cortisol measures were unrelated to stress-induced RT among girls. Taken together, data suggest that among boys, a blunted cortisol response to stress underlies an increase in risk taking in the context of psychological stress. Further research with an additional behavioral stress task is needed prior to drawing conclusions regarding the relation between female gender, cortisol response to stress, and risk taking in the context of psychological stress.     

Behavior Therapy in a Family Context: Treating Elective Mutism

This paper discusses the necessity of using both behavioral and family approaches in combination, while working with electively mute children. The symptom and its significance within the family system is presented along with a rationale for avoiding the pitfalls of individual approaches with such children. A case history outlining specific behavioral techniques is described in detail with an exploration of the use of reinforcement theory, counter-conditioning, and successive approximations in bringing about change in electively mute children. The need for bringing about changes within the family system so as to maintain the changes that have occurred through use of the behavior techniques is discussed and presented as crucial to the treatment process. The paper takes the position that either approach, by itself, will not be effective in helping electively mute children but that the treatment of choice is a combination of therapeutic techniques.     

The Efficacy of Systemic Therapy for Childhood and Adolescent Externalizing Disorders: A Systematic Review of 47 RCT

Systemic (family) therapy is a widely used psychotherapy approach. However, most systematic efficacy reviews have focused solely on “family‐based treatment” rather than on the theoretic orientation “systemic therapy.” We systematically review trials on the efficacy of systemic therapy for the treatment of childhood and adolescent externalizing disorders. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems‐oriented therapy in various forms (family, individual, group, multi‐family group therapy) with child or adolescent index patients (0–17 years) suffering from mental disorders were identified by data base searches and cross‐references. Inclusion criteria were as follows: index patient diagnosed with a DSM‐ or ICD‐listed mental disorder, and trial published in any language up to the end of 2011. The RCTs were analyzed for their research methodology, interventions applied, and results (postintervention; follow‐up). A total of 47 trials from the United States, Europe, and China, published in English, German, and Mandarin, were identified. A total of 42 of them showed systemic therapy to be efficacious for the treatment of attention deficit hyperactivity disorders, conduct disorders, and substance use disorders. Results were stable across follow‐up periods of up to 14 years. There is a sound evidence base for the efficacy of systemic therapy for children and adolescents (and their families) diagnosed with externalizing disorders.     

Linking Childhood Sexual Abuse and Early Adolescent Risk Behavior: The Intervening Role of Internalizing and Externalizing Problems

A robust literature links childhood sexual abuse (CSA) to later substance use and sexual risk behavior; yet, relatively little empirical attention has been devoted to identifying the mechanisms linking CSA to risky behavior among youth, with even less work examining such processes in boys. With the aim of addressing this gap in the literature, the current study examined the indirect effect of childhood sexual abuse (CSA; from age 2 to 12) trajectory group on risky behavior at age 14 (alcohol use & sexual intercourse) via the intervening role of caregiver-reported internalizing and externalizing problems at age 12. Analyses were conducted with a subsample of youth (n?=?657 sexual intercourse; n?=?667 alcohol use) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a multisite prospective study of youth at risk for maltreatment. For boys and girls, there was an indirect effect from CSA to sexual intercourse through externalizing problems. The same pattern emerged for alcohol use, but only for girls. Findings did not support an indirect path through internalizing problems for either boys or girls for either outcome. Findings suggest more focal targets for prevention efforts aimed at maintaining the health and safety of maltreated boys and girls during the adolescent transition.     

Extrarelationship Involvement Among Heterosexual Males: An Explanation Based on the Theory of Planned Behavior, Relationship Quality, and Past Behavior

The present study investigated the reasons why males in relationships engage in extrarelationship involvements (ERls). The theory of planned behavior was used as the basis for a decision-making model for ERI. The contribution of relationship factors and past behavior to explain ERI was also investigated. A division of perceived behavioral control into individual components of self-efficacy, control, and planning was also tested. Different sets of factors were associated with intention and behavior. ERI intentions were predicted by attitudes toward ERI, planning, game-playing love, and positive experience of past ERI. Present ERI behavior was predicted by ERI behavior in the past 6 months. Results generally supported the theory of planned behavior, especially for the prediction of intention.     

Psychopathy as Predictor and Moderator of Multisystemic Therapy Outcomes among Adolescents Treated for Antisocial Behavior

Objective

The aim of the present study was to determine whether psychopathic traits act as a predictor and/or moderator of the effectiveness of Multisystemic Therapy (MST).

Method

The sample included N?=?256 adolescents (188 boys and 68 girls) referred for conduct problems, randomized to MST or Treatment As Usual (TAU). The mean age was 16 years (SD?=?1.31). Assessments were carried out before and immediately after treatment (6 months later). Three psychopathic traits (callous/unemotional traits, narcissism, and impulsiveness) were assessed with parent reports. Adolescents and parents were informants on externalizing problems.

Results

MST was more effective than TAU in decreasing externalizing problems for the “lower callous/unemotional” and “lower narcissism” group, but not for the “high callous/unemotional” and “high narcissism” group (moderators). Impulsiveness was found to predict more post-treatment externalizing problems rated by adolescents (predictor), but not more post-treatment externalizing problems rated by parents.

Conclusions

These findings point out the clinical relevance of adequately assessing psychopathic traits in adolescents referred for treatment of antisocial behaviour, and identifying those adolescents who show high levels of these traits. It is important to tailor MST specifically to meet the needs of juveniles with high levels of callous/unemotional traits and high levels of narcissism to obtain the same level of effectiveness as with juveniles scoring lower on these traits.     

Summer Treatment Program for Preschoolers with Externalizing Behavior Problems: a Preliminary Examination of Parenting Outcomes

Within an at-risk sample of preschoolers with externalizing behavior problems (EBP), the current study examined the initial promise of a multimodal intervention, the Summer Treatment Program for Pre-Kindergarteners (STP-PreK), in improving parenting outcomes. Using an open trial design, 154 parents and their preschool children (73% male; M _age = 5.06 years; 82% Hispanic/Latino background) with at-risk or clinically elevated levels of EBP (57% of which were referred by schools or mental health/medical professionals) completed a baseline and post-treatment assessment. A subsample of 90 families completed a follow-up assessment approximately 6 to 9 months after treatment completion. Parental measures of parenting stress and discipline strategies were collected across all three assessments. Observational data were also collected across all assessments during a 5-min standardized child-led play situation and a 5-min parent-led clean up task. The parenting component of the STP-PreK included a School Readiness Parenting Program (SRPP) of which the behavioral management component was implemented via a Parent-Child Interaction Therapy (PCIT) adaptation (8 weekly group sessions with 15–20 parents in each group, lack of requirement of “mastery” criteria). All parenting outcomes (both ratings and observed) significantly improved after the intervention (Cohen’s d mean effect size across measures 0.89) with all effects being maintained at the 6–9 month follow-up. These findings highlight the initial promise of our SRPP’s PCIT adaptation in targeting multiple aspects of parenting while yielding comparable parenting skills acquisition compared to traditional individual PCIT.