Dimensional Latent Structure of Early Disruptive Behavior Disorders: A Taxometric Analysis in Preschoolers

Although disruptive behavior disorders (DBDs) are used as a distinct categorical diagnosis in clinical practice, they have repeatedly been described as having a dimensional structure in taxometric analyses. In the current study the authors analyzed the latent status of disruptive behaviors (DB) in a large sample (N?=?2,808) of German preschool children (2–6 years old, mean age 53.7 months, SD?=?13.5, 48.4% girls). The Eyberg Child Behavior Inventory (ECBI) as well as the Strengths and Difficulties Questionnaire (SDQ) were used to compile indicators of the DB core dimensions (Temper Loss, Aggression, Noncompliance, and Low Concern for others). Three widely used taxometric methods (a) MAXEIG, (b) MAMBAC, and (c) L-Mode were applied. Simulation data were created to evaluate the Comparison Curve Fit Index values (CCFIs), which were below 0.45, supporting a dimensional solution. Hence, in the current study the latent structure of DB in preschoolers encompassed differences in degree rather than kind. Researchers and practitioners should be mindful of the dimensional latent status of DB in theory building, assessment, classification, and labeling.     

Gender Differences in the Relationship of Language Development to Disruptive Behavior and Peer Relationships in Preschoolers

The present study examined whether there are gender differences among preschoolers in how language development is related to disruptive behavior and peer relationships. Participants were 185 largely minority, preschool children from low income families and their 16 teachers. Videotaped observations were coded to assess disruptive and off-task behavior in group learning situations. Teachers rated disruptive behavior and the quality of peer relationships and they provided information about service referrals. Language skills were assessed with standardized tests. Lower levels of language skills were more strongly associated with disruptive behavior and poor peer relationships for boys than for girls. Disruptive behavior was related to the probability that a child would be referred for services. Language development difficulties tended to be seen by teachers only when paired with behavior problems.     

Parenting Disruptive Preschoolers: Experiences of Mothers and Fathers

This study examined parental functioning and interactions with young children with Oppositional Defiant Disorder (ODD), with emphasis on differences between mothers and fathers in their responses to their child and in their unique contributions to the prediction of child disruptive behavior. Participants were 53 3- to 6-year olds with ODD who presented for treatment with two parents. Mothers reported more severe disruptive behavior and higher parenting stress than fathers. During parent-child interactions, mothers showed more responsiveness than fathers, even though children were more compliant during interactions with fathers. Regression analyses showed that fathers' parent-related stress was predictive of both mothers' and father's reports of disruptive child behavior; mothers' marital satisfaction was predictive of behavioral observations of child compliance with both mothers and fathers. This study revealed several important differences in the experiences of mothers versus fathers of disruptive children and indicates the importance of including the father in the child's assessment and treatment.     

Preschoolers with Asthma: Narratives of Family Functioning Predict Behavior Problems

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low-income preschoolers. The study included parent report of asthma severity and a narrative story-stem method to assess children's representations of both general and disease-specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based-assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.     

Sexual and Physical Abuse Among Adolescent Girls with Disruptive Behavior Problems

We examined the prevalence and age of onset of physical and sexual abuse in a clinic-referred sample of adolescent girls, as well as differences in diagnoses and symptoms among abused and non-abused girls. Forty-nine girls (aged 13–17 years) with disruptive behavior were interviewed along with their primary caretaker. Data were gathered through both a structured interview with the girl and her parent, as well as self and parent-report questionnaires. Findings indicated that the prevalence of Conduct Disorder (CD) and Major Depression were higher for abused girls. Somatoform Pain Disorder was significantly less likely for physically abused girls, compared to girls who were both physically and sexually abused. Of CD symptoms, truancy was twice as high for the physically and sexually abused group, compared to the prevalence for non-abused girls. Internalizing symptoms were also highest for the dual abuse group. Onset graphs show that the onset of sexual abuse usually occurred at an earlier age than the onset of physical abuse. Abused girls showed an earlier age of onset of CD symptoms. Results indicated that the experience of combined types of abuse is associated with a poorer psychiatric prognosis.     

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.     

Screening for Significant Behavior Problems in Diverse Young Children Living in Poverty

The development and use of first line screening instruments is an essential first step in assessing behavior disorders in very young children. The Early Childhood Behavior Screen (ECBS) is a parent-report measure for behavior disorders and is normed on young children (1–5 years old) living in poverty. The current study presents psychometric support for the discriminative validity of the ECBS’s 10-item Challenging Behavior Scale (CBS) as a first-line screener for externalizing behavior problems for preschool aged-children in poverty. The study’s sample included 673 participants (M age years = 2.81; 63.2 % male; 65.8 % African American) that all met the federal definitional standard for living in poverty. A confirmatory factor analysis was run to provide support for the ECBS factor structure. Receiver operating characteristics (ROC) curve analyses were used to test the CBS’s ability to distinguish between 428 clinic-referred children and 245 non-clinic-referred children. Results showed an acceptable fit model for the ECBS, providing further evidence of its construct validity. Optimal cut-scores by child age derived from the ROC curve analyses were provided with corresponding levels of sensitivity, specificity, and positive and negative predictive values. Sensitivity rates for cut scores ranged from 0.76 to 0.83 and specificity rates ranged from 0.88 to 0.95. Acceptable test–retest reliability and good internal consistency also was observed. The CBS quickly identifies young children from low-income, urban, diverse populations that may be at-risk for developing significant behavior disorders and should be considered by health care professionals who work with very young children.     

Improving School Readiness in Preschoolers with Behavior Problems: Results from a Summer Treatment Program

To examine a) the feasibility of delivering a summer treatment program for pre-kindergarteners (STP-PreK) with externalizing behavior problems (EBP) and b) the extent to which the STP-PreK was effective in improving children’s school readiness outcomes. Participants for this study included 30 preschool children (77 % boys; Mean age?=?5.33 years; 77 % Hispanic background) with at-risk or clinically elevated levels of EBP. The STP-PreK was held at an early education center and ran for 8-weeks (M-F, 8 a.m.–5 p.m.) during the summer between preschool and kindergarten. In addition to a behavioral modification system and comprehensive school readiness curriculum, a social-emotional curriculum was also embedded within the STP-PreK to target children’s self-regulation skills (SR). Children’s pre- and post-school readiness outcomes included a standardized school readiness assessment as well as parental report of EBP, adaptive functioning, and overall readiness for kindergarten. SR skills were measured via a standardized executive functioning task, two frustration tasks, and parental report of children’s emotion regulation, and executive functioning. The STP-PreK was well received by parents as evidenced by high attendance and satisfaction ratings. Additionally, all school readiness outcomes (both parent and observational tasks) significantly improved after the intervention (Cohen’s d effect sizes ranged from 0.47 to 2.22) with all effects, except parental report of emotion regulation, being maintained at a 6-month follow-up. These findings highlight the feasibility and utility of delivering an early intervention summer program that can successfully target multiple aspects of children’s school readiness, including behavioral, social-emotional/self-regulation, and academics.     

The Association between Self-Regulation and Symptoms of Autism Spectrum Disorder in Preschoolers with Externalizing Behavior Problems

The purpose of the current study was to examine the role of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) symptoms in predicting deficits in self-regulation across the domains of executive functioning and emotion regulation. Parents of 40 preschoolers with externalizing behavior problems reported on children’s ADHD and ASD symptoms, and emotion regulation. Children completed a standardized executive functioning battery. Results indicated that 28% of parents and 53% of teachers rated children above the subclinical range on ASD symptoms. An interaction emerged such that higher ASD symptoms were only associated with poorer executive functioning for children with lower ADHD symptoms. However, ASD symptoms were predictive of poorer emotion regulation independent of ADHD symptoms. Findings revealed clinically significant ASD symptoms, which aided in explaining heterogeneity in self-regulation deficits.     

The Combined Influence of Monitoring and Early Puberty on Disruptive Behavior Problems in African American Girls

Journal of Child and Family Studies - Adolescent girls’ disruptive behavior problems (DBP) are associated with risk for other mental health challenges and legal system involvement. Existing...     

Multidisciplinary Early Intervention for Preschoolers with Externalizing Behavior Problems and Language Impairment: Results from an Open Trial

Journal of Psychopathology and Behavioral Assessment - The purpose of the study was to a) examine school readiness (SR) outcomes in preschoolers with externalizing behavior problems (EBPs) and...     

The Effects of Emotion Regulation Treatment on Disruptive Behavior Problems in Children: A Randomized Controlled Trial

Research on Child and Adolescent Psychopathology - Disruptive behavior problems are a frequent reason for children’s referrals to psychological services and can have negative effects on...     

Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis

We review 85 empirical articles published since 2000 that measured the acquisition and/or utilization of parent management skills and/or child cognitive-behavioral skills in the context of an evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there are no standardized measures of skill acquisition or skill utilization that are used across treatments, (2) little is known about predictors, correlates, or outcomes associated with skill acquisition and utilization, and (3) few studies systematically examined techniques to enhance the acquisition and utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed an overall treatment–control ES = .31, p < .01 for skill acquisition and ES = .20, p = ns for skill utilization. We recommend that future research focus on the following three areas: (1) development of standardized measures of skill acquisition and utilization from a “common elements” perspective that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated with skill acquisition and utilization; and (3) development of innovative interventions to enhance the acquisition and utilization of cognitive-behavioral and parent management skills.     

Joint Trajectories of Symptoms of Disruptive Behavior Problems and Depressive Symptoms During Early Adolescence and Adjustment Problems During Emerging Adulthood

The joint, longitudinal trajectories of symptoms of disruptive behavior problems and of depression were examined in a community sample drawn from neighborhoods with elevated rates of delinquency. Growth mixture modeling was applied to a 6?year transition period from childhood to adolescence, age 10 to 16?years, to identify latent classes of trajectories for each symptom type. Several classes emerged for the two types of symptoms, namely a group of youth with high levels of disruptive behavior, a group with increasing levels, and a group with low levels, as well as a group with increasing levels of depression, a group with high levels, a group with decreasing levels, and a group with low levels. Within each symptom type, membership in either the high or in the increasing classes was related to a variety of problematic outcomes during emerging adulthood. The co-occurrence of the disruptive behavior and depression classes was then evaluated using parallel process analysis. Youth exhibiting high depressive symptoms were at increased risk for disruptive behavior problems, and youth with increasing disruptive behavior problems were at risk for depressive symptoms. However, only a very small number of youth had both a high depression trajectory and a high disruptive behavior trajectory. Implications of the findings for the design of prevention and treatment programs are discussed.     

母亲感知的共同教养对幼儿行为问题的影响：一个有调节的中介模型

为探讨婚姻冲突在母亲感知的共同教养与儿童行为问题之间的中介作用,以及儿童心理韧性在其中的调节作用,本研究选取上海市2所幼儿园170名5岁儿童及母亲进行为期一年的追踪,结果发现:(1)母亲感知的共同教养与婚姻冲突、儿童行为问题呈显著负相关;(2)婚姻冲突在母亲感知的共同教养与儿童行为问题之间起中介作用;(3)儿童心理韧性在婚姻冲突影响儿童行为问题的关系中起调节作用,即儿童心理韧性调节了中介过程的后半段路径。上述结果表明,母亲感知的共同教养会通过婚姻冲突影响学龄前儿童行为问题,儿童拥有较高的心理韧性能够缓冲父母婚姻冲突对儿童行为问题的不良影响。     

Treatment Effectiveness of a Brief Behavioral Intervention for Preschool Disruptive Behavior

Parent management training is an evidence-based treatment for disruptive behavior. However, the number of treatment sessions can be high, contributing to high attrition rates. The purpose of this study was to examine post-treatment, 6-month, and 1-year treatment outcomes of the Brief Behavioral Intervention. One hundred twenty children aged 2–6.5 years demonstrating clinically significant disruptive behavior were referred to an outpatient clinic for treatment and participated in the study. Attrition was below reported rates in the literature. Significant decreases in child disruptive behavior and parent stress were found from pre-to-post intervention, and improvements were maintained at follow-ups. Significant pre-to-post intervention teacher reported decreases in behavior were reported.     

Diversity in Pathways to Common Childhood Disruptive Behavior Disorders

Oppositional-Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are highly comorbid, a phenomenon thought to be due to shared etiological factors and mechanisms. Little work has attempted to chart multiple-level-of-analysis pathways (i.e., simultaneously including biological, environmental, and trait influences) to ODD and ADHD, the goal of the present investigation. 559 children/adolescents (325 boys) between the ages of 6 and 18 participated in a multi-stage, comprehensive diagnostic procedure. 148 were classified as ODD; 309 were classified as ADHD, based on parent, teacher, and clinician ratings. Children provided buccal or salivary samples of DNA, assayed for select markers in DRD4 and 5HTT. Parents completed the Alabama Parenting Questionnaire and the California Q-Sort. Children completed the Child Perception of Interparental Conflict Scale. Correlational associations consistent with multiple-level-of-analysis pathways to ODD and ADHD emerged. For ODD, children with the short allele of the 5HTT promoter polymorphism had higher neuroticism and ODD symptoms regardless of level of self-blame in relation to inter-parental conflict, whereas children without this allele had more ODD symptoms only in the context of more self-blame for inter-parental conflict. For ADHD (and ODD), children homozygous for the long allele of DRD4 120?bp insertion polymorphism had lower conscientiousness when exposed to inconsistent parenting, whereas children without this genotype were more resilient to effects of inconsistent discipline on conscientiousness. Thus, ODD and ADHD appear to demonstrate somewhat distinct correlational associations between etiological factors and mechanisms consistent with pathway models using a multiple-level-of-analysis approach.     

A Meta-Analysis of Program Characteristics for Youth with Disruptive Behavior Problems: The Moderating Role of Program Format and Youth Gender

There is high variability in efficacy for interventions for youth with disruptive behavior problems (DBP). Despite evidence of the unique correlates and critical consequences of girls’ DBP, there is a dearth of research examining treatment efficacy for girls. This meta-analysis of 167 unique effect sizes from 29 studies (28,483 youth, 50% female; median age: 14) suggests that existing treatments have a medium positive effect on DBP (g = .33). For both boys and girls, the most effective interventions included (a) multimodal or group format, (b) cognitive skills or family systems interventions, and (c) length-intensive programs for (d) younger children. Boys demonstrated significantly greater treatment gains from group format interventions compared to girls, which is particularly important given that the group program format was the most prevalent format for boys and girls, with 14 studies involving 10,433 youth encompassing this category. This is the first meta-analysis to examine the effect of program characteristics in a sample of programs selected to be specifically inclusive of girls. Given that girls are underrepresented in intervention research on DBP, findings are discussed in terms of gender-responsive considerations and elucidating how key aspects of program structure can support more effective intervention outcomes for youth.