Age trends in early behavioral predictors of serious antisocial behaviors

A risk group of disruptive boys (N=65) identified in kindergarten was assessed using the same procedures at ages 6–7, 8–9, and 10–11. Criteria used to define the predictors and criterion variable were the same at all assessment times. Severity was addressed by comparing different forms of behaviors, considering the extent of harmful consequences to others (aggressiveness was considered as most harmful, whereas inattention was considered as least harmful), manifestation in multiple settings, and extreme scores (manipulation of cutoff scores). Different assessment strategies (direct observations, ratings) and different informants (trained observers, mothers and teachers) were used. Aggressiveness as rated by mothers was highly stable from age 6 to age 11. Inattention as rated by teachers was stable only from age 6 to age 9, whereas no stability was found for observations of task inappropriate behaviors. Taskinappropriate behaviors observed in mother-child interactions and in multiple settings at age 6–7 were significant predictors of self-reported antisocial behaviors at age 12, but this prediction was not repeated at ages 8–9 and 10–11. Teacher ratings of inattention at ages 6–7 and 8–9 were also significant predictors of self-reported antisocial behaviors at age 12. The predictive power was much lower when mothers' ratings of aggressiveness were used. Findings from the present study support the hypothesis that some antisocial behavior precursors are age dependent, in that they are more characteristic of certain age groups than of others. Implications for the selection of assessment screening procedures are discussed.     

Correspondence of teacher ratings and direct observations of classroom behavior of psychiatric inpatient children

The present investigation examined the correspondence of teacher ratings and direct observations of classroom behavior. Techers, extraclass raters, and observers completed standard rating scales and/or measures of overt classroom behaviors of psychiatric inpatient children (N=32). The study assessed if the correspondence between ratings and direct observations was influenced by who evaluates the child (teachers, raters) and the assessment format (general ratings, discrete behaviors). The results indicated that (1) measures from different assessors correlated in the low to moderate range, (2) data from extraclass raters corresponded more closely with direct observations than with data from teachers, (3) teacher and rater estimates of overt child behavior did not correlate more highly with direct observations than did standard rating scales, and (4) teachers and raters viewed child behavior as more appropriate than direct observations indicated. Measures from teachers, raters, and observers readily distinguished attention deficit disorder children with hyperactivity from their peers. However, teacher evaluations delineated these children more sharply than other assessors.Completion of this paper was facilitated by a Research Scientist Development Award (MH00353) to the first author from the National Institute of Mental Health.     

Correspondence between personality trait ratings and behavioral events

To investigate the validity of the trait, Energetic, two studies were conducted in which trait ratings of Energetic and objective measures of performance were recorded. The first study used naive raters (N= 55) who observed pairs of subjects perform in a laboratory setting. There was 84% agreement (p < .001) among the raters as to which person was more Energetic, and people rated as more Energetic performed more energetically on the objectively measured tasks (p < .001). The second study used peer ratings of Energetic and objective measures of energetic behavior in a laboratory setting. There was high agreement among the peers in ratings of Energetic, r = .95 (N = 30) and r = .93 (N = 31) for two groups. Nine men from the upper-quartile and nine men from the lower-quartile of the Energetic scores were tested in the laboratory and were given a structured interview regarding their physical activities. The correlation between peer ratings and laboratory performance was .56 and between peer ratings and the interview data, .64. The results support the position that trait ratings can be valid indicators of regularities in behavior. The procedures used in these studies could be a generally useful model for investigations of the validity of trait ratings.     

Behavioral Versus Nonbehavioral Guided Self-Help for Parents of Children With Externalizing Disorders in a Randomized Controlled Trial

Self-help interventions for parents, which have a behavioral basis, are considered to be an effective treatment option for children with externalizing disorders. Nonbehavioral approaches are widely used but have little empirical evidence. The main objective of this trial was to compare the efficacy of a behavioral and a nonbehavioral guided self-help program for parents. Families of children (aged 4–11 years) diagnosed with attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) were randomized to either a behavioral or a nonbehavioral guided self-help program including 8 parenting booklets and 10 counseling telephone calls. The analyses considered the ratings of 5 informants: blinded clinician, therapist, participant, (her or his) partner, and teacher. Of the 149 families randomized to treatment (intention-to-treat sample [ITT]), 110 parents completed the intervention (per-protocol sample [PP]). For the 4 primary outcome measures (blinded clinician- and participant-rated ADHD and ODD) at post-assessment, the analysis revealed a treatment advantage for the behavioral group in blinded clinician-rated ODD symptoms (ITT: d = 0.37; PP: d = 0.35). Further treatment differences, all in favor of the behavioral group (ITT and PP), were detected in therapist ratings (i.e., ODD) and participant ratings (e.g., parental self-efficacy [only PP], negative parenting behavior, parental stress). In both samples, no differences were found at post-assessment for ratings of the partner and the teacher, or at the 12-month follow-up (only participant ratings available). Behavioral guided self-help shows some treatment advantage in the short term. No superiority over nonbehavioral therapy was detected 12 months after treatment termination.     

MULTIVARIATE ASSESSMENT OF CONFLICT IN DISTRESSED AND NONDISTRESSED MOTHER-ADOLESCENT DYADS

A battery of measures was used to assess conflict between mothers and young adolescents (females and males, 11 to 15 years of age). Two groups of families, one composed of a distressed clinical sample (N = 38), the other a nondistressed normative sample (N = 40), participated. The assessment battery included retrospective judgments, frequency estimates, self-monitored home recording, and tape-recorded discussion of a home problem. Content of assessment measures tapped aspects of parental control, decisionmaking, self-reported interaction behavior, arguments, interaction behavior rated by independent “blind” observers, frequency and anger-intensity of specific problematic issues, and perceptions of positive and negative behaviors of the other family member. Based on univariate analyses, 21 of the 26 defined variables discriminated significantly in the predicted direction. Maternal and adolescent reports of behavior and independent ratings of tape-recorded interaction emerged as strong and consistent discriminators. Stepwise multivariate discriminant analysis provided successful classification of 100% of the families based on the inclusion of nine variables. In a cross-validation sample, 84% of the families were correctly classified. Implications for systematic outcome research as well as clinical application are discussed.     

Treating Parents with Attention-Deficit/Hyperactivity Disorder: The Effects of Behavioral Parent Training and Acute Stimulant Medication Treatment on Parent–Child Interactions

This multiple baseline study evaluated the efficacy of behavioral parent training (BPT) for 12 parents (M age?=?39.17 years; 91 % mothers) and their children (ages 6–12; 83 % boys) both with Attention-Deficit/Hyperactivity Disorder (ADHD), and also explored the acute effect of stimulant medication for parents before and after BPT. Parents rated their own and their children’s symptoms and impairment and were stabilized on optimally dosed medication. Then, parents discontinued medication and were randomly assigned to a 3, 4, or 5 week baseline (BL), during which they provided twice-weekly ratings of their impairment, parenting, and their child’s behavior. Following BL, parents and their children completed two laboratory tasks, once on their optimally dosed medication and once on a placebo to assess observable effects of medication on parent–child behavior, and they completed additional assessments of family functioning. Parents then completed eight BPT sessions, during which they were unmedicated. Twice-weekly ratings of parent and child behavior were collected during BPT and additional ratings were collected upon completing BPT. Two more parent–child tasks with and without parent medication were conducted upon BPT completion to assess the observable effects of BPT and BPT plus medication. Ten (83.33 %) parents completed the trial. Improvements in parent and child behavior were observed, and parents reported improved child behavior with BPT. Few benefits of BPT emerged through parent reports of parent functioning, with the exception of inconsistent discipline, and no medication or interaction effects emerged. These results, although preliminary, suggest that some parents with ADHD benefit from BPT. While pharmacological treatment is the most common intervention for adults with ADHD, further examination of psychosocial treatments for adults is needed.     

Child and parent evaluations of depression and aggression in psychiatric inpatient children

This investigation examined the agreement between children and their parents on measures of depression and aggression. A total of 120 inpatient children (ages 7–13) and their mothers and fathers independently completed self-report and interview measures that focused on the children's dysfunction. Children and their parents differed in their ratings of each symptom area, with children providing significantly less severe ratings than their parents. Children who met DSM III criteria for major depression or conduct disorder were significantly higher in their ratings of depression and aggression than children without these diagnoses, as reflected in both child and parent ratings. Child and parent ratings correlated in the low to moderate range on measures of children's symptoms, whereas mother and father ratings correlated in the moderate to high range. The correspondence between children and parents did not vary as a function of symptom area (depression and aggression) or assessment format (self-report and interviews). The results suggest that children are able to rate the severity of their dysfunction, although they tend to provide lowerbound estimates than do their parents.     

Gender-deviant boys compared with normal and clinical control boys

The physical movement and social characteristics of effeminate behavior-problem, referred boys (N=13)were compared with those of normal boys (N=25)and boys (N=12)referred for nongender problems. Parent reports, observer ratings, and videotapes were collected in a series of structured tasks. As expected, mothers described gender-problem sons as much more feminine than the other two groups in interests, activities, and mannerisms. Gender-problem sons were also seen as relatively inactive and introverted. Further, they were non-significantly lower than the clinical control boys in perceived behavior problems, but both groups had marginally more problems than the normal boys. Gender-problem and clinical control boys both showed more body constriction than normal boys in ratings of a videotaped interview. They also both showed less ideal ball-throw form than normal boys on a set of variables scored with slow-motion video. However, in a set of behaviors directly rated in the various tasks, the gender-problem boys gave a uniquely general impression of uncoordination. The groups did not differ on seven additional variables.The research was supported in part by USPHS Grant MH17072. The authors are indebted to the more than two dozen research staff members who contributed many essential services at various stages of the project, to the families who generously participated, to the clinicians who referred their clients to our project, and to Marion Hee for computational assistance.     

Race,social class,and predictive bias: An evaluation using the WISC,WRAT, and teacher ratings

This study evaluated the interrelationships of a brief form of the Wechsler Intelligence Scale for Children (WISC), the Wide Range Achievement Test (WRAT), and teacher ratings of classroom achievement in a large sample (n = 7,028) of 6- to 11-year-old children. Additionally, the study focused on the differential accuracy of these measures in predicting achievement among test takers who differed in race and socioeconomic status (SES). Overall, the results indicated a substantial relationship between the WISC and WRAT (r = .67); the WISC and teacher ratings (r = .45); and the WRAT and teacher ratings (r = .55). The relationship between the WISC and WRAT was found to be independent of race but did tend to decrease with increasing SES. The two relationships involving teacher ratings were found to be lower for black children (WISC vs. Teacher ratings, r = .33; WRAT vs. Teacher ratings, r = .47) and for black children tended to decrease with increasing SES. Although the correlational analyses indicated that race and SES functioned as moderator variables to some extent, an evaluation of possible predictive biases when using the common (total sample) regression equation indicated that biases in predicting achievement tended to be small and in some cases favored the socially disadvantaged child.     

Culture,carrying, and communication: Beliefs and behavior associated with babywearing

Ethnographic research suggests mother-infant physical contact predicts high levels of maternal responsiveness to infant cues, yet it is unclear whether this responsiveness is driven by the act of physical contact or by underlying beliefs about responsiveness. We examine beliefs and behavior associated with infant carrying (i.e., babywearing) among U.S. mothers and experimentally test the effect of mother-infant physical contact on maternal responsiveness. In Study 1 (N = 23 dyads), babywearing mothers were more likely to interact contingently in response to infant cues than non-babywearing mothers during an in-lab play session. In Study 2 (N = 492 mothers), babywearing predicted maternal beliefs emphasizing responsiveness to infant cues. In Study 3 (N = 20 dyads), we experimentally manipulated mother-infant physical contact in the lab using a within-subjects design and found that babywearing increased maternal tactile interaction, decreased maternal and infant object contact, and increased maternal responsiveness to infant vocalizations. Our results motivate further research examining how culturally-mediated infant carrying practices shape the infant’s early social environment and subsequent development.     

Psychometric Evaluation of 5- and 7-Year-Old Children's Self-Reports of Conduct Problems

Past research suggests that young children are incapable of reporting information about their own behavior problems. To test this, we examined the validity and the usefulness of children's self-reports in the E-Risk Study, a nationally representative birth cohort of 2,232 children. We used the Berkeley Puppet Interview to obtain children's self-reports of conduct problems when they were 5-years old and the Dominic-R when they were 7-years old. We also collected information about the children and their families by interviewing mothers, sending questionnaires to teachers, and rating examiners' observations during home visits. Results indicate that when children's self-reports are gathered with structured and developmentally appropriate instruments, they are shown to be valid measures: conduct problems reported by the children themselves were associated with known correlates including individual characteristics (e.g., IQ), related behaviors (e.g., hyperactivity), and family variables (e.g., economic disadvantages). Observed correlations closely matched effect sizes reported in the literature using adults' reports of children's behavioral problems. In addition, children's self-reports can be useful: both measures distinguished children meeting DSM-IV criteria for research diagnoses of conduct disorder. Children's reports also contributed unique information not provided by adults. For research and clinical purposes, young children's self-reports can be viewed as a valuable complement to adults' ratings and observational measures of children's behavior problems.     

Comparisons of behavior transactions between conduct-disordered children and their mothers in the clinic and at home

The effects of various degrees of structure during clinic observations and the location of the observation (home or clinic) on the behaviors of mothers and children were examined. Forty families with conduct-problem children between the ages of 3 and 8 years participated. Correlations indicated little relationship between behavior in structured and in unstructured clinic conditions. There was also a lack of correlation between the structured clinic and the home observations. However, there were high correlations between mothers' and children's behaviors in the unstructured clinic observation and the home observations. ANOVA further indicated that there were significant differences between the actual rates of behaviors observed in the home and clinic locations. Results are discussed in relation to the potential of structured clinic observations to provide more relevant and efficient information about mothers and conduct-problem children.     

Virtual Reality One-Session Treatment of Child-Specific Phobia of Dogs: A Controlled,Multiple Baseline Case Series

Specific phobia (SP) typically onsets in childhood and frequently predicts other mental health disorders later in life. Fortunately, childhood SP can be effectively treated with cognitive behavior therapy (CBT), including the exposure-based one-session treatment (OST) approach. Despite empirical support for CBT and OST, clinicians, for various reasons, frequently fail to implement exposure-based therapy in routine clinical practice, including perceived difficulties in implementing exposure. Virtual reality (VR) exposure therapy may overcome some of these challenges and provides an alternative modality of therapy. This preliminary study examined the efficacy of VR OST for 8 children with a SP of dogs (aged 8–12 years) (M = age 10.25; SD = 2.11) using a multiple-baseline controlled case series. Following a stable baseline period of either 2, 3, or 4 weeks, it was expected that specific phobia severity would significantly decline after VR OST and remain improved over the 3-week maintenance phase. Assessments were conducted posttreatment and at 1-month follow up (study end-point). It was found that phobia symptoms remained relatively stable across the baselines, with significant reductions from pretreatment to posttreatment and to follow-up on clinician severity ratings (pre- to post- g = 1.12; pre- to follow-up g = 2.40), target symptom ratings (g = 1.14; 1.29), and behavioral avoidance (g = -1.27; -1.96). The treatment was also associated with clinically significant outcomes, whereby at one-month follow up, 75% of children were considered “recovered” and 88% completed the BAT (interacted with their feared stimuli). This study provides support for the effectiveness of VR OST.     

BEHAVIORAL OBSERVATION SCALES FOR PERFORMANCE APPRAISAL PURPOSES

Behavioral items ( N = 78) critical to the job success of logging supervisors were developed from 1204 critical incidents, the frequency with which a supervisor ( N = 300) engaged in each behavior was rated on a 5-point Likert type scale by two sets of observers. A factor analysis reduced the items to 38 and 33, respectively, for the two sets of observers which in turn constituted 10 and 11 factors or criteria for performance evaluation purposes. Multiple regression equations based on composite scores were used to predict cost-related measures of logging crew effectiveness. The shrinkage in Rs after double cross-validation was moderately small. Moreover, the behavioral observation scales (BOS) that were developed by factor analyzing the observation ratings had moderately high reliability and accounted for more variance in the cost-related measures than did the BOS developed by traditional judgmental clustering techniques. The similarities and differences between BOS and BES procedures are discussed.     

The effects of behavior rehearsal and feedback on the acquisition of problem-solving skills in distressed and nondistressed couples

Couples who were paid to participate in an experimental marital enrichment program were randomly assigned to one of four treatment conditions or to a control group. All groups received training in solving marital problems, but the groups differed according to how they were trained; some received feedback (FB) on their previous taped performances, some had the opportunity to practice the skills suggested by the therapist (BR), some had both (complete treatment), and some simply were presented with instructions. Changes in problem-solving skills were assessed by behavioral observations of the frequency of positive problem-solving behavior before and after treatment, and global ratings of problem-solving effectiveness made by trained raters. In general, the complete treatment condition produced greater changes from pre- to post-test than any other condition. Couples in this condition showed significantly greater increases in positive behavior than any other group, and on global ratings of problem-solving skills they evidenced the greatest improvement, although on this measure they did not improve significantly more than BR couples.     

A Clinical Trial of In-Home CBT for Depressed Mothers in Home Visitation

Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visitation (n = 47) or standard home visitation (SHV; n = 46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs.