Examining Influences on Problem Recognition and Help-Seeking for Child Externalizing Behaviors Among African American Mothers

Childhood behavior problems are one of the most common clinical referrals. If left untreated, these behaviors can result in detrimental consequences to the child’s development (Wehmeier et al., 2010; Scholtens et al., 2012). Behavior parent training has been identified as first-line treatment for oppositional behavior; however, many racial minority families fail to enroll in behavior parent training. The current study examines maternal help-seeking for children displaying oppositional behavior in hopes to delineate variables that might influence parent training enrollment among African American families. Participants were 112 African American mothers who were provided child behavior vignettes and completed measures assessing factors related to problem recognition, parental attributions, child rearing values, mental health stigmatization, racial identity, and treatment utilization. Results found that when presented with a child displaying clinically significant externalizing child behaviors, slightly more than half of African American mothers recognized clinically significant child behavior problems. Mothers were more likely to engage in behavioral parent training if problematic behavior was recognized. Additionally, mothers’ attributions of child behavior, cultural values, and mental health stigmatization were influential to help seeking. This study supports the importance of considering cultural variables that impact problem recognition and subsequent treatment utilization among African American families.     

Assessing Parenting Practices Through Parent-Report and Direct Observation During Parent-Training

The specific parenting domains measured by the Alabama Parenting Questionnaire (APQ) make it particularly relevant to interventions concerned with the modification of parenting practices. This study assessed the validity and clinical utility of parent reports on the APQ using observational data of parents and children (N=56, aged 4–8 years) participating in a parent training intervention for childhood conduct problems. Parent reports on the measure were found to converge well with observations of parents’ use of praise, and harsh/aversive parenting. APQ scores also reflected change in parenting practices across treatment, and were associated with clinical child outcomes. Comparisons of the five original APQ subscales with a three-factor empirically-derived form of the measure indicated greater support for the original subscales, which were found to be valid and clinically informative in the treatment of childhood conduct problems.     

Introduction to special section on three-generation studies

Interest in lifespan research and cross-generational associations in parenting practices and child behaviors has grown rapidly in recent years. The four papers presented in this journal test three key intergenerational research questions regarding intergenerational continuities for externalizing behaviors, using different 3-generational samples.     

Vocabularies

Negative emotionality is considered to be the core of the difficult temperament concept (J. E. Bates, 1989; R. L. Shiner, 1998). In this correlational study, the authors examined whether the relations between children's negative emotionality and problematic behavior (internalizing and externalizing) were partially mediated by parenting style (authoritative and authoritarian) in a community sample of 196 3-year-old children and their mothers. The authors assessed maternal perception of child negative emotionality using the Children's Behavior Questionnaire (M. K. Rothbart, S. A. Ahadi, K. L. Hershey, &; P. Fisher, 2001) and assessed problematic child behavior by means of maternal report using the Child Behavior Checklist (T. M. Achenbach, 1992). The results showed that the relations between child negative emotionality and internalizing and externalizing behaviors were partially mediated by mothers' authoritative parenting style. Moreover, when the authors used confirmatory factor analysis to decontaminate possible overlap in item content between measures assessing temperament and problematic behavior, the association between negative emotionality and internalizing behavior was fully mediated by authoritative parenting.     

Enhancements to the Behavioral Parent Training Paradigm for Families of Children with ADHD: Review and Future Directions

Behavioral parent training (BPT) is one of the empirically supported psychosocial treatments for ADHD. Over many years and in many studies, BPT has been documented to improve both child ADHD behavior and maladaptive parenting behavior. In some studies, BPT has also been found to result in benefits in additional domains, such as parenting stress and child classroom behavior. However, the BPT literature on children selected as having ADHD lags behind research conducted on BPT for children selected as having oppositional defiant and conduct disorders (ODD and CD, respectively) with regard to examination of factors that may limit treatment attainment, compliance, and outcomes, such as single parenthood, parental psychopathology, and child comorbidity. Because of the high degree of comorbidity between ADHD and ODD/CD, it is difficult to separate the two BPT literatures. The parameters of BPT (e.g.. format and setting), parent factors, and child factors that may contribute to treatment outcomes for families of children with ADHD are reviewed here and recommendations for future BPT research in the area of ADHD are made.     

A Truly Early Starter Model of Antisocial Behavior Revisited

This paper revisits a developmental model of the origins of early conduct problems. Several of the model's primary tenets have now been validated in two samples of at-risk children followed prospectively from infancy to school-age. In both cohorts, child, family, and sociodemographic factors all play a significant role in the development of early conduct problems. In particular, the quality of the caregiving environment during the child's second year differentiates clinical impairment according to both parent and teacher report 6 years later. We conclude by making recommendations for future studies. Research that utilizes a developmental framework, incorporates more sophisticated measurement of infant negative emotionality, and addresses the influences of neighborhood and culture, is suggested.     

Improved Perceptions of Emotion Regulation and Reflective Functioning in Parents: Two Additional Positive Outcomes of Parent-Child Interaction Therapy

The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children’s externalizing behaviors and parenting problems, was associated with improvements in parents’ emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children’s improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents’ self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents’ self-report of children’s symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children’s symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents’ perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children’s externalizing behaviors.