Parental and Child Psychopathology: Moderated Mediation by Gender and Parent–Child Relationship Quality

Previous literature has not examined the processes underlying the relations among parent–child relationship quality, parental psychopathology, and child psychopathology in the context of gender. Further, research examining these variables in emerging adulthood is lacking. The current study examined whether parent–child relationship quality would mediate the relation between parental and child psychopathology, and whether gender moderated these associations. Participants were emerging adults (N?=?665) who reported on perceptions of their parents’ and their own psychological problems as well as their parent–child relationship quality. Results indicated that the relation between parental internalizing problems and parent–child relationship quality was positive for males, and that mother–child relationship quality was related positively to psychological problems in males. This suggests that sons may grow closer to their parents (particularly their mother) who are exhibiting internalizing problems; in turn, this enmeshed relationship may facilitate transmission of psychopathology. Mediational paths were conditional upon gender, suggesting moderated mediation. Overall, the current study emphasizes that the complexities of parenting must be understood in the context of gender. Further, the mother–son dyad may particularly warrant further attention.     

A Multivariate Model of Parent–Adolescent Relationship Variables in Early Adolescence

Given the importance of predicting outcomes for early adolescents, this study examines a multivariate model of parent–adolescent relationship variables, including parenting, family environment, and conflict. Participants, who completed measures assessing these variables, included 710 culturally diverse 11–14-year-olds who were attending a middle school in a Southeastern state. The parents of a subset of these adolescents (i.e., 487 mother–father pairs) participated in this study as well. Correlational analyses indicate that authoritative and authoritarian parenting, family cohesion and adaptability, and conflict are significant predictors of early adolescents’ internalizing and externalizing problems. Structural equation modeling analyses indicate that fathers’ parenting may not predict directly externalizing problems in male and female adolescents but instead may act through conflict. More direct relationships exist when examining mothers’ parenting. The impact of parenting, family environment, and conflict on early adolescents’ internalizing and externalizing problems and the importance of both gender and cross-informant ratings are emphasized.     

The Emergence of Parent–Child Coercive Processes in Toddlerhood

Parent–child coercion typically emerges in toddlerhood with the child’s first acts of willful defiance and the parent’s first disciplinary attempts. We explored how parents and children may contribute to this process by examining bidirectional and interactive effects between child and maternal negative behavior in 310 low-income, ethnically diverse boys. Using multiple informants and methods, child negative emotionality and maternal negative control were assessed at 18 months and child disruptive behavior and maternal negative control were measured at 24 months. Indicative of parent effects, maternal negative control at 18 months amplified the relation between children’s negative emotionality at 18 months and disruptive behavior at 24 months. Child effects were found in an unexpected direction such that children’s negative emotionality at 18 months predicted decreases in mothers’ negative control at 24 months. Findings are discussed within a transactional framework that emphasizes mutual influence of children and parents over the course of development.     

The Prospective Links Between Hyperactive/Impulsive,Inattentive, and Oppositional-Defiant Behaviors in Childhood and Antisocial Behavior in Adolescence: The Moderating Influence of Gender and the Parent–Child Relationship Quality

We prospectively investigated the effect of child hyperactive/impulsive, inattentive, and oppositional/defiant behaviors on the development of youth antisocial behaviors, and the moderating influence of gender and the parent–child relationship quality in a normative sample. Participants (N = 673, 50 % girls) were assessed at 10 years of age (parent reports) and at age 15 (parent and adolescent reports). Using latent change models, we found that initial levels of, as well as increases in, hyperactivity/impulsivity and oppositional behaviors and initial levels of inattention behaviors predicted youth antisocial behaviors. The increase in oppositional behaviors was predictive of youth antisocial behaviors in girls only. Child hyperactive/impulsive behaviors predicted youth antisocial behaviors only in children for whom the quality of the parent–child relationship deteriorated from childhood to adolescence. Thus, both initial levels of and increases in disruptive behaviors as well as gender are important for understanding the development of antisocial behaviors in adolescence. We received partial support for the hypothesized, moderating role of a high-quality parent–child relationship.     

Prospective Relationship Between Obsessive–Compulsive and Depressive Symptoms During Multimodal Treatment in Pediatric Obsessive–Compulsive Disorder

The present study examined the prospective relationship between obsessive–compulsive and depressive symptoms during a multimodal treatment study involving youth with obsessive–compulsive disorder (OCD). Participants included fifty-six youth, aged 7–17 years (M = 12.16 years) who were enrolled in a two-site randomized controlled pharmacological and cognitive behavioral therapy treatment trial. Obsessive–compulsive severity was measured using the Children’s Yale-Brown Obsessive–Compulsive Scale, and depressive symptoms were rated using the Children’s Depression Rating Scale-Revised. Multi-level modeling analyses indicated that, on average over the course of treatment, variable and less severe obsessive–compulsive symptoms significantly predicted a decrease in depressive symptoms. Additionally, week-to-week fluctuations in OCD severity did not significantly predict weekly changes in depressive symptom severity. Level of baseline depressive symptom severity did not moderate these relationships. Findings suggest that when treating youth with OCD with co-occurring depression, therapists should begin by treating obsessive–compulsive symptoms, as when these are targeted effectively, depressive symptoms diminish as well.     

Evaluation of a Treatment Manual and Workshops for Disseminating,Parent–Child Interaction Therapy

This study’s main purposes were to: (a) evaluate a treatment manual as a dissemination strategy, (b) compare two workshop formats for evidence-based treatment (EBT) training, and (c) provide preliminary data on therapist characteristics potentially associated with successful EBT adoption. Forty-two community-based clinicians were assigned to one of two training groups (didactic or experiential). Behavior observation and self-report data were collected at four time points. Results suggest that reading a treatment manual is useful, but not sufficient. Experiential and didactic training were equally effective in increasing knowledge, skill, and satisfaction; however, after a 2-day training, few participants demonstrated mastery of skills.

Gene–Environment Interaction in Major Depression and Antidepressant Treatment Response

Response to antidepressants is interindividually variable. It has been suggested that this variability is a direct consequence of etiological heterogeneity. Therefore, the same genes, environments, and gene–environment interactions implicated in different etiological pathways to depression may also predict response to treatment. This article reviews the evidence relevant to this hypothesis by first outlining the roles of genes, environments, and gene–environment interplay in the etiology of depression, and then considering the same factors in treatment response. Environmental exposures, such as childhood maltreatment, are potent predictors of both depression and treatment response. Although alone genetic factors have failed to consistently predict either phenotype, several polymorphisms have been shown to moderate the effects of environmental adversity on the development of depression and treatment response. These findings suggest that the dissection of etiological pathways to depression may provide the key to understanding and predicting response to antidepressants.     

Autism Severity and Qualities of Parent–Child Relations

The aim of this study was to examine how severity of autism affects children’s interactions (relatedness) and relationships with their parents. Participants were 25 parent–child dyads that included offspring who were children with autism aged from 4 to 14 years. The severity of the children’s autism was assessed using the calibrated severity metric of the Autism Diagnostic Observation Schedule (Gotham et al. in J Autism Dev Disord 39:693–705, 2009). Parent–child dyads were videotaped in 10-min semi-structured play interactions, and qualities of interpersonal relatedness were rated with the Dyadic Coding Scales (Humber and Moss in Am J Orthopsychiatr 75(1):128–141, 2005). Quality of relationships between parents and children were evaluated with a parent self-report measure, the Parent Child Relationship Inventory (Gerard in Parent–Child Relationship Inventory (PCRI) manual. WPS, Los Angeles, 1994). Multivariate regression analysis revealed that severity of autism was inversely related to patterns of parent–child interaction but not to reported quality of parent–child relationship. We consider the implications for thinking about relatedness and relationships among children with autism, and opportunities for intervention.     

Short-Term Group Therapy for Complicated Grief: The Relationship Between Patients’ In-Session Reflection and Outcome

Objective: The objective of the present study was to examine the nature of patients’ work in two types of short-term group psychotherapy. The study sought to investigate the relationship between patients’ psychodynamic work versus supportive work in group psychotherapy and treatment outcome at termination and at 6-month follow-up. Psychodynamic work refers to reflection regarding intrapsychic motivations, defenses, and relational patterns, and supportive work refers to practical problem solving. Method: Participants were 110 patients who completed two forms of group therapy for complicated grief: interpretive therapy and supportive therapy. Two types of patients’ in-session activity—psychodynamic work and supportive work—were rated by group therapists in both treatments. Pre-post and follow-up outcome domains included general symptoms, grief symptoms, and life dissatisfaction/severity of target objectives. Results: There was no significant difference in the nature of patients’ therapeutic work between interpretive and supportive groups. Psychodynamic work was associated with pre-post improvement in grief symptoms. Psychodynamic work was also associated with further improvement in grief symptoms at 6-month follow-up, along with improvement in broader symptom domains. Supportive work was not associated with any pre-post or follow-up benefit. Conclusion: The findings provide evidence that psychodynamic work—focused on the development of insight and self-reflection—in group psychotherapy can contribute to further benefit after the completion of treatment. This finding cut across two approaches to short-term group therapy for complicated grief, suggesting that it may reflect a general curative mechanism of group treatments.     

The Role of Infrastructure in the Transformation of Child–Adolescent Mental Health Systems

There is a widespread recognition that the mental health system is not effective in meeting the needs of the children, adolescents, and families who seek its services. In response to this recognition, researchers and policy makers are developing and implementing strategies to transform mental health systems. This paper suggests that transformational interventions should not proceed faster than our understanding of the complexities of a mental health system. In a complex system, all component parts are interactive and interdependent. Problems with one component cannot be solved in isolation from other components. The inter-relationships between problems create inter-dependencies; and changes in the balance of these inter-dependencies can cause dramatic shifts in policy priorities, such as when managers of mental health systems respond to budget reductions in a recessionary economy. This paper examines the problem domains in mental health systems that are affected by complexity dynamics, and proposes that a well-built infrastructure is a necessary foundation for structural change in a child–adolescent mental health system. The concept of metastructure is proposed to account for the rule-based processes that govern the actions of agents within a system.     

Match or Mismatch? Influence of Parental and Offspring ASD and ADHD Symptoms on the Parent–Child Relationship

Few studies have examined the influence of parental ASD and ADHD symptoms in combination with child pathology on the parent- child relationship as perceived by the child. A sample of 132 families was recruited with one child with ASD (with/without ADHD), and one unaffected sibling. Affected children (regardless of diagnosis) reported lower acceptance and conflict resolution scores than their unaffected siblings, with conflict resolution scores (but not acceptance) being lower than the norm according to both affected and unaffected children in both fathers and mothers. Higher paternal, but not maternal, ASD and ADHD symptoms were related to poorer scores regarding acceptance and conflict resolution, respectively. Treatment targeting conflict resolution skills of parents and the feeling of being less accepted in children with ASD/ADHD may be beneficial.     

The Effectiveness of Parent–Child Interaction Therapy with Depressive Mothers: The Changing Relationship as the Agent of Individual Change

This study uses a multi-method approach to investigate the effectiveness of Parent–Child Interaction Therapy (PCIT) in reducing children’s behavior problems when parents report clinical levels of depressive symptoms. Participants were 132 children, 2–7 years of age, and their biological mothers, who either reported low (N = 78) or clinical levels of depressive symptoms (N = 54). Results showed that depressive mothers were likely to report more severe child behavior problems than non-depressive mothers at the pre-treatment assessment, but that depressive mothers reported greater reductions in child behavior problems than non-depressive mothers from pre- to post-treatment. The two groups showed similar levels of observed interaction quality at the pre-treatment assessment (i.e., parent and child emotional availability and parent verbalization patterns) and similar improvements in interaction quality from pre- to post-treatment. The implications of the findings for clinical practice were discussed.     

Joint Attention in Parent–Child Dyads Involving Children with Selective Mutism: A Comparison Between Anxious and Typically Developing Children

Although joint attention processes are known to play an important role in adaptive social behavior in typical development, we know little about these processes in clinical child populations. We compared early school age children with selective mutism (SM; n = 19) versus mixed anxiety (MA; n = 18) and community controls (CC; n = 26) on joint attention measures coded from direct observations with their parent during an unstructured free play task and two structured tasks. As predicted, the SM dyads established significantly fewer episodes of joint attention through parental initiation acts than the MA and CC dyads during the structured tasks. Findings suggest that children with SM may withdraw from their parents during stressful situations, thus missing out on opportunities for learning other coping skills. We discuss the implications of the present findings for understanding the maintenance and treatment of SM.