From child maltreatment to adolescent cannabis abuse and dependence: a developmental cascade model

A developmental cascade model tested associations among child maltreatment, internalizing and externalizing psychopathology, social competence, and cannabis abuse and dependence symptoms in a longitudinal cohort (N = 415). Nested structural equation models evaluated continuity and cross-domain influences among broad multi-informant constructs across four developmental periods: age 7 to 9, 10 to 12, 13 to 15, and 15 to 18. Results indicated significant paths from child maltreatment to early externalizing and internalizing problems and social competence, as well as to cannabis abuse and dependence (CAD) symptoms in adolescence. Youth CAD symptoms were primarily related directly to child maltreatment and externalizing problems. Childhood internalizing symptoms contributed to later childhood decreases in social competence, which predicted increases in late adolescent externalizing problems. Using a developmental psychopathology framework, results are discussed in relation to cascade and transactional effects and the interplay between problem behaviors during childhood and development of CAD symptoms during early and late adolescence.     

Sleep problems,internalizing and externalizing symptoms,and domains of health-related quality of life: bidirectional associations from early childhood to early adolescence

Study ObjectivesTo examine longitudinal, bidirectional associations among behavioral sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life (HRQoL) from early childhood to adolescence in a population sample of Australian children.MethodData were drawn from the Longitudinal Study of Australian Children, a national prospective cohort study with 4983 children participating in the Kindergarten cohort. Data were collected when children were aged 4–5, 6–7, 8–9, 10–11, and 12–13 years. At each study wave, the primary parent (97% mothers) reported on behavioral child sleep problems, internalizing and externalizing symptoms, and HRQoL domains (psychosocial and physical). Cross-lagged structural equation models were used to evaluate bidirectional associations.ResultsAt nearly every age, behavioral sleep problems were associated with worse subsequent psychosocial and physical HRQoL. Despite bidirectional associations between mental health and HRQoL at many waves, HRQoL domains more strongly predicted later internalizing symptoms, while externalizing symptoms more strongly predicted later HRQoL. Many of the bidirectional associations among sleep, mental health, and HRQoL were found earlier in childhood.ConclusionsBehavioral sleep problems may forecast later HRQoL psychosocial and physical impairments. Attending to both sleep problems and HRQoL could prevent the progression of internalizing conditions, while a focus on externalizing concerns could prevent the worsening of these symptoms, sleep problems, and HRQoL, particularly during the transition to school.     

Bias in self-perceptions and internalizing and externalizing problems in adjustment during early adolescence: a prospective investigation.

We investigated bias in self-perceptions of competence (relative to parent ratings) for family, school, and peer domains as predictors of adjustment problems among 139 young adolescents over a 1-year period using a prospective design. Regressions examined measures of bias at Time 1 (T1) as predictors of ratings of internalizing and externalizing problems at Time 2 (T2), controlling for T1 adjustment ratings. For the family domain, curvilinear trends were found. Follow-up analyses revealed that for this domain both negative bias (self-perceptions less favorable than parent ratings) and positive bias (self-perceptions more favorable than parent ratings) predicted greater internalizing and externalizing problems as rated by youth, parents, and teachers. For the peer domain, higher scores on the measure of bias predicted greater internalizing and externalizing problems as rated by teachers. These findings are consistent with the view that accuracy in self-perceptions of competence can have important implications across multiple domains of development.     

Biological, behavioral, and relational levels of resilience in the context of risk for early childhood behavior problems

Longitudinal growth patterns of internalizing and externalizing behavior problems were examined in a community sample of 441 children across the ages of 2 to 5 using hierarchical linear modeling. Contextual risk was measured using five indicators (socioeconomic status, marital status, number of siblings, parent stress, parent psychopathology), and three levels of child resilience (biological, behavioral, and relational) were also assessed. Results indicate that a general pattern of decline in both types of behavior problems was observed for the entire sample across time, although considerable individual variability in this pattern was observed. Children's externalizing and internalizing behavior at age 5 was predicted by the level of risk at age 2. All three child resilience factors were also predictive of externalizing and internalizing behaviors at age 5. In the prediction of the slope of problem behavior over time, risk status interacted with both temperamental fearlessness and a mutually responsive orientation with the mother to predict the decline in externalizing and internalizing problem behavior. Results underscore the complex interactions of risk and multiple levels of resilience that are implicated in the maintenance of problem behavior over time. They highlight the importance of considering whether expected resilience factors operate similarly across different levels of risk.     

Associations Between Marital Conflict and Adolescent Conflict Appraisals,Stress Physiology,and Mental Health

The goal of the current study was to examine conflict appraisals and diurnal cortisol production as mediators of the robust association between marital conflict and adolescent adjustment problems. Parents reported their marital conflict and were observed engaging in a marital conflict discussion; they also reported adolescent internalizing and externalizing behaviors. Adolescents (n = 105, 52% female, 10–17 years of age) appraised their parents’ marital conflict and reported their internalizing and externalizing behaviors. After the laboratory visit, adolescents provided four saliva samples on each of 2 consecutive days to assess diurnal cortisol production. More-negative marital conflict predicted more self-blame for parental conflict, which in turn predicted less robust decreases in cortisol across the day. Further, this flattened cortisol production pattern mediated the relationship between greater self-blame for parental conflict and adolescents’ elevated internalizing behaviors. Feeling responsible for parental conflict appears to be particularly damaging in terms of physiological regulation and adjustment, and may therefore be a particularly useful intervention target.     

Applying the polyvagal theory to children's emotion regulation: Social context, socialization, and adjustment

Effective emotion regulation is essential for children's positive development. Polyvagal theory provides a framework for understanding how parasympathetic regulation of cardiac activity contributes to children's adaptive versus maladaptive functioning. Maintenance of cardiac respiratory sinus arrhythmia (RSA) under social challenge should support emotion regulation and behavioral adjustment. Children's effective parasympathetic regulation and behavioral adjustment should be supported by appropriate parental socialization. These proposals were evaluated in a short-term longitudinal study of 94 preschool-aged children. Parenting and basal RSA were measured at home, then 6-10 months later behavioral adjustment and RSA in lab baseline and socially challenging contexts were measured. Children with relatively higher RSA in social challenge than at baseline (DeltaRSA) had fewer internalizing problems (IP) and externalizing problems (EP), and better behavioral self-regulation (SR). Mothers who used more negative control had children with lower DeltaRSA, more IP and EP, and less SR. Structural equation modeling showed that vagal regulation mediated associations between maternal negative control and children's adjustment; maternal negative control did not predict EP or SR after accounting for DeltaRSA. Associations were consistent across boys and girls, with one exception: Higher DeltaRSA was significantly associated with fewer EP in boys only. These findings suggest that the practical significance of physiological regulation might be best revealed in ecologically valid procedures, and that children's physiological mechanisms of emotion regulation are shaped by their experiences of parental socialization.     

Specificity of relations between children's control-related beliefs and internalizing and externalizing psychopathology

The authors examined the specificity of the relation between 3 types of control-related beliefs and internalizing and externalizing psychopathology in a sample of 290 clinic-referred children aged 7 to 17 years. Self-reported beliefs about control (the capacity to cause an intended outcome), contingency (the degree to which a desired outcome can be controlled by a relevant behavior), and competence (an individual's ability to produce the relevant behavior) across 3 domains (academic, behavioral, and social) showed more specific relations with psychopathology than have been previously reported. Among children with externalizing psychopathology, internalizing psychopathology may be specifically associated with increased self-critical awareness about their conduct; externalizing psychopathology may attenuate the specific negative relation between internalizing psychopathology and control-related beliefs in the social domain.     

Trajectories of peer victimization in elementary school children: Associations with changes in internalizing,externalizing, social competence,and school climate

The current study examines the developmental changes (internalizing and externalizing symptoms, social competence, and experiences of school climate) in children who follow distinct trajectories of peer victimization in a sample of elementary school children across 2 years. Data were from children, and their parents and teachers, in Grades 1–3 followed across five waves. Latent class analyses revealed four distinct victimization trajectory groups characterized by chronically high, increasing, decreasing, or low-stable levels across time. Multilevel analyses showed that children in the chronically high peer victimization group had higher initials levels of internalizing and externalizing symptoms, lower levels of social competence, and poorer experiences of school climate compared to children in the low-stable group. Over time, children in the increasing group had slower rates of increases in social competence than children in the low-stable group and had worsening experiences of school climate compared to children in the low-stable peer victimization group. Findings suggest children who are chronically victimized may be at a developmental disadvantage compared to children who report little or declining peer victimization over time.     

Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems

Effortful control was examined as a moderator of the relations of three domains of contextual risk factors to growth in internalizing and externalizing problems in a community sample (N = 189) of children (8-12 years at Time 1). Socioeconomic, maternal, and environmental risk factors were examined as predictors of initial levels and growth in children's adjustment problems across 3 years. The effects of the risk factors depended on children's level of effortful control. For children lower in effortful control, socioeconomic risk was related to significantly higher initial levels of internalizing and externalizing problems and decreases over time. However, children lower in effortful control had higher levels of problems at all three time points than children higher in effortful control. Maternal risk was associated with increases in internalizing for children lower in effortful control, and environmental risk was related to increases in internalizing and externalizing problems for children lower in effortful control, but not those higher in effortful control. Children who were lower in effortful control appeared to experience more adverse effects of contextual risk than those higher in effortful control, suggesting that interventions aimed at improving children's effortful control might serve to protect children from increased risk of adjustment problems associated with contextual risk factors.     

Structured leisure activities in middle childhood: Links to well‐being

Associations between children's (N = 147) participation in structured leisure activities and their adjustment were examined. Caregivers provided lists of extracurricular activities (clubs, sports, and church activities) in which children participated. Children and caregivers participated in interviews and completed questionnaires designed to measure children's adjustment in four domains (academic competence, psychosocial development, externalizing behavior, and internalizing behavior). Classroom teachers completed additional measures of children's academic and social competence. Greater participation in club activities was linked with higher academic grades and more positive teacher ratings of academic competence. Greater participation in sports was associated with higher levels of psychosocial maturity and more positive teacher ratings of social competence. There were no associations between involvement in church activities and any indicators of adjustment. Activity involvement was unassociated with externalizing or internalizing behavior. Findings are discussed in terms of both selection into different types of extracurricular activities and the skills emphasized in the pursuit of such activities. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 641–659, 2003.     

Bias in Self-Perceptions and Internalizing and Externalizing Problems in Adjustment During Early Adolescence: A Prospective Investigation

We investigated bias in self-perceptions of competence (relative to parent ratings) for family, school, and peer domains as predictors of adjustment problems among 139 young adolescents over a 1-year period using a prospective design. Regressions examined measures of bias at Time 1 (T1) as predictors of ratings of internalizing and externalizing problems at Time 2 (T2), controlling for T1 adjustment ratings. For the family domain, curvilinear trends were found. Follow-up analyses revealed that for this domain both negative bias (self-perceptions less favorable than parent ratings) and positive bias (self-perceptions more favorable than parent ratings) predicted greater internalizing and externalizing problems as rated by youth, parents, and teachers. For the peer domain, higher scores on the measure of bias predicted greater internalizing and externalizing problems as rated by teachers. These findings are consistent with the view that accuracy in self-perceptions of competence can have important implications across multiple domains of development.     

The timing of child physical maltreatment: a cross-domain growth analysis of impact on adolescent externalizing and internalizing problems.

In a sample of 578 children assessed in kindergarten through the eighth grade, we used growth modeling to determine the basic developmental trajectories of mother-reported and teacher-reported externalizing and internalizing behaviors for three physical maltreatment groups of children-early-harmed (prior to age 5 years), later-harmed (age 5 years and over), and nonharmed--controlling for SES and gender. Results demonstrated that the earlier children experienced harsh physical treatment by significant adults, the more likely they were to experience adjustment problems in early adolescence. Over multiple domains, early physical maltreatment was related to more negative sequelae than the same type of maltreatment occurring at later periods. In addition, the fitted growth models revealed that the early-harmed group exhibited someswhat higher initial levels of teacher-reported externalizing problems in kindergarten and significantly different rates of change in these problem behaviors than other children, as reported by mothers over the 9 years of this study. The early-harmed children were also seen by teachers, in kindergarten, as exhibiting higher levels of internalizing behaviors. The later-harmed children were seen by their teachers as increasing their externalizing problem behaviors more rapidly over the 9 years than did the early- or nonharmed children. These findings indicate that the timing of maltreatment is a salient factor in examining the developmental effects of physical harm.     

Stability in infant frontal asymmetry as a predictor of toddlerhood internalizing and externalizing behaviors

Stability in frontal brain electrical activity (i.e., electroencephalographic or EEG) asymmetry at 10 and 24 months was examined with respect to maternal ratings of internalizing and externalizing behaviors at 30 months in a sample of 48 children. Children with stable left frontal EEG asymmetry during infancy were rated higher in externalizing behaviors by their mothers, whereas children with stable right frontal EEG asymmetry were rated higher in internalizing behaviors. These findings highlight the need to focus on the early stability in physiological measures that may be implicated later in developing behavioral problems. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52:158–167, 2010     

Survivors of childhood brain tumors: behavioral,emotional, and social adjustment

This paper reviews the literature on the psychological adjustment and quality of life in children who survive brain tumors. A total of 31 studies were reviewed. Findings are discussed in terms of the rates of general psychological adjustment, internalizing behavior problems, externalizing behavior problems, social competence, correlates or predictors of adjustment, and quality of life among survivors. Although these survivors appear to be at risk for compromised social competence and long-term quality of life, reports in the literature on rates of psychological adjustment in this population vary widely. Limitations in the current literature are discussed including inadequate assessment techniques, lack of appropriate comparison groups, and small sample sizes. Directions for future research are offered.     

Psychosocial adjustment among pediatric cancer patients: a multidimensional assessment

Identified types and frequencies of psychological difficulties manifested by pediatric oncology patients and child-, family-, and illness-related correlates of adjustment. Parents of 48 children with cancer, 4 to 17 years of age, completed the Personality Inventory for Children (PIC). Analysis of mean PIC scores indicated that the children had a high frequency of somatic concerns and problems in academic functioning. Similar mean PIC profiles were obtained for children across gender, age, and diagnostic groups. Overall, 52% of the children had profiles with two or more clinically significant problem areas. Children's adjustment was associated with gender, social competence, and parental coping. Boys exhibited significantly more problems than did girls. Children whom teachers rated as less socially competent and whose parents reported few effective coping responses exhibited greater difficulties in adjustment.     

Contributions of Genes and Environments to Stability and Change in Externalizing and Internalizing Problems During Elementary and Middle School

We examined longitudinally collected behavioral reports by teachers on a unique twin sample at the ages of 7, 8, 9, 10, 11, and 12 years. As twin and adoption studies implicate the role of genetic influence on behavioral problems found to be stable in epidemiological samples, the current study employs a developmental behavior genetic model to examine the extent to which genetic and environmental contributions to problem behaviors are stable and/or change during development. In this sample of 410 monozygotic (MZ) and 354 dizygotic (DZ) twins, MZ twins were rated as more similar than DZ twins on average. In general, boys were more frequently rated as displaying externalizing behaviors than were girls across each of the six observations, while girls’ internalizing problems were found not to be significantly different from boys’. For both sexes, stability in externalizing problem behaviors was due to a single common genetic factor whose effects acted pleiotropically at each age in the presence of unique environmental influences that were transmitted from age-to-age. Change was largely due to uncorrelated age-specific non-shared environmental and additive genetic effects. Contributions to stability for internalizing problems were due to age-to-age transmission of earlier expressed genetic effects. Change for girls and boys internalizing problems were largely due to environmental experiences unique to siblings along with uncorrelated age-specific genetic effects. These results further inform the notion that individual environments are important factors in the etiology of problem behaviors, but suggest that heritable contributions to phenotypic stability are largely the same across middle childhood and early adolescence. Clinical implications of these findings are discussed.     

Suicidal thoughts and attempts among adolescents: a longitudinal 8-year follow-up study

BACKGROUND: To study the prevalence of and factors associated with suicidal behaviour among 580 adolescents. METHODS: An 8-year longitudinal study included questions about suicidal attempts and thoughts at age 16. Children were evaluated with parent and teacher Rutter scales and self-reported Child Depression Inventory at age 8. At age 16, parents filled in the Child Behaviour Check List and adolescents the Youth Self Report. RESULTS: 14% of girls and 7% of boys reported suicidal thoughts or preoccupations at age 16. Emotional and behavioural problems at age 8, especially antisocial symptoms, reported by parents and teachers and depressive symptoms reported by the child were correlated with suicidal thoughts and behaviour 8 years later. At age 16, internalizing and externalizing problems and low social competence were associated with suicidal features. Only about 20% of those who reported suicidal features had been referred to child mental health services. CONCLUSIONS: Many adolescents with suicidal thoughts and behaviour had a high rate of behavioural and emotional problems already at age 8. CLINICAL IMPLICATIONS: The early school years represent an opportunity for interventions which may prevent self-destructive behaviours in adolescence.     

Parenting behavior dimensions and child psychopathology: specificity, task dependency, and interactive relations.

This study examined the specificity of relations between parent or caregiver behaviors and childhood internalizing and externalizing problems in a sample of 70 fourth-grade children (64% boys, M age = 9.7 years). Specificity was assessed via (a) unique effects, (b) differential effects, and (c) interactive effects. When measured as unique and differential effects, specificity was not found for warmth or psychological control but was found for caregiver's use of behavior control. Higher levels of behavior control were uniquely related to lower levels of externalizing problems and higher levels of internalizing problems; differential effects analyses indicated that higher levels of behavior control were related to decreases in the within-child difference in relative levels of level of internalizing versus externalizing problems. Interactive relations among the 3 parenting behavior dimensions also were identified. Although caregivers emphasized different parenting behavior dimensions across 2 separate caregiver-child interaction tasks, relations between parenting behavior dimensions and child psychopathology did not vary as a function of task. These findings indicate the importance of assessing and simultaneously analyzing multiple parenting behavior dimensions and multiple child psychopathology domains.     

Disinhibited behaviors in young children: relations with impulsivity and autonomic psychophysiology

Cardiac activity has long been considered as a psychophysiological marker of adaptive psychological adjustment. Irregularities in autonomic nervous system activity have long been implicated in both externalizing and disinhibitory behaviors. The present study used a battery of assessments in children ages 4.5-5.5 years to examine the relation among disinhibitory measures. Additionally, cardiovascular activity and reactivity was examined. Mothers rated impulsivity and internalizing/externalizing behaviors. Reward-dominance and passive-avoidance response inhibition (i.e., via errors of commission) tasks were included. Results showed that behaviorally uninhibited children began with an attenuated sympathetic response (i.e., lengthened pre-ejection period) to an interview with a novel experimenter, while inhibited children began with a high level of sympathetic activity. Further, behavioral impulsivity was related to low sympathetic activity at rest. Consistent with theories of disinhibition, externalizing behaviors and measures of behavioral impulsivity were related to a reward-dominant response style. Findings are discussed with regard to motivational theories of behavior.     

Children’s Executive Function Attenuate the Link Between Maternal Intrusiveness and Internalizing Behaviors at School Entry

The goal of this study was to examine the independent and interactive roles of harsh-intrusive maternal behaviors and children’s executive function in the development of internalizing behaviors across the first years of school. A diverse sample (58% African American, 42% European American) of 137 children (48% female) was followed from kindergarten (age 5 years) through school entry (ages 6–7 years). At age 5, maternal harsh-intrusive parenting behaviors were rated from a mother–child structured play task, and children completed 3 executive function tasks that measured inhibitory control, working memory, and attention set-shifting. Teachers reported on children’s internalizing behaviors at ages 5, 6, and 7. Harsh-intrusive parenting behaviors at age 5 years were positively related to internalizing behaviors in the first years of school, whereas high executive function abilities at age 5 years were related to lower internalizing behaviors in the first years of school. In addition, executive function buffered the association between parenting behaviors and internalizing behaviors such that the link between harsh-intrusive parenting and child internalizing behaviors was evident only among children with low executive function and not among children with high executive function. Interventions that focus on reducing negative parenting behaviors and improving children’s executive function may prevent internalizing behaviors from increasing during times of social and academic challenge.