Inhalant use in adolescents in northern Russia

Purpose

To determine the prevalence of inhalant use in Russian adolescents and to investigate associated psychosocial problems from a gender perspective.

Methods

Data on inhalant use and comorbid psychopathology were collected by means of self-reports from 2892 (42.4% boys) sixth to tenth grade students in public schools in Arkhangelsk, Russia. Multivariate analysis of covariance was used to assess differences in the levels of internalizing and externalizing problems in boys and girls, who were non-users and users of inhalants.

Results

The prevalence of inhalant use was 6.1% among boys and 3.4% among girls. Compared with non-users, inhalant users scored significantly higher on internalizing and externalizing problems, functional impairment and lower on academic motivation, with psychopathology increasing with age. While there were no gender differences for internalizing problems, increased levels of externalizing problems in inhalant users were gender-specific (significantly higher in boys).

Conclusions

Inhalant use is related to significantly higher levels of comorbid psychopathology in Russian adolescents. Comprehensive, evidence-based prevention and intervention policies are needed to address inhalant use and its harmful effects.

     

A longitudinal study of socioeconomic status,family processes,and child adjustment from preschool until early elementary school: the role of social competence

Objective

Using a short-term longitudinal design, this study examined the concurrent and longitudinal relationships among familial socioeconomic status (SES; i.e., family income and maternal and paternal education levels), marital conflict (i.e., constructive and destructive marital conflict), parenting practices (i.e., positive and negative parenting practices), child social competence (i.e., social skills), and child behavioral adjustment (i.e., internalizing and externalizing problems) in a comprehensive model.

Methods

The sample included a total of 1604 preschoolers aged 5 years at Time 1 and first graders aged 6 years at Time 2 (51.5% male). Parents completed a self-reported questionnaire regarding their SES, marital conflict, parenting practices, and their children’s behavioral adjustment. Teachers also evaluated the children’s social competence.

Results

The path analysis results revealed that Time 1 family income and maternal and paternal education levels were respectively related to Time 1 social skills and Time 2 internalizing and externalizing problems, both directly and indirectly, through their influence on destructive and constructive marital conflict, as well as negative and positive parenting practices. Notably, after controlling for Time 1 behavioral problems as mediating mechanisms in the link between family factors (i.e., SES, marital conflict, and parenting practices) and behavioral adjustment, Time 1 social skills significantly and inversely influenced both the internalization and externalization of problems at Time 2.

Conclusions

The merit of examining SES, marital conflict, and parenting practices as multidimensional constructs is discussed in relation to an understanding of processes and pathways within families that affect child mental health functioning. The results suggest social competence, which is influenced by the multidimensional constructs of family factors, may prove protective in reducing the risk of child maladjustment, especially for children who are socioeconomically disadvantaged.

     

Eating disorder psychopathology as a marker of psychosocial distress and suicide risk in female and male adolescent psychiatric inpatients

Objective

The aim of this study was to examine psychosocial correlates of specific aspects of eating disorder (ED) psychopathology (ie, dietary restriction, body dissatisfaction, binge eating, and self-induced vomiting) in psychiatrically hospitalized adolescent girls and boys.

Method

A total of 492 psychiatric inpatients (286 adolescent girls and 206 adolescent boys), aged 12 to 19 years, completed self-report measures of psychosocial and behavioral functioning, including measures of suicide risk and ED psychopathology. Associations between ED psychopathology and psychosocial functioning were examined separately by sex and after controlling for depressive/negative affect using Beck Depression Inventory scores.

Results

Among the adolescent boys and girls, after controlling for depressive/negative affect, ED psychopathology was significantly associated with anxiety, low self-esteem, and current distress regarding childhood abuse. Among adolescent girls, after controlling for depressive/negative affect, ED psychopathology was significantly related to hopelessness and suicidality. Among adolescent boys, after controlling for depressive/negative affect, ED psychopathology was positively related to self-reported history of sexual abuse and various externalizing problems (drug abuse, violence, and impulsivity).

Conclusion

In psychiatrically hospitalized adolescents, ED psychopathology may be an important marker of broad psychosocial distress and behavioral problems among girls and boys, although the nature of the specific associations differs by sex.     

Parenting correlates of child behavior problems in a multiethnic community sample of preschool children in northern Norway

Abstract. A multiethnic community sample of 191 families with four-year-old children in northern Norway was used to explore whether parenting factors were associated with child behavior problems, and whether these associations differed for boys and girls or for the two main ethnic groups in this region: the indigenous Sami and the majority Norwegians. The Child Behavior Checklist (CBCL) and a semi-structured interview on child-rearing were used as instruments. As would be expected from a developmental perspective, elevated scores of child behavior problems were associated with lower levels of parental cuddling and with higher levels of physical punishment. Family demographics such as low maternal age and single parenthood were also associated with more behavioral problems. Girls seemed to be more strongly influenced by child-rearing factors than boys. Subgroup analyses suggested that for harsh treatment, patterns of correlations differed between Sami and Norwegian groups, especially for boys. A positive correlation between physical punishment and externalizing problems emerged for Norwegian boys, but not for Sami boys. Teasing/ridiculing was positively correlated with internalizing problems for Norwegian boys, but inversely correlated for Sami boys. These findings emphasize the importance of taking the childs cultural context and gender into account when assessing parenting influences on behavioral problems in children.     

Gender Differences in at Risk Versus Offender Adolescents: A Dimensional Approach of Antisocial Behavior

The current study investigated gender differences in the main components of antisocial behavior in an at-risk versus an offender group of adolescents. One-hundred and forty-three adolescents divided into two different risk groups [at risk (n = 54) and offenders (n = 89)] were compared according to gender (111 boys and 32 girls). Externalizing symptoms were assessed with the Delinquent and Aggressive subscales of the Youth Self-report Questionnaire, internalizing problems with the Beck Anxiety Inventory and the Beck Depressive Inventory and personality traits with the Barratt-Impulsiveness Scale as well as the Youth Psychopathic Traits Inventory. Results revealed a consistent interaction pattern, with girls presenting higher levels of externalizing symptoms, more motor impulsivity and a more arrogant and deceitful interpersonal style than boys in the at-risk group. In contrast, in the offenders’ group, psychopathic traits were more present in boys than in girls. Regarding internalizing problems, girls showed more depression than boys, independently of the risk group. Among offending youths, girls present equally severe externalizing problems, and problematic personality traits as boys. At-risk girls have the highest rates of difficulties across the tested domains and should therefore be specifically targeted for prevention and intervention.     

Temperamental predictors of externalizing problems among boys and girls: a longitudinal study in a high-risk sample from ages 3 months to 15 years

In a high-risk community sample, we examined the role of regulative temperament and emotionality as well as the extent of gender specificity in the development of externalizing problems. 151 boys and 157 girls born at differing degrees of obstetric and psychosocial risk were followed from birth into adolescence. In infancy and childhood, NYLS-derived temperamental characteristics were assessed by a highly structured parent interview and standardized behavioral observations. At age 15 years, externalizing problems were measured by the Child Behavior Checklist. As revealed by multiple linear regression and logistic regression, low regulative abilities predicted adolescent behavioral and attentional problems over and above obstetric and psychosocial risks. Gender specificity was found in the strength of the association rather than in the kind with a stronger long-term prediction from infant and toddler temperament in girls. Compared to regulative abilities, temperament factors describing aspects of mood and fear/withdrawal versus approach tendencies played a minor role in the development of externalizing problems. Findings are discussed in terms of gender-specific risk factors and possible differential developmental trajectories to subtypes of disruptive behavior.     

Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Moderating Role of Sex

Background

Children exposed to multiple stressors are more likely to be overweight, but little is known about the mechanisms explaining this association.

Purpose

This cross-sectional study examined whether children exposed to multiple stressors had higher waist circumference, and whether this association was mediated through children’s television time.

Methods

Participants were 319 parent–child dyads. Children were 2–5 years old and had at least one overweight parent (BMI ≥ 25 kg/m²). Data were collected at baseline of a larger childhood obesity prevention study and included information on psychosocial stressors (e.g., parenting stress), demographic stressors (e.g., low income), children’s television time, and children’s waist circumference. Two cumulative risk scores were created by summing stressors in each domain (demographic and psychosocial). Mediation and moderated mediation analyses were conducted.

Results

Indirect effects of both cumulative risk scores on waist circumference through television time were not significant; however, moderated mediation analyses found significant moderation by gender. The indirect effects of both risk scores on waist circumference through television time were significant and positive for girls, but near-zero for boys.

Conclusions

Reducing television time should be explored as a strategy for buffering against the negative health effects of exposure to multiple stressors among girls. Longitudinal and intervention research is needed to confirm these results and to identify mediating factors between cumulative risk and body weight among boys.

     

Temperament Traits and Psychopathology in Young Clinically Referred Children Compared to a General Population Sample

Evidence from general population studies shows the contribution of various temperament traits to the development of child psychopathology. Little is known about which traits are associated with internalizing and externalizing problems in young clinically referred children. The current study assessed temperament and internalizing and externalizing problems in 216 referred children (M?=?4.35 years, SD 0.89, 81% boys). A comparison was made with an age and gender matched general population sample. Referred children showed less effortful control than general population children. Less effortful control and more negative affectivity were associated with more internalizing and externalizing problems across groups. Surgency, and specifically temperamental impulsivity, was more strongly associated with externalizing problems in referred children compared to general population. Less soothability, less inhibitory control and more frustration predicted (sub)clinical levels of comborbid internalizing and externalizing problems in referred children. The results can be used in diagnostic and treatment procedures in early childhood.     

The Effectiveness of Parent Management Training—Oregon Model in Clinically Referred Children with Externalizing Behavior Problems in The Netherlands

The present study examined the effectiveness of parent management training—Oregon model (PMTO) as a treatment for children with externalizing behavior problems in The Netherlands. Clinically referred children (N = 146) aged 4–11 years and their parents were partly randomized to either PMTO (n = 91) or Care As Usual (CAU; n = 55). Families were assessed at four time points: at pretreatment, and after 6, 12, and 18 months. Results showed that both PMTO and CAU were effective in reducing child externalizing behavior, parenting stress and parental psychopathology, with no significant differences between the two treatment conditions. PMTO and CAU interventions also produced some improvements in self-reported parenting skills, but not in observed parenting skills. According to the Reliable Change Index, 16.9 and 45.8 % of the children within the PMTO group showed full recovery or improvement in externalizing behavior, respectively, versus 9.7 and 42.8 % in the CAU condition. Finally, the effect size of PMTO on parent-reported externalizing behavior problems as found in the present study was comparable to that found in previous studies evaluating PMTO as an intervention for this type of child psychopathology.     

Systematic Review and Meta-analysis of Parent Group Interventions for Primary School Children Aged 4–12 Years with Externalizing and/or Internalizing Problems

This systematic review and meta-analysis evaluates the efficacy of parent training group interventions to treat child externalizing and/or internalizing problems. A search identified 21 randomized controlled trials of parent group interventions aimed at ameliorating child externalizing and/or internalizing problems in children aged 4–12 years. Random effects meta-analyses yielded significant pooled treatment effect size (g) estimates for child externalizing (g?=??0.38) and internalizing problems (g?=??0.18). Child anxiety symptoms or internalizing problems evident in children with externalizing behavior problems did not change significantly following intervention. Study quality was a statistically significant moderator of treatment response for child externalizing problems, however hours of planned parent group treatment and treatment recipient were not. Findings support the use of parent group interventions as an effective treatment for reducing externalizing problems in children aged 4–12 years. Whilst statistically significant, programs had a limited impact on internalizing symptoms, indicating a need for further investigation.     

Childhood problem behavior and parental divorce: evidence for gene–environment interaction

Objective

The importance of genetic and environmental influences on children’s behavioral and emotional problems may vary as a function of environmental exposure. We previously reported that 12-year-olds with divorced parents showed more internalizing and externalizing problems than children with married parents, and that externalizing problems in girls precede and predict later parental divorce. The aim of the current study was to investigate as to whether genetic and environmental influences on internalizing and externalizing problems were different for children from divorced versus non-divorced families.

Methods

Maternal ratings on internalizing and externalizing problems were collected with the Child Behavior Checklist in 4,592 twin pairs at ages 3 and 12?years, of whom 367 pairs had experienced a parental divorce between these ages. Variance in internalizing and externalizing problems at ages 3 and 12 was analyzed with biometric models in which additive genetic and environmental effects were allowed to depend on parental divorce and sex. A difference in the contribution of genetic and environmental influences between divorced and non-divorced groups would constitute evidence for gene–environment interaction.

Results

For both pre- and post-divorce internalizing and externalizing problems, the total variances were larger for children from divorced families, which was mainly due to higher environmental variances. As a consequence, heritabilities were lower for children from divorced families, and the relative contributions of environmental influences were higher.

Conclusions

Environmental influences become more important in explaining variation in children’s problem behaviors in the context of parental divorce.     

Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors

Background

Little is known about the social context of girls with conduct disorder (CD), a question of increasing importance to clinicians and researchers. The purpose of this study was to examine the associations between three social context domains (neighborhood, family characteristics, and parenting behaviors) and CD in adolescent girls, additionally testing for race moderation effects. We predicted that disadvantaged neighborhoods, family characteristics such as parental marital status, and parenting behaviors such as negative discipline would characterize girls with CD. We also hypothesized that parenting behaviors would mediate the associations between neighborhood and family characteristics and CD.

Methods

We recruited 93 15–17 year-old girls from the community and used a structured psychiatric interview to assign participants to a CD group (n = 52) or a demographically matched group with no psychiatric disorder (n = 41). Each girl and parent also filled out questionnaires about neighborhood, family characteristics, and parenting behaviors.

Results

Neighborhood quality was not associated with CD in girls. Some family characteristics (parental antisociality) and parenting behaviors (levels of family activities and negative discipline) were characteristic of girls with CD, but notll. There was no moderation by race. Our hypothesis that the association between family characteristics and CD would be mediated by parenting behaviors was not supported.

Conclusion

This study expanded upon previous research by investigating multiple social context domains in girls with CD and by selecting a comparison group who were not different in age, social class, or race. When these factors are thus controlled, CD in adolescent girls is not significantly associated with neighborhood, but is associated with some family characteristics and some types of parental behaviors. However, the mechanisms underlying these relationships need to be further investigated. We discuss possible explanations for our findings and suggest directions for future research.     

A controlled evaluation of a brief parenting psychoeducation intervention in Burundi

Purpose

Conduct problems and emotional distress have been identified as key problems among children and adolescents in post-war Burundi. This pilot study aims to evaluate the impact of a brief parenting psychoeducation intervention on children’s mental health.

Methods

This study employs a controlled pre and post evaluation design. The two-session psychoeducation intervention was offered to groups of parents of children (mean age 12.3 years, 60.8 % female) who had been screened for elevated psychosocial distress. Children in the intervention group (n = 58) were compared to a waitlist control group (n = 62). Outcome indicators included child-reported levels of aggression (using the Aggression Questionnaire), depression symptoms (using the Depression Self Rating Scale) and perceived family social support.

Results

The intervention had a beneficial effect on reducing conduct problems compared to the control condition (Cohen d = 0.60), especially among boys, while not showing impact on depression symptoms or family social support. Parents evaluated the intervention positively, with increased awareness of positive parenting strategies and appropriate disciplinary techniques reported as the most common learning points.

Conclusion

A brief parenting psychoeducation intervention conducted by lay community counselors is a promising public health strategy in dealing with widespread conduct problems in boys living in violence-affected settings and not so for social and emotional indicators and for girls. An efficacy study is warranted to confirm these preliminary findings.     

Girls get by with a little help from their friends: gender differences in protective effects of social support for psychotic phenomena amongst poly-victimised adolescents

Purpose

To investigate whether social support is protective for psychotic experiences similarly among poly-victimised adolescent girls and boys.

Methods

We utilised data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative sample of 2232 UK-born twins. Participants were privately interviewed at age 18 about victimisation, psychotic experiences, and social support during adolescence.

Results

Perceived social support (overall and from friends) was found to be protective against psychotic experiences amongst poly-victimised adolescent girls, but not boys. Though boys were similarly protected by family support.

Conclusions

Social support-focused interventions targeting psychotic phenomena amongst poly-victimised adolescents may be more effective for girls.

     

Psychosocial aspects in girls with idiopathic precocious puberty

Objective

Precocious puberty leads to discrepancies between physical and chronological age. The aim of the present study was to evaluate behavioral patterns and social competences in 34 girls with idiopathic precocious puberty.

Methods

Height, body weight, and BMI were determined, and pubertal development was assessed. The Korean-child behavior checklist (K-CBCL) was completed by parents.

Results

1) Body weight and BMI were significantly higher in precocious puberty group than in the control group. 2) T scores of total social competence and school scales of K-CBCL were significantly higher in the precocious puberty group than in the control group. 3) T scores of externalizing problems and total behavior problems of K-CBCL were also significantly higher in the precocious puberty group. 4) T scores of thought problems and attention problems of K-CBCL were significantly higher in the precocious puberty group than the control group.

Conclusion

Although girls with precocious puberty had more behavioral problems, no significant differences were observed between the two study groups in terms of clinically-important T scores. However, the concerns of parents and patients regarding behavioral and emotional changes might be most important when evaluating psychosocial problems. Early recognition, sufficient understanding, communication with patients and parents regarding physical developmental difference from children in the same age, can improve the self-image of those with precocious puberty.     

Child physical abuse: factors influencing the associations between self-reported exposure and self-reported health problems: a cross-sectional study

Background

Child physical abuse (CPA) is an extensive public health problem because of its associations with poor health outcomes. The aim of this study was to examine which of the background factors of CPA committed by a parent or other caregiver relates to self-reported poor health among girls and boys (13; 15 and 17 years old): perpetrator, last year exposure; severity and frequency; socioeconomic load and foreign background.

Methods

In a cross-sectional study in a Swedish county (n?=?8024) a path analysis was performed to evaluate a model where all background variables were put as predictors of three health-status variables: mental; physical and general health problems. In a second step a log linear analysis was performed to examine how the distribution over the health-status categories was different for different combinations of background factors.

Results

Children exposed to CPA reported poor health to a much higher extent than those who were not exposed. In the path analysis it was found that frequency and severity of abuse (boys only) and having experienced CPA during the last year, was significantly associated with poor health as well as socioeconomic load in the families. Foreign background was significantly negatively associated with all three health indicators especially for girls. Neither mother nor father as perpetrator remained significant in the path analysis, while the results from the log linear analyses showed that mother-abuse did in fact relate to poor general health and mental as well as physical health problems among boys and girls. Father-abuse was associated with poor mental health if severe abuse was reported. Poor mental health was also associated with mild father-abuse if exposure during the last year was reported.

Conclusion

Despite the limitations that cross-sectional studies imply, this study provides new knowledge about factors associated with poor health among physically abused children. It describes details of CPA that have significant associations to different aspects of poor health and thus what needs to be addressed by professionals within mental health providers and social services. Understanding how different factors may contribute to different health outcomes for exposed children is important in future research and needs further studies.

     

Parenting stress in Chinese mothers of children with autism spectrum disorders

Objective

Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China.

Methods

In this cross-sectional study, data about participants’ demographic characteristics, parenting stress, anxiety, depression, child’s behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home.

Results

The participants reported elevated parenting stress. Mothers’ parenting stress was associated with levels of depression and anxiety, and child’s behavioral symptoms. Child’s behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress.

Conclusions

Government support may play an important role in reducing parenting stress in this population.     

Maternal and Paternal Parenting and Associations with School Performance in a Sample of Children with Varying Levels of Externalizing Behavior Problems

This study examined associations between parenting behaviors and school performance in children oversampled for externalizing behavior problems. Participants were 147 mothers (M _age = 36.46 years, SD = 5.66) and 110 fathers (M _age = 39.31 SD = 6.26) of 148 children (M _age = 9.64 years, SD = 1.59). The majority of children (83.7%) met diagnostic criteria for attention-deficit/hyperactivity disorder and/or oppositional defiant disorder or conduct disorder. Ratings of maternal and paternal effective control and emotional responsiveness were collected, and standardized achievement scores, teacher ratings of disruptive classroom behavior, and teacher ratings of student–teacher and student–peer relationships were used as indicators of school performance. Associations of medium size emerged between maternal parenting and school performance domains. In contrast, very few associations between paternal variables were demonstrated, with the exception of paternal reduction of child emotion being robustly associated with school performance variables. Exploratory analyses demonstrated that paternal positive involvement mitigated the negative effects of dysfunctional maternal behavior on spelling achievement and peer functioning. These findings point to the importance of considering parent functioning in the school performance of children with externalizing problems. Attention to addressing parenting difficulties common to many children with externalizing behavior problems may help to promote adaptive school functioning.     

Prevalence of emotional and behavioral problems and subthreshold psychiatric disorders in Austrian adolescents and the need for prevention

Purpose

Epidemiological data are crucial to plan adequate prevention strategies. Thus, this study aims at obtaining the prevalence of mental health problems (MHP) and subthreshold psychiatric disorders based on a representative sample of Austrian adolescents.

Methods

Adolescents aged 10–18 were recruited from Austrian schools. Emotional and behavioral problems were determined using the Youth Self-Report (YSR); the point prevalence of subthreshold psychiatric disorders was assessed using structured diagnostic interviews. Sociodemographic variables including socioeconomic background, migration status, family structure, and place of residence were obtained. In addition, a non-school sample (unemployed adolescents, and child and adolescent psychiatry patients) was included to enhance representativeness and generalizability.

Results

3446 students, 37 unemployed adolescents, and 125 child and adolescent psychiatric patients provided analyzable YSR data sets. In the school sample, 16.5% scored in the clinically relevant range, while internalizing problems were more prevalent (17.8%) than externalizing problems (7.4%). These prevalences increased by 0.7–2.0% when the non-school sample was taken into account. A low socioeconomic status (SES) and living in single parent families were associated with higher problem scores. Regarding the interviewed sample (377 students and 407 parents), subthreshold psychiatric disorders were observed in 12.7% of students. 92.5% of them have not yet received any kind of help.

Conclusions

A significant proportion of Austrian adolescents are at risk for MHP. A non-responder analysis indicates that the observed prevalence may be even underestimated. These findings emphasize the urgent need for targeted prevention, especially for reducing anxiety and depressive symptoms and for adolescents in disadvantaged families.