Parent reports of child behavior problems in young Sami children: a cross-cultural comparison

 In a general population study of 4-year-olds, using the Child Behavior Checklist (CBCL), parent reports of child behavior problems were compared in samples of 67 monoethnic Sami, 52 multiethnic Sami/Norwegian, and 63 monoethnic Norwegian children from the Sami core area in northern Norway. Mean CBCL total problem scores were low for all three groups [Sami: 21.1 (SD 15.5), Sami/Norwegian: 19.4 (SD 12.2) and Norwegian: 18.8 (SD 13.6)]. No significant differences across ethnic groups were found for the Total Problems scale and the Internalizing and Externalizing scales, nor for the syndrome scales, except for the Withdrawn scale, the Sami/Norwegian sample showing the highest scores. However, significant ethnicity × gender interactions emerged, indicating that the effect of ethnicity was different for boys versus girls. Sami mothers reported the highest and the Norwegian mothers the lowest scores for girls, whereas the opposite pattern was found for boys. Correlations between mothers' and fathers' reports were generally low. Differences in mean scale scores between pairs of parents (n = 122) were found for boys but not for girls, mothers scoring higher than fathers. The authors underline the importance of taking gender differences, age and ethnic context into account when assessing problem behavior in minority children. Methodological problems in cross-cultural assessments, including the influence of cultural norms of child behavior on parents' problem ratings, are discussed. Accepted: 18 January 2000     

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.     

Preschoolers’ Psychosocial Problems: In the Eyes of the Beholder? Adding Teacher Characteristics as Determinants of Discrepant Parent–Teacher Reports

In this study, we explored informant characteristics as determinants of parent–teacher disagreement on preschoolers’ psychosocial problems. Teacher characteristics were included in the analyses, in addition to child and parent factors. Psychosocial problems of 732 4-year olds from a Norwegian community sample were assessed by parents and teachers (CBCL-TRF). Furthermore, teachers reported on their education, experience and relationship to the child. Parental stress and psychopathology were also measured. Teachers rated children considerably lower than their parents did, especially on internalizing problems. When teachers rated more child problems, this was strongly associated with conflict in the teacher–child relationship, which predicted disagreement more than other factors. The highest agreement was on boys’ externalizing problems. Girls’ behavior was rated much lower by teachers than boys’ behavior compared to parents’ ratings. Possible teacher perception biases are discussed, such as teacher–child conflict, non-identification of internalizing problems, and same-gender child preference.     

Sleep quality, duration and behavioral symptoms among 5–6-year-old children

The objective of the present study was to examine whether parent-reported short sleep duration and sleeping difficulties are related to behavioral symptoms among pre-school aged children. The study is a cross-sectional survey of 297 families with 5–6-year-old children. The Sleep Disturbance Scale for children was used to measure sleep duration and sleeping difficulties, and the Child Behavior Checklist and Teacher’s Report Form were used to measure attention problems, and internalizing and externalizing symptoms. In multivariate logistic regression models, short sleep duration was according to parental reports related to inattention (adjusted odds ratio 4.70, 95% CI 1.58–14.00), internalizing (adjusted odds ratio 3.84, 95% CI 1.32–11.21), and total psychiatric symptoms (adjusted odds ratio 3.53, 95% CI 1.23–10.17) while according to teacher’s reports it was almost significantly related to internalizing symptoms (adjusted odds ratio 4.20, 95% CI 0.86–20.51). Sleeping difficulties were strongly related to all subtypes of psychiatric symptoms according to parental reports (adjusted odds ratios ranging from 6.47 to 11.71) and to externalizing symptoms according to teachers’ reports (adjusted odds ratio 7.35, 95% CI 1.69–32.08). Both short sleep duration and sleeping difficulties are associated with children’s behavioral symptoms. Intervention studies are needed to study whether children’s behavioral symptoms can be reduced by lengthening sleep duration or improving sleep quality.     

Social competence and emotional/behavioral problems in a birth cohort of Sami and Norwegian preadolescents in Arctic Norway as reported by mothers and teachers

In a 7-year follow-up birth cohort from the general population in the Sami core area in Finnmark, Arctic Norway, we examined mothers’ and teachers’ reports of social competence and emotional/behavioral problems among 71 indigenous Sami and 77 Norwegian 11–12-year-olds. The instruments used were the Child Behavior Checklist (CBCL) for parents and the Teacher Report Form (TRF). No ethnic differences were found on competence scales. Total Problems reported by Sami and Norwegian mothers were low in comparison with the overall mean found in multicultural meta-studies. Sami mothers reported lower Total Problems and Attention Problems than did Norwegian mothers. There were no ethnic differences on the TRF measures. Consistent with other international studies, mothers and teachers rated girls higher than boys on social competence and boys higher than girls on Externalizing and Attention Problems. Gender differences were larger on the TRF than on the CBCL. The very low problem ratings made by the Sami mothers indicate that there is a need for specific clinical cut-off points to distinguish between clinically referred and non-referred children in this indigenous Arctic population.     

Agreement Between Parents and Teachers on Behavioral/Emotional Problems in Japanese School Children Using the Child Behavior Checklist

We investigated the agreement between Japanese parents' and teachers' ratings concerning their children's behavioral/emotional problems. Mothers (n = 276) and teachers (n = 19) assessed each child (n = 316; 6 to 12 years old ) using Japanese parent and teacher version of the Child Behavior Checklist. Parent–teacher agreement were examined through three indices; mean scores, correlations and D scores (generalized distance between item profile). Mean scores rated by parents were significantly higher than those by teachers. The differences of parents' ratings according to sex of the child or parents' occupational level, and those of teachers' ratings according to sex of the child were consistent with previous Western studies. Parent-teacher correlations were in the low to middle range (0.16–0.36). We obtained significant sets of independent variables accounting for the variance of D scores, but the effect size of these variables was small. These results indicated that, as seen in Western studies, Japanese parents and teachers would also assess their child's problems differently and the child's demographics affect their evaluation. For further research, parent and teacher characteristics which may influence on their perspective of the child's problems could be examined.     

Early predictors of parent- and self-reported perceived global psychological difficulties among adolescents

Aims To study predictors at age 3 and at age 12 for parent and self-reported perceived global psychological difficulties at age 15. Method A representative birth cohort was prospectively followed from early childhood to age 15. Ratings of children’s behavioral and emotional problems were collected at age 3 (Child Behavior Check List 2/3) and at age 12 (Child Behavior Check List 4–16, Youth Self Report). Mothers and fathers separately completed a questionnaire on their own well-being, health and mental distress when the child was 12. At the same time-point, family functioning was measured with the Family Assessment device. Outcome variables included both parent and self-reports of children’s perceived psychological difficulties at age 15. Results At age 15, of the 707 children with both parent and self-reports on perceived difficulties available, 10% had more perceived difficulties than peers of the same age in parent or self-reports. There was a significant increase in perceived difficulties from age 12 to age 15 in self-reports but not in parent reports. The parent–child agreement on difficulties at both time-points was very low (proportion of agreement 0.12–0.17). At age 3, externalizing problems, especially aggressiviness, predicted parent reports of child’s difficulties at 15 years of age in univariate analysis. At age 12, parent-reported child’s externalizing symptoms and perceived difficulties, poor social competence in self-reports, and mothers’ reports of her own poor well-being, independently predicted parents’ reporting of their child’s perceived difficulties at age 15. Self-reports of internalizing problems and mother’s own reports of her depressiviness when the child was 12 independently predicted the 15-year old’s self-reported difficulties. Furthermore, in univariate analysis, poor family functioning at age 12 predicted perceived difficulties in parent and self-reports. Conclusions Both parent and self-reports of a child’s difficulties are the outcome of an accumulation of the child’s psychopathology, parental distress, and family dysfunction. The results emphasize the importance of early detection of children at risk of negative developmental pathways. In clinical practice and in prevention interventions, it is important to take into account the child’s individual psychopathology, parental distress, and family dysfunction.     

Suicide attempts among indigenous Sami adolescents and majority peers in Arctic Norway: prevalence and associated risk factors

The prevalence of suicide attempts and associated risk factors such as sociodemographic conditions, emotional/behavioural problems and parent-child relationships were examined among 591 indigenous Sami and 2100 majority adolescents in Arctic Norway. There were no significant ethnic differences in prevalence of suicide attempts. In both ethnic groups, suicidal ideation, anxious/depressed problems and eating behaviour problems were associated with suicide attempts. Cross-cultural differences in risk factors associated with suicide attempts existed. For Sami adolescents, factors diverging from the traditional cultural norms were associated with suicide attempts, such as alcohol intoxication, single-parent home and paternal overprotection (p相似文献   

Predictors of outcome in infant and toddlers functional or behavioral disorders after a brief parent–infant psychotherapy

The efficacy of parent–child psychotherapies is widely recognized today. There are, however, less data on predictive factors for outcome in infants and toddlers and their parents. The aim of this study was to highlight predictive factors for outcome after a brief psychotherapy in a population of 49 infants and toddlers aged 3–30 months presenting functional or behavioral disorders. Two assessments were performed, the first before treatment and the second a month after the end of the therapy. These assessments included an evaluation of the child’s symptoms, and of depressive or anxiety symptoms in the parents. The assessments after therapy show complete or partial improvement in the child’s symptoms for nearly three quarters, and a decrease in the number of anxious and depressive mothers, and also in the number of depressive fathers. Three independent factors appear as predictive of unfavorable outcome for the child: frequency and intensity of behavioral problems and fears, and the absence of the father at more than two-thirds of consultations. The outcome for the mother is associated solely with her anxiety score at the start of the therapy. This study underlines the particular difficulties involved in the treatment of infants and toddlers presenting behavioral disturbances and emotional difficulties, and the value of involving the father in treatment.     

Influence of Risk Factors and Cultural Assets on Latino Adolescents’ Trajectories of Self-Esteem and Internalizing Symptoms

In this study, we examined longitudinal, person-centered trajectories of acculturation, internalizing symptoms, and self-esteem in 349 Latino adolescents. We compared acculturation measures (time in the US, culture-of-origin involvement, US cultural involvement, for both parents and adolescents); acculturation stressors (perceived discrimination, acculturation conflicts); and family dynamics (parent–adolescent conflict, familism). Results indicated that, over time, Latino adolescents’ internalizing problems decreased and their self-esteem increased. However, we showed that increased length of time living in the US was significantly related to lower self-esteem among adolescents. Parent–adolescent conflict was a strong risk factor, which not only directly heightened internalizing symptoms and lowered self-esteem, but also mediated the effects of acculturation conflicts and perceived discrimination on these outcomes. Our findings revealed familism as a cultural asset associated with fewer internalizing symptoms and higher self-esteem. Internalizing symptoms were also minimized by the adolescent’s involvement in the US culture whereas bicultural adolescents with high culture-of-origin involvement reported higher self-esteem. We discussed the limitations and implications of this study for future research and practice.     

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.     

Changes in social competence in young children treated because of conduct problems as viewed by multiple informants

In the present study changes in social competence were examined in a clinic sample of 127 children aged 4–8. The children were recruited to a controlled treatment study because of conduct problems at home and were randomised to the Incredible Years parent training (PT), combined PT and child therapy (CT) or a waiting-list control-group. Assessments were conducted pre- and post-treatment and at a one-year follow-up by multiple informants (mother, father, teacher and child). Parent training combined with child treatment showed most improvement in child social competence based on mother, father and child reports, however, father reports showed positive results for children treated with PT only. Treated mothers and fathers showed a decrease in correlations in their reports of social competence in the child after treatment as compared to parents in the waiting-list condition. No generalisation effects to peer-relationships in day-care/school were found, neither on teacher or child reports. A broad perspective using multiple informants from different settings is needed when effects of treatment of young children with conduct problems are evaluated and should include various aspects of social competence.     

Teachers’ assessments of children aged eight predict life satisfaction in adolescence

The objective was to investigate how teachers’ assessments of children predict life satisfaction in adolescence. This is a prospective cohort study on the population-based Northern Finland Birth Cohort 1986 (n = 8,959). Information was gathered from parents, teachers and adolescents using questionnaires at the age of 7, 8 and 15. Response rates were 80–90%. Emotional and behavioural problems were assessed with Rutter Children’s Behavioural Questionnaires for teachers (RB2) and parents (RA2) during the first grade at age 8. At adolescence, self-reported life satisfaction was measured with a question including five response alternatives. According to teachers’ assessments, 13.9% of the children had high emotional or behavioural problems (RB2 ≥9). These assessments predicted life dissatisfaction in adolescence (OR_crude = 1.77; 95% CI 1.43–2.20) in several models including also health behaviour and use of psychotropic medicine. However, introducing all the significant variables in the same model, RB2 lost its significance (OR = 1.28; 0.96–1.70), but good school achievement assessed by teachers was still a significant predictor. Life satisfaction in adolescence was associated with a variety of favourable concurrent factors. In conclusion teachers’ assessments of children during the first school year predicted life satisfaction in adolescence. In mental health promotion, teachers’ early assessments should be utilized for the benefit of children.     

The Effectiveness of Parent–Child Interaction Therapy for Families of Children on the Autism Spectrum

We report the results of a pilot trial of an evidence-based treatment—Parent–Child Interaction Therapy (PCIT; Eyberg et al. Psychopharmacology Bulletin, 31(1), 83–91, 1995) for boys aged 5–12 with high functioning autism spectrum disorders and clinically significant behavioral problems. The study also included an investigation of the role of shared positive affect during the course of therapy on child and parent outcomes. The intervention group showed reductions in parent perceptions of child problem behaviors and child atypicality, as well as an increase in child adaptability. Shared positive affect in parent child dyads and parent positive affect increased between the initial and final phases of the therapy. Parent positive affect after the first phase was related to perceptions of improvement in problem behaviors and adaptive functioning.     

Perceived Need and Use of Child Mental Health Services in Korea

This study examined the degree of perceived need and use of child mental health services in Korea, as well as the factors associated therewith. The sample consisted of 3,477 children aged 8–13 years. Overall, 10.4% of the parents demonstrated a perceived need for mental health services regarding their children’s emotional or behavioral problems, while 1.9% used mental health services. Although the perceived need for mental health services is high, only a small proportion of children receive them. Whether a child receives mental health care is influenced by the child’s psychopathology, especially when social and/or thought problems exist.     

Child and Family Predictors of Therapy Outcome for Children with Behavioral and Emotional Problems

This study investigated the characteristics of 106 children primarily referred for externalizing behavior problems and their families, and assessed the prediction of treatment outcome following a standardized short-term, cognitive behavioral group program. Exploring Together comprised a children’s group (anger management, problem-solving and social skills training), a parents’ group (parenting skills training, dealing with parents’ personal, relationship and family-of-origin issues), and a combined children’s and parents’ group (to target parent–child interactions). The main predictors of reductions in externalizing and internalizing behaviors at home following treatment were children’s pre-existing levels of these behavioral and emotional problems (children with higher levels improved most), and positive parent–child interaction. Higher pre-existing levels of behavioral and emotional problems and low levels of attention problems predicted greater improvement in post-treatment school behaviors. Implications of the findings for improving interventions for childhood behavioral and emotional problems are discussed     

Screening for emotional and behavioural problems amongst 5–11-year-old school children in Karachi,Pakistan

Background While a number of studies in the western countries have provided estimates of prevalence for child psychiatric morbidity and associated risk factors, relatively little is known about child psychiatric problems and risk factors in developing countries like Pakistan. Method A cross sectional survey of 5–11-year-old children attending main stream private and community schools in Karachi was conducted. Seven private and eight community schools agreed to participate. About 1488 consent forms were sent to 700 parents of private school and 788 parents of community school children. A total of 675 parents agreed to participate in the study. The response rate was 45.4%. Assessment of children’s mental health was conducted using Strength and difficulties questionnaire (SDQ) by parents based on cut-off provided by Goodman. Results About 47% children were rated as normal, 19% as borderline and 34% as abnormal by the parents. Ordinal regression was used to identify factors associated with parent’s rating. The odds of female children of being normal was 1.5 times relative to male children, adjusting for school type and mother’s education (ORadj = 1.5, 95% CI: 1.1–2.0). Children attending private schools were more likely to be normal as compared to community school children, adjusting for child’s gender and mother’s education (ORadj = 2.3, 95% CI: 1.3–4.0). Conclusion In the present study, prevalence of child mental health problems was higher than reported in studies from other countries. Prevalence was higher amongst children attending community schools. Consistent with most studies, male children were at a higher risk than females. There is a need for developing programs to train, sensitise and mobilize teachers and parents regarding child’s psychological, emotional and behavioural problems with special attention to community schools. Since the male child is at a greater risk we should be cognizant of this while evaluating children for psychopathology.     

Self-reported strengths and difficulties in a large Norwegian population 10–19 years

This study reports young people’s assessment of own problems and strengths from a Norwegian survey (n=29,631, age range 10–19), based on the self-report version of the Strengths and Difficulties Questionnaire (response rate 84.3%). Differences according to the age and gender are illuminated. Girls reported most emotional problems and boys most conduct and peer problems. Compared to other countries, Norwegian adolescents reported more hyperactive behaviour. Total problem scores were highest in early-adolescence for boys (Mean=10.8, SD=6.1), and for girls it is in late adolescence (Mean 11.3, SD=5.2). One third of the subjects reported at least minor perceived difficulties. All symptom scales were strongly associated with perceived difficulties, impact and burden to others (P<0.001) with significant gender and age effects. Impact scores were included in the estimate of possible caseness. Combining symptom scores and impact scores, 3.7% of the sample was defined as a high risk group, while 8.8% needed special attention from mental health services. The results also suggested that SDQ could be a valuable screening instrument for older adolescents.     

Quality of life in children and adolescents with obsessive-compulsive disorder: base rates,parent–child agreement,and clinical correlates

The presence of obsessive-compulsive disorder (OCD) has been linked to decreased quality of life (QoL) among adults, yet little is known about the impact of OCD on QoL in pediatric patients. Sixty-two youth with OCD and their parent(s) were administered the Children’s Yale-Brown Obsessive Compulsive Scale following a clinical interview. Children completed the Pediatric Quality of Life Inventory and parents completed the Pediatric Quality of Life Parent Proxy Inventory and Child Behavior Checklist. QoL scores for OCD patients were significantly lower than for healthy controls, but similar to QoL in a general psychiatric sample on the majority of domains. Parent–child agreement on QoL was moderate to strong across age groups. Results indicate that, in youth with OCD, QoL is reduced relative to healthy controls, related to OCD symptom severity per parent-report, and are strongly predicted by the presence of comorbid externalizing and internalizing symptoms.     

Agreement between youth-reported and parent-reported psychopathology in a referred sample

Objective  The study examined parent-youth agreement regarding reports on psychopathology among adolescents suffering from psychiatric disorders. Method  A total of 1,718 patients between the age of 11 and 18, as well as their parents, were assessed using the child behavior checklist (CBCL), and the youth self-report (YSR). Results  Poor to low agreement between parent- and adolescent-reported problem behavior on the internalizing scale, the total problem scale and moderate agreement concerning the externalizing scale of the CBCL and the YSR were found. Independent from the amount of psychiatric diagnoses, adolescents reported significantly less behavioral problems than their parents. Concerning externalizing problems, parent-youth disagreement was stronger for patients suffering from comorbid psychiatric disorders, than for adolescents displaying only one psychiatric disorder. Conclusion  In clinically referred children, parents are likely to emphasize the severity of the difficulties, whereas adolescents’ under-report symptoms.