Biomedical subjects

Anna S Lau

Publications and source records attributed to Anna S Lau.

11 recordsLinked to original sources

PubMed2006

Abusive parents' reports of child behavior problems: relationship to observed parent-child interactions.

PURPOSE: We evaluated the hypothesis that abusive parents' reports may exaggerate rates of child behavior problems in a clinical sample. METHOD: The association between parental ratings of behavior problems and independent observations of child behaviors was examined in a sample of 205 clinic-referred families, 58 of which had a reported history of physical abuse. RESULTS: Relative to the comparison group, parents in the abuse group reported more externalizing problems in their children after controlling for parental psychopathology, and displayed more emotionally controlling and less supportive behavior during parent-child interactions. However, there was no association between abuse history and observed child behaviors during the interaction tasks. Abuse status significantly moderated the association between parent-reported externalizing behaviors and observed demanding behavior by the child; the association was significant among comparison families, but not in the abuse group families. CONCLUSIONS: Results indicate that abusive parents may over-report externalizing behavior problems in their children.

Adolescent↗

PubMed2006

Racial variation in self-labeled child abuse and associated internalizing symptoms among adolescents who are high risk.

One thousand and ten Non-Hispanic White, African American, Hispanic, and Asian Pacific Islander youth who were high risk and receiving public sector services were interviewed regarding history of child emotional and physical abuse and current internalizing symptoms. The study examined whether race moderated the association between adolescents' reports of specific parent behaviors and their self-labeling as victims of abuse. The study also examined whether reports of parental behaviors or self-labeled abuse better predicted internalizing symptoms, and whether these associations differed by race. When reporting punitive parent behavior, Non-Hispanic White youth were more likely to describe themselves as abused compared to Asian Pacific Islanders. Reported punitive parental behaviors accounted for more variance in internalizing symptoms than did self-labeled abuse. Reports of parent behaviors were more strongly related to concurrent internalizing symptoms among ethnic minority youth than among Non-Hispanic White youth. Results are discussed in the context of cultural competence in identification of child abuse.

Adolescent↗

PubMed2005

What's in a name? A comparison of methods for classifying predominant type of maltreatment.

OBJECTIVE: The primary aim of the study was to identify a classification scheme, for determining the predominant type of maltreatment in a child's history that best predicts differences in developmental outcomes. METHOD: Three different predominant type classification schemes were examined in a sample of 519 children with a history of alleged maltreatment. Cases were classified into predominant maltreatment types according to three different schemes: Hierarchical regression analyses examined whether the HT, SFT, and EHT type classifications contributed to prediction of child behavior problems, trauma symptoms and adaptive functioning. RESULTS: After controlling for demographic factors, the HT definitions predicted four outcomes, while the SFT definitions predicted three, and the EHT classifications contributed to the prediction of five child outcomes. The co-occurrence of multiple types of maltreatment was robustly related to outcomes. However, the HT and SFT classifications predicted outcomes even after accounting for the co-occurrence of multiple maltreatment subtypes. CONCLUSION: A classification scheme that differentiates between type combinations and single maltreatment types may have the greatest predictive validity. Over and above knowing about co-occurrence of maltreatment sub-types, it is important to understand what type, or constellation of types, of maltreatment have been alleged in a child's history.

Child↗

PubMed2005

Defining maltreatment according to substantiation: distinction without a difference?

OBJECTIVE: To examine whether children with substantiated maltreatment reports between 4 and 8 years of age differ from children with unsubstantiated reports on any of 10 behavioral and developmental outcomes. METHOD: Longitudinal data from 806 children and their adult caregivers collected in four US study sites were pooled and analyzed using Analysis of Variance (ANOVA) and multivariate linear regression. RESULTS: There were no significant differences between the mean scores of children with unsubstantiated and substantiated maltreatment reports filed between 4 and 8 years of age for any of the 10 behavioral and developmental outcomes. In the multivariate analysis, substantiation status was not significantly associated with any of the 10 outcomes after adjusting for prior functioning, prior maltreatment status, and sociodemographic characteristics. Findings from within-site analyses were generally consistent with the pooled analyses in finding no association between substantiation status and the outcomes examined. CONCLUSIONS: In this high-risk sample, the behavioral and developmental outcomes of 8-year-old children with unsubstantiated and substantiated maltreatment reports filed between ages 4 and 8 were indistinguishable. Future research should attempt to replicate these findings on probability samples that represent the full range of childhood maltreatment risk and with models that control for the impact of social services.

Analysis of Variance↗

PubMed2005

The acculturation gap-distress hypothesis among high-risk Mexican American families.

The authors tested the acculturation gap-distress hypothesis by examining whether parent-adolescent acculturation gaps were associated with greater conflict and youth conduct problems among 260 high-risk Mexican American families. The authors operationalized acculturation gaps in 2 ways: parent-youth mismatches in acculturation style, and parent-youth discrepancies in acculturation toward both mainstream and heritage cultures. Acculturation gaps were common, but results of hierarchical regression analyses indicated that parent-youth discrepancies in acculturation toward mainstream and heritage cultures were not related to increased conflict or youth conduct problems. Conduct problems were no higher in families in which the adolescent was more aligned with mainstream culture than the parent. Unexpectedly, the authors found more youth conduct problems in families in which the youth was more aligned with traditional culture than the parent. The results call into question the assumption that the more rapid acculturation of adolescents to American culture inevitably leads to distress in minority families.

Acculturation↗

PubMed2005

Racial and ethnic differences in utilization of mental health services among high-risk youths.

OBJECTIVE: Racial and ethnic disparities in mental health service use have been identified as a major public health problem. However, the extent to which these disparities may be accounted for by other confounding sociodemographic or clinical predictors of service use (e.g., family income, functional impairment, caregiver strain) is relatively unexplored, especially for youth services. The goal of this study was to test for racial/ethnic disparities in use of a variety of outpatient, inpatient, and informal mental health services among high-risk youths, with the effects of other predictive factors controlled. METHOD: Participants were 1,256 youths ages 6-18 years who received services in a large, publicly funded system of care (including the child welfare, juvenile justice, special education, alcohol and drug abuse, and mental health service sectors). Youths and caregivers were interviewed with established measures of mental health service use, psychiatric diagnoses, functional impairment, caregiver strain, and parental depression. RESULTS: Significant racial/ethnic group differences in likelihood of receiving any mental health service and, specifically, formal outpatient services were found after the effects of potentially confounding variables were controlled. Race/ethnicity did not exert a significant effect on the use of informal or 24-hour-care services. CONCLUSIONS: Racial/ethnic disparities in service use remain a public health problem.

Adolescent↗

PubMed2004

Parent-child interactions in relation to critical and emotionally overinvolved expressed emotion (EE): is EE a proxy for behavior?

Expressed emotion measures, encompassing dimensions of criticism (CRIT), and emotional overinvolvement (EOI) are increasingly being used to assess the parent-child relationship in child clinical populations, despite the lack of studies assessing their validity. We examined the correspondence between CRIT, EOI, and parent-child interactions as observed by neutral coders in a sample of 252 clinic-referred children and adolescents, ages 7-17 years. We found support for the validity of the CRIT code, with high critical parents showing more antagonism, negativity, disgust, harshness, and less responsiveness, compared to parents who scored in the low or borderline ranges. In contrast, none of the observed behaviors were found to correspond with parental EOI, suggesting either that this construct lacks validity with juvenile samples or that behaviors that correspond to EOI are difficult to observe. We conclude that high parental CRIT can be used as an index of problematic parent-child interactions.

Adolescent↗

PubMed2003

Going home: the complex effects of reunification on internalizing problems among children in foster care.

When children in fostercare are reunified with their families of origin they encounter changes that may influence their well-being in both positive and negative ways. We examined the effects of reunification among 218 children in foster care to test an integrative model of the effects of reunification using structural equation modeling. We hypothesized that reunification would exert indirect effects on subsequent child adjustment via changes in adverse life events, perceived social isolation, and mental health service utilization. Results indicated no direct effect of reunification on subsequent internalizing problems, but reunification was related to increased adverse life events that, in turn, were related to elevated symptoms. Second, reunification was negatively associated with mental health service use. Finally, reunification was associated with decreased child perceptions of social isolation. In summary, reunification with biological parents is associated with multiple environmental changes, with most but not all effects indicating negative consequences.

Adolescent↗

PubMed2003

Reported maltreatment among clinic-referred children: implications for presenting problems, treatment attrition, and long-term outcomes.

OBJECTIVE: To examine the treatment implications of a reported history of maltreatment in a sample of 343 children referred to Los Angeles area mental health clinics for emotional and behavioral problems. METHOD: Child Protective Service records identified 161 of the 343 families as having a documented history of maltreatment. Parent reports of child behavior problems were obtained following clinic intake and at 2-year follow-up, and attrition was assessed via medical records. The authors examined the associations between a history of maltreatment and severity of child presenting problems, treatment attrition, and long-term mental health outcomes. RESULTS: Compared to other clinic-referred children, youngsters with a history of maltreatment entered treatment with more externalizing behavior problems, were more likely to exit treatment early and without therapist consent, and continued to show greater externalizing problems 2 years later. CONCLUSIONS: Maltreated children have significant mental health needs that may not be well addressed currently in community mental health clinics.

Anxiety↗

PubMed2003

Race/Ethnicity and rates of self-reported maltreatment among high-risk youth in public sectors of care.

This study examined rates of youth-reported maltreatment history and the association between youth-reported maltreatment and foster care history across four racial/ethnic groups in a public system of care. Interviews were conducted with 1,045 youth (European Americans, African Americans, Hispanic Americans, and Asian Pacific Islanders) and their primary caregivers, sampled from one of five service sectors (alcohol/drug services, child welfare, juvenilejustice, mental health, and special education) in San Diego. Overall, racial/ethnic differences in youth-reported maltreatment were minimal. However, in the child welfare sector, African American youth self-reported maltreatment less frequently than other youth. There were significant racial/ethnic differences in foster care history, with African Americans far more likely to have been placed, even after controlling for youth-reported maltreatment, income, age, and gender. Furthermore, maltreatment history was associated with placement for all youth except African Americans. These results suggest that the overrepresentation of minority children in child welfare does not stem from greater rates of maltreatment.

Adolescent↗

PubMed2002

Correlates of suicidal behaviors among Asian American outpatient youths.

Medical record abstraction was conducted at an ethnic-specific mental health outpatient clinic to identify correlates of suicidal behaviors in a sample of 285 Asian American youths. Some risk factors, such as parent-child conflict and age, which have been associated with suicidality in majority group youths, predicted suicidality in this sample, whereas other risk factors, such as gender, did not generalize to this sample. Acculturation interacted with the risk factor of parent-child conflict to predict suicidality. Less acculturated Asian youths were at proportionally greater risk for suicidality under conditions of high parent-child conflict than were their more acculturated counterparts. This finding underscores the importance of culture as a context for determining the relevance of stressors for potentiating psychopathology.

Adolescent↗