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Marital discord and child behavior problems: a meta-analysis.

The relation of marital discord to the behavior problems of children was examined through a meta-analysis of the results of prior research. The sample comprised all published studies through 1988 that met criteria for the meta-analysis and that could be located through a combined computer and hand search of the literature. Marital discord included conflict, disharmony, and lack of agreement between currently married parents. Child behavior problems were defined as conduct problems, excluding internalized difficulties, such as anxiety. Four hypotheses were drawn from recent reviews of studies on this topic: The relation between marital conflict and child behavior problems will be (1) positive overall and will be stronger (2) for boys than for girls, (3) for cases based entirely on parent self-report data than for cases involving external sources of data, (4) for clinic than for nonclinic families. Results supported the first three hypotheses. Little evidence was found for an association between marital conflict and the behavior problems of girls. Findings are discussed in terms of their methodological and theoretical implications and in relation to a recent review of research on sex differences in children's reactions to divorce.

Child↗

Comparing parent and teacher ratings of social competence and problem behaviors.

A comparison between parent and teacher ratings of 109 school children on the French version of the Nisonger Child Behavior Rating Form, which measures social competence and problem behaviors of children with developmental disabilities, was conducted. Results indicated no significant differences between parent and teacher ratings on the two social competence subscales and two problem behavior subscales. Ratings differed significantly on three problem behavior subscales: (a) Conduct Problem, (b) Insecure/Anxious, and (c) Hyperactive. These results may be indicative of complementary information according to the context (home vs. school). Also, results support the premise that it is important to collect information from multiple sources in order to obtain a complete and global assessment of the child's problem behavior/psychopathology.

Adolescent↗

Menstrual discomfort as a biological setting event for severe problem behavior: assessment and intervention.

Assessment and intervention approaches for problem behavior need to be extended to deal with biological setting events. To meet assessment needs, we developed a strategy involving four components: interview, archival record review, direct observation, and functional analysis. Data indicated that problem behaviors (aggression, self-injury, and tantrums) were linked to both a biological setting event (menstrual discomfort) and certain discriminative stimuli (task demands). To meet intervention needs, we developed a multicomponent strategy that addressed both the biological context (menstrual discomfort) and the psychosocial context (task demands). Intervention reduced problem behaviors to near-zero levels, maintained for 15 to 22 months across 3 participants. We discuss the extension of our approach to other biological setting events as well as multiple motivational variables.

Adolescent↗

Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents.

PURPOSE: To examine the relationship between body mass index (BMI), body weight perception (BWP), and indicators of internalizing and externalizing distress and social, attention and thought problems in a large representative sample of Dutch youth. METHODS: A total of 1826 pupils in the eighth grade of primary education and 5730 students in the first four years of secondary education gave their height and weight to obtain an estimate of their BMI. They reported their evaluation of their body weight and completed Achenbach's Youth Self-Report (YSR) (1991), which assesses eight types of problem behavior. Data were analyzed in a multivariate framework with BMI and BWP as predictors and the YSR scores on different kinds of problem behavior as dependent variables, controlling for background characteristics. RESULTS: Both BMI and BWP are associated with internalizing and externalizing problem behavior, and social, attention and thought problems. Multivariate tests show that BWP is more closely linked to problem behavior than BMI. Adolescents who were either underweight or overweight but considered themselves in good shape had no more problems than the group with normal BMI and BWP 'good'. The perception of being 'too thin' and particularly the perception of being 'too heavy' best predict problem behavior in both male and female adolescents. Overweight youngsters with an adequate perception of their weight have less somatic complaints than their normal-weight peers who perceive themselves as too heavy, but they show higher withdrawnness, social problems, and anxiety/depression. CONCLUSIONS: Adolescent girls are more dissatisfied with their weight than boys; however, the relationship between weight perception and problem behavior is the same for both genders.

Adolescent↗

The comorbidities of adolescent problem behaviors: a latent class model.

The correlations and comorbidities of a series of adolescent problem behaviors were studied in a sample of 739 New Zealand 15-year-olds. This analysis revealed the presence of strong comorbidities between different problem behaviors. The data were modeled using methods of unrestricted latent class analysis and this suggested that the best fitting model to describe the data was one which assumed that adolescent problem behaviors were described by four general classes of children. While the same general four-class model applied to males and females, there were marked gender differences in the rates of problems. Specifically, the predominant problem behaviors in females were those relating to an accelerated transition to adulthood marked by early sexual activity, alcohol abuse, and cannabis use whereas the predominant problems for boys were related to antisocial and law-breaking behaviors. Rates of children with no problems (85%) and with multiple problems (3%) were similar for boys and girls.

Adolescent↗

Behavioral problems and the effects of early intervention on eight-year-old children with learning disabilities.

OBJECTIVES: 1) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children. 2) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities (LD). METHODS: This is a secondary data analysis of the Infant Health and Development Program (IHDP), a randomized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature. The findings are based on a prospective follow-up of these children at 8 years of age. RESULTS: Compared to children without verbal LD (VLD), those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89% more likely to exhibit externalizing behavior problems. Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors, as well as an increased likelihood of attention problems among children with VLD. No significant association was found between nonverbal LD (NVLD) and any type of behavior problem. Furthermore, there was a significant interaction between VLD and the intervention, in which the odds of internalizing behavior problems were greater among children with VLD. No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD. CONCLUSIONS: These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children.

Child↗

Linking extreme marital discord, child rearing, and child behavior problems: evidence from battered women.

Relations between marital discord, parental behavior, and child behavior were investigated in a sample of 37 battered women and 37 comparison mothers and their children, aged 2-8 years. It was hypothesized that violent fathers would be more irritable but less involved, battered women more stressed and inconsistent in discipline, and both parents would reportedly use fewer positive and more negative child-rearing responses than comparison families. Based on maternal self-reports and mother-child observations, the only robust self-report difference between the groups of mothers were the level of stress and reports of inconsistency in parenting; in contrast, all of the expected differences were found between the mothers' reports of the 2 groups of fathers. Group effects on child behavior problems were also found. Children from violent families were reported to have more internalizing behavior problems, more difficult temperaments, and to be more aggressive than the comparison children. In the violent families, maternal stress and paternal irritability were the 2 significant predictors of child behavior problems, whereas in the comparison families only maternal stress was a reliable predictor.

Adult↗

The relationship between manic symptoms on the DASH II and YMRS and feeding/mealtime behavior problems.

This study represents the first to assess whether a relationship between manic symptoms and feeding/mealtime behavior problems exists in individuals with ID. Participants were compared across three groups (manic, non-manic psychiatrically impaired, and controls) on the diagnostic assessment for the severely handicapped-revised (DASH-II) and young mania rating scale (YMRS) and items of the screening tool of feeding problems (STEP). Individuals in the manic group exhibited clinically significant symptoms of mania (n=18), those in the non-manic psychiatrically impaired group exhibited symptoms of psychopathology other than mania (n=18), and those in the control group did not exhibit symptoms of mania or any other psychopathology (n=18). Significant differences were found across the groups for a number of items. Specifically, individuals exhibiting symptoms of mania were significantly more likely to 'continue to eat as long as food was available', 'to require special positioning during feeding, and 'to engage in problem behaviors during mealtime (e.g., aggression)'. These individuals were also significantly less likely to 'eat foods of only certain textures'. Implications of these data are discussed.

Adult↗

Predicting behavior problems in children with epilepsy: child factors, disease factors, family stress, and child-mother interaction.

This study examines the relative role of parent-child relationships, family stress, and disease factors in predicting behavior problems in children with epilepsy. It extends existing literature on parent-child relationships and behavior problems by examining children with biological risk. Child-mother interaction was observed for 51 children with epilepsy ages 7-13 years and related to teacher- and parent-reported behavior problems. Child's self-reliance correlated with parent-reported problems; expression of affect related to teacher-reported externalizing problems. A child self-reliance factor accounted for behavior problems after partialing age, gender, IQ, epilepsy variables, and family stress. The term child gender x quality of mother-child interaction predicted teacher-reported externalizing problems, with mother-child interaction correlated with behavior problems for boys. Child-parent relationships predict the development of behavior problems over and above the influence of disease-related factors, even for children at considerable biological risk.

Adolescent↗

Antecedents and behavior-problem outcomes of parental monitoring and psychological control in early adolescence.

The early childhood antecedents and behavior-problem correlates of monitoring and psychological control were examined in this prospective, longitudinal, multi-informant study. Parenting data were collected during home visit interviews with 440 mothers and their 13-year-old children. Behavior problems (anxiety/depression and delinquent behavior) were assessed via mother, teacher, and/or adolescent reports at ages 8 through 10 years and again at ages 13 through 14. Home-interview data collected at age 5 years were used to measure antecedent parenting (harsh/reactive, positive/proactive), family background (e.g., socioeconomic status), and mother-rated child behavior problems. Consistent with expectation, monitoring was anteceded by a proactive parenting style and by advantageous family-ecological characteristics, and psychological control was anteceded by harsh parenting and by mothers' earlier reports of child externalizing problems. Consistent with prior research, monitoring was associated with fewer delinquent behavior problems. Links between psychological control and adjustment were more complex: High levels of psychological control were associated with more delinquent problems for girls and for teens who were low in preadolescent delinquent problems, and with more anxiety/depression for girls and for teens who were high in preadolescent anxiety/depression.

Adolescent↗

Sleep and behavior problems among preschoolers.

This study described the relationship between amount of sleep and behavior problems among preschoolers. Participants were 510 children aged 2 to 5 years who were enrolled through 68 private pediatric practices. Parents reported on the amount of sleep their child obtained at night and in 24-hour periods. With demographic variables controlled, regression models were used to determine whether sleep was associated with behavior problems. The relationship between less sleep at night and the presence of a DSM-III-R psychiatric diagnosis was significant (odds ratio = 1.23, p = .026). Less night sleep (p < .0001) and less sleep in a 24-hour period (p < .004) were associated with increased total behavior problems on the Child Behavior Checklist; less night sleep (p < .0002) and less 24-hour sleep (p < .004) were also associated with more externalizing problems on that measure. Further research is needed to ascertain whether sleep is playing a causal role in the increase of behavior problems.

Child Behavior Disorders↗

A prospective study of the relationship over time of behavior problems, intellectual functioning, and family functioning in children with sickle cell disease: a report from the Cooperative Study of Sickle Cell Disease.

OBJECTIVE: To longitudinally assess the relationship of behavioral problems, intellectual functioning, and family functioning in children with sickle cell disease (SCD). METHOD: The study sample included 222 children enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD). The study protocol included intellectual evaluation and brain magnetic resonance imaging (MRI) of the children, and mothers completed the Child Behavior Checklist and Family Environment Scale. At least two complete sets of measures were obtained across four assessment points over the study period of 9 years. RESULTS: Intellectual functioning declined, but family functioning and behavior problem scores did not change significantly. Consistent behavior problems were reported by mothers for 9% of the children. The risk of consistent behavior problems was not related to MRI classification, gender, education level of mother, or age of the child but significantly increased with higher baseline levels of family conflict and decreased with higher baseline full-scale IQ. An increase in behavior problems was associated with an increase in family conflict. CONCLUSIONS: Maternal appraisal of family conflict is a risk factor for the small subgroup of children with SCD with consistent mother-reported behavior problems and a salient intervention target for fostering adaptation.

Adaptation, Psychological↗

Evaluation of the All Stars character education and problem behavior prevention program: effects on mediator and outcome variables for middle school students.

The effects of All Stars, a character education and problem behavior prevention program, on variables theorized to mediate problem behaviors and on the problem behavior variables of substance use, sexual behavior, and violence among middle school students are reported. In an independent, randomized, single-cohort, longitudinal evaluation of the program, 1,655 students completed pretest, posttest, and 1-year follow-up surveys measuring demographics, mediating variables, and behavioral outcome variables. Results indicate that the All Stars program, when administered by teachers, had an immediate effect on mediating variables that did not persist over time. Inclusion of ethnicity in the design showed that the program, when administered by specialists, had delayed effects on mediating variables for African American and Hispanic students. However, no consistent effects were found for student problem behaviors in either condition. Implications for prevention practice and directions for future research are discussed.

Adolescent↗

The relations between emotional understanding, intellectual functioning, and disruptive behavior problems in elementary-school-aged children.

This study examined individual differences in children's emotional understanding and behavioral adjustment. Participants included 220 first- and second-grade children (75% regular education, 25% special education) who were individually interviewed using the Kusche Affective Interview--Revised. Dependent measures of emotional understanding and experience included the ability to provide personal examples of 10 different emotions and the cues used for recognition of five emotions in oneself and other persons. Children were also administered the WISC-R Vocabulary, Block Design, and Coding subtests. One parent independently completed an Achenbach Child Behavior Checklist for each child. Results indicated that children who were rated as higher in behavior problems showed deficits in emotional understanding. Intellectual functioning was negatively associated with behavior problems and attenuated the effects of behavior problems on emotional understanding. Implications of the current findings for prevention and treatment programs for children with behavior problems are discussed.

Awareness↗

Tics and problem behaviors in schoolchildren: prevalence, characterization, and associations.

OBJECTIVE: Tic disorders are the most common movement disorder diagnosed in children and have symptoms that fluctuate in frequency and intensity over time. We conducted an 8-month longitudinal observational study to determine the variations in frequency of motor tics and associated problem behaviors. METHODS: A total of 553 children, kindergarten through sixth grade, were observed monthly from November 1999 to June 2000 by 3 raters. Motor tics were recorded by location and rated for severity as none (0), mild (1), moderate (2), or severe (3). Problem behaviors were rated as absent (0), subclinical (1), or clinical (2) in each of 6 categories: disruptive, hyperactive, impulsive, aggressive, anxious, and distracted. RESULTS: The monthly point prevalence of motor tics ranged from 3.2% to 9.6%, with an overall frequency of 24.4%. The monthly point prevalence of problem behaviors ranged from 2.6% to 11.0%, with an overall frequency of 25.7%. The incidence of motor tics and problem behaviors was significantly higher during the winter months of November through February, compared with the spring months of March through June (motor tics: z = 4.97; problem behaviors: z = 3.79). Motor tics were observed in 2 distinct patterns (isolated and persistent), which varied by the number of months present, gender ratio of affected children, severity of tic symptoms, and association with problem behaviors. CONCLUSIONS: Motor tics and problem behaviors are frequent occurrences among schoolchildren and seem to occur more frequently during the winter months. For most children, the tics were mild, observed on only 1 occasion, and were not accompanied by problem behaviors.

Child↗

Classroom intervention for illness-related problem behavior in children with developmental disabilities.

There is growing evidence of an association between physical illness and problem behavior in children with developmental disabilities. Such behavior can compromise school performance. Therefore, the purpose of the present study was to evaluate, using a group design, the effectiveness of medical intervention alone (N = 11) versus behavioral plus medical intervention (N = 10) for illness-related problem behavior in a school setting. Following intervention, the behavioral plus medical intervention group showed lower levels of problem behavior and completed more academic tasks than did the medical intervention alone group. The results are discussed with respect to the concept of illness and pain as a setting event for problem behavior. The need for research to develop algorithms that allow one to select the best combination of medical and behavioral interventions for specific illnesses and contexts is noted.

Autistic Disorder↗

Emotional autonomy and problem behavior among Chinese adolescents.

The author examined the association between emotional autonomy and problem behavior among Chinese adolescents living in Hong Kong. The respondents were 512 adolescents, 16 to 18 years of age, who were interviewed for a cross-sectional study. Three dimensions of emotional autonomy including individuation, nondependency on parents, and de-idealization of parents were significantly and positively correlated with the amount of problem behavior the participants engaged in during the past 6 months. Using a simple linear multiple regression model, the author found that problem behavior was associated with only one aspect of emotional autonomy-individuation. Results indicated that the relationship between problem behavior and three aspects of emotional autonomy was similar in both individualistic and collectivistic societies.

Adolescent↗

Externalizing problem behaviors and headache: a follow-up study of adolescent Finnish twins.

OBJECTIVE: To examine the association of teacher- and parent-rated behavior with headache in a prospective follow-up study of adolescent Finnish twins. METHODS: Questionnaire data were collected during 1995-2001 from a nationwide sample of Finnish families of 11-year-old twins who were born 1983-1987 (n = 5393) and again at age of 14. Psychological factors were measured by using parents' and teachers' ratings of a 37-item multidimensional rating instrument at the ages of 11 and 14. RESULTS: At age 11, headache frequency (5 categories) was associated with total scales of externalizing and internalizing problem behaviors and adaptive behaviors, assessed by parents, but only with externalizing problem behaviors assessed by teachers. Results were similar at age 14. The incidence of at least monthly headache between the ages of 11 and 14 years was predicted by externalizing problem behaviors and 2 subscales of adaptive behaviors: constructiveness and poor compliance. In twin pairs discordant for headache, externalizing and internalizing problem behaviors were more common among headache sufferers than among headache-nonsufferers. Headache-discordant monozygotic co-twins confirmed the association of externalizing problem behaviors with headache. CONCLUSIONS: The frequency of adolescents' headache is predicted by psychological factors, especially by externalizing problem behaviors. This seems to be independent of genetic or familial influences on behavior and headache. Behavioral problems may be a sign of worsening of headache or vice versa.

Adolescent↗