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PubMed2000

Parental history of alcoholism and problem behaviors in Native-American children and adolescents.

BACKGROUND: A positive family history of alcoholism is one of the most consistent and powerful predictors of a person's risk for developing this disorder. This finding has stimulated much research on etiological vulnerability factors and mechanisms by which children of alcoholic parents are at high risk for developing alcohol-related problems. In primarily Euro-American samples, parental alcoholism has been associated with a variety of negative outcomes for children and adolescents, including problematic behavior. Native-American Indians, in addition to high rates of alcoholism and alcohol-related mortality, have the highest prevalence of a positive family history for alcoholism of all ethnic groups in the United States. METHODS: This study used the Achenbach Child Behavior Checklist (CBCL) to evaluate behavioral problems in 96 Mission Indian children and adolescents based on the presence or absence of parental alcohol dependence and sex of the offspring. RESULTS: Consistent with previous research, results indicated a high prevalence of a positive family history of alcoholism in these Native-American youths. Seventy-four percent of the offspring had either one or both parents with alcohol dependence (children of alcoholics). Only 7% had no first- or second-degree alcoholic relatives. Results indicated that sons of alcoholics scored significantly higher on the Total Behavior Problem scale, as well as the Internalizing and Externalizing scales, of the CBCL than sons of nonalcoholics, whereas there were no significant differences in CBCL scores between daughters of alcoholics and daughters of nonalcoholics. It is noteworthy that scores on the CBCL for Mission Indian children of alcoholics were comparable to scores in the published literature of children of alcoholics of other ethnicities. In addition, a relatively low percentage of youths were identified with significant levels of behavioral problems. CONCLUSIONS: These findings suggest that sons of alcoholics of Mission Indian heritage experience more problems than sons of nonalcoholics, but also suggest that Mission Indian children of alcoholics are not more vulnerable to behavioral problems than children of alcoholic parents of other ethnic backgrounds.

Adolescent↗
PubMedDate not supplied

Impact of a psychoeducational intervention on caregiver response to behavioral problems.

BACKGROUND: Eighty percent of persons with Alzheimer's disease and related disorders are cared for by family members who often lack adequate support and training for this all-consuming job. OBJECTIVE: To evaluate the efficacy of a longitudinal, multisite, community-based intervention designed to teach home caregivers to manage behavioral problems in persons with Alzheimer's disease. METHODS: Usable data were analyzed from 237 caregiver/care recipient dyads (n = 132 Experimental; n = 105 Comparison). The experimental group received a psychoeducational nursing intervention that was conceptually grounded in the Progressively Lowered Stress Threshold model (Hall & Buckwalter, 1987). The comparison group received routine information and referrals for case management, community-based services, and support groups. Although a variety of psychosocial outcomes were compared between caregivers in the two groups, this article focuses on frequency and response to behavioral problems and functional decline. RESULTS: The Progressively Lowered Stress Threshold intervention had a statistically significant effect on spousal response to memory/behavioral problems (p <.01) for all caregivers and on response to activities of daily living problems (p <.01) for spousal caregivers. In addition, nonspouses in the experimental group reported a reduction in the frequency of memory/behavioral problems (p <.01). No intervention effect on reports of activities of daily living frequencies was found for either spouses or nonspouses. CONCLUSIONS: This Progressively Lowered Stress Threshold-based intervention had a positive impact on both the frequency of and response to problem behaviors among spousal caregivers.

Activities of Daily Living↗
PubMed2006

Cognitive-behavioral treatment for specific phobias with a child demonstrating severe problem behavior and developmental delays.

Cognitive-behavioral treatments (CBTs) are widely used for anxiety disorders in typically developing children; however, there has been no previous attempt to administer CBT for specific phobia (in this case study, one-session treatment) to developmentally or intellectually disabled children. This case study integrates both cognitive-behavioral and behavior analytic assessment techniques in the CBT of water and height phobia in a 7-year-old male with developmental delays and severe behavior problems. One-session treatment [Ost, L. G. (1989). One-session treatment for specific phobias. Behaviour Research and Therapy, 27, 1-7; Ost, L. G. (1997). Rapid treatment of specific phobias. In G. C. L. Davey (Ed.), Phobias: A handbook of theory, research, and treatment (pp. 227-247). New York: Wiley] was provided for water phobia and then 2 months later for height phobia. The massed exposure therapy sessions combined graduated in vivo exposure, participant modeling, cognitive challenges, reinforcement, and other techniques. Both indirect and direct observation measures were utilized to evaluate treatment efficacy. Results suggested CBT reduced or eliminated behavioral avoidance, specific phobia symptoms, and subjective fear. Negative vocalizations were reduced during height exposure following treatment. Vocalizations following treatment for water phobia were less clear and may have been indicative of typical 7-year-old protests during bath time. Findings indicate CBT can be effective for treating clinical fears in an individual with developmental disabilities and severe behavior. Future research in this population should examine CBT as an alternative to other techniques (e.g., forced exposure) for treating fears.

Child↗
PubMed2005

Preschooler witnesses of marital violence: predictors and mediators of child behavior problems.

This paper describes a conceptual approach to understanding the impact of marital violence on preschoolers, examines the predictors and mediators of child behavioral problems in a clinical sample of multiethnic preschoolers who witnessed their mothers' battering by their father figure, and presents empirical evidence supporting the use of relationship-based therapeutic modalities in treating preschoolers exposed to violence. We find that exposure to violence and maternal life stress are each predictive of child behavior problems, and that the impact of maternal life stress on child behavior problems is mediated by maternal psychopathology and the quality of the mother-child relationship.

Child Behavior Disorders↗
PubMedDate not supplied

Prenatal cocaine exposure: an examination of childhood externalizing and internalizing behavior problems at age 7 years.

AIM: This study examines the relationship between prenatal cocaine exposure and parent-reported child behavior problems at age 7 years. METHODS: Data are from 407 African-American children (210 cocaine-exposed, 197 non-cocaine-exposed) enrolled prospectively at birth in a longitudinal study on the neurodevelopmental consequences of in utero exposure to cocaine. Prenatal cocaine exposure was assessed at delivery through maternal self-report and bioassays (maternal and infant urine and infant meconium). The Achenbach Child Behavior Checklist (CBCL), a measure of childhood externalizing and internalizing behavior problems, was completed by the child's current primary caregiver during an assessment visit scheduled when the child was seven years old. RESULTS: Structural equation and GLM/GEE models disclosed no association linking prenatal cocaine exposure status or level of cocaine exposure to child behavior (CBCL Externalizing and Internalizing scores or the eight CBCL subscale scores). CONCLUSIONS: This evidence, based on standardized ratings by the current primary caregiver, fails to support hypothesized cocaine-associated behavioral problems in school-aged children with in utero cocaine exposure. A next step in this line of research is to secure standardized ratings from other informants (e.g., teachers, youth self-report).

Adult↗
PubMed1982

The Houston Parent--Child Development Center and the primary prevention of behavior problems in young children.

This study reports the effectiveness of the Houston Parent--Child Development Center (PCDC) program for preventing behavior problems in young children. The PCDC is a 2-year, intensive parent-child education program for children 1-3 and their parents. Low-income Mexican American families were randomly assigned to program or control groups. A follow-up of the program 1-4 years later, when children averaged 5 1/2 years of age, was carried out with 128 mothers who were interviewed about behavior problems of their children. A MANCOVA showed main effects for group and sex as well as a group by sex interaction. The principle result was that control boys were more destructive, overactive, negative attention-seeking, and less emotionally sensitive than program boys and girls and control girls. The program is seen as an effective primary prevention approach to behavior problems. Prior evaluations have shown that it also enhances children's cognitive skills. Other parent--child education programs should be examined as approaches to primary prevention.

Child↗
PubMed1998

The effect of sex hormone replacement therapy on behavior problems and moods in adolescents with delayed puberty.

OBJECTIVE: The objective of this clinical study was to determine the effects of sex steroids on behavior and mood in adolescents with hypogonadism. STUDY DESIGN: The experimental design consisted of a randomized, double-blind, placebo-controlled, crossover trial lasting for 21 months. The study group consisted of 39 boys and 16 girls recruited from a pediatric endocrine clinic for delayed puberty. Depo-testosterone (to boys) or conjugated estrogens (to girls) was administered in 3-month blocks, alternating with placebo, at 3 dose levels approximating early, middle, and late pubertal amounts. The Child Behavior Checklist, Youth Self Report, Differential Emotion Scale, and Daily Mood Diary were administered after each placebo and treatment period to ascertain the effect of sex steroids on self- and parent-reported behavior problems and moods. RESULTS: The data demonstrated only one significant treatment effect, namely, an increase in withdrawn behavior problems during administration of low-dose estrogen in girls. There were no consistent sex differences. CONCLUSION: These results demonstrate that administered testosterone or estrogen has minimal effects on behavior problems or mood in adolescents.

Adolescent↗
PubMed2006

Behavior problems among inner-city children with asthma: findings from a community-based sample.

OBJECTIVE: Previous studies have suggested a relationship between childhood asthma and behavior problems. However, few studies have used community-based samples to assess the prevalence of behavior problems among urban children with asthma symptoms. The objective of this study was to evaluate the relationship between asthma symptoms and behavior among a population-based sample of inner-city children and to determine the prevalence of behavioral comorbidity among children with asthma symptoms. METHODS: In 2003, parents of children who were entering kindergarten in the city of Rochester completed a detailed survey regarding the child's background, medical history (with specific questions about asthma symptoms), and behavior. We compared children with no asthma symptoms, intermittent symptoms, and persistent symptoms with regard to positive peer social skills (eg, makes friends easily), negative peer social skills (eg, fights with other children), task orientation (eg, concentrates well), and shy/anxious behavior (eg, is withdrawn) (validated scales; range: 1-4). We used multivariate regression to determine the independent association between symptom severity and behavioral outcomes. RESULTS: A total of 1619 children were included (response rate: 80%; mean age: 5.1 year), and 15% had asthma symptoms (8% persistent, 7% intermittent). Average negative peer scores were worse for children with persistent asthma symptoms compared with children with intermittent and no symptoms (mean scores: 1.88, 1.70, and 1.65). Children with persistent symptoms also scored worse than children with no symptoms on the assessment of task orientation (2.85 vs 3.03) and shy/anxious behavior (2.11 vs 1.89). Among children with persistent asthma symptoms, >20% scored >1 SD below average on 2 or more scales, compared with 16% of children with intermittent symptoms and 10% with no symptoms. CONCLUSIONS: Urban children with persistent asthma symptoms demonstrate more behavior problems across several domains compared with children with no symptoms. These findings suggest a clear need for an early biopsychosocial approach to care for vulnerable children with asthma.

Asthma↗
PubMed2004

Malnutrition at age 3 years and externalizing behavior problems at ages 8, 11, and 17 years.

OBJECTIVE: Poor nutrition is thought to predispose to externalizing behavior problems, but to date there appear to have been no prospective longitudinal studies testing this hypothesis. This study assessed whether 1) poor nutrition at age 3 years predisposes to antisocial behavior at ages 8, 11, and 17 years, 2) such relationships are independent of psychosocial adversity, and 3) IQ mediates the relationship between nutrition and externalizing behavior problems. METHOD: The participants were drawn from a birth cohort (N=1,795) in whom signs of malnutrition were assessed at age 3 years, cognitive measures were assessed at ages 3 and 11 years, and antisocial, aggressive, and hyperactive behavior was assessed at ages 8, 11, and 17 years. RESULTS: In relation to comparison subjects (N=1,206), the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. The results were independent of psychosocial adversity and were not moderated by gender. There was a dose-response relationship between degree of malnutrition and degree of externalizing behavior at ages 8 and 17. Low IQ mediated the link between malnutrition and externalizing behavior at ages 8 and 11. CONCLUSIONS: These results indicate that malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior.

Adolescent↗
PubMed2003

The Revised Memory and Behavior Problems Checklist--Nursing Home: instrument development and measurement of burden among certified nursing assistants.

Confirmatory factor analysis of the Revised Memory and Behavior Problems Checklist--Nursing Home (RMBPC) replicated the factor structure of the community-based RMBPC (L. Teri et al., 1992). The reliability of the total score was high as indexed by estimates of internal consistency (alpha = .95), test-retest reliability (r = .86), and interrater reliability between 2 interviewers (r = .88). Notably, the interrater reliability between 2 independent certified nursing assistants (CNAs) regarding residents' behavior problem frequency was more modest (r = .46), possibly reflecting the degree to which resident behaviors capture individual CNA's attention. This may have implications for the interpretation of data from the Minimum Data Set. CNAs reported moderately severe burden associated with behavior problems in 47% of residents under their care.

Adult↗
PubMed2002

Sibling collusion and problem behavior in early adolescence: toward a process model for family mutuality.

Sibling collusion is a process by which siblings form coalitions that promote deviance and undermine parenting. Collusive sibling processes were identified and measured using macro ratings of videotaped family interactions. Hypotheses were tested on a multiethnic sample of urban youth, with a target child identified as either "high risk" (n = 26) or "normative" (n = 26), and their families. Siblings in families with a high-risk target child showed reliably higher rates of collusion than those in families with a normative target child. Sibling collusion also accounted for variance in problem behavior after controlling for involvement with deviant peers. Findings suggest that deviant conduct forms a common ground among siblings, potentially amplifying risk of mutuality in problem behavior during early adolescence. These data also indicate that attention to sibling relationship processes is relevant to family interventions designed to mitigate the development of behavior problems.

Adolescent↗
PubMed2004

[The investigation of behavior problem with secondary deformity of cleft lip].

OBJECTIVE: To investigate the behaviors of the children suffered from the secondary deformity after the repair of the cleft lip. METHODS: With the application of the PCPI, eighty patients with the secondary deformity after the repair of the cleft lip were selected in this study and 134 normal children was used for the control. RESULTS: In the age between 6 and 11 years, there were no significant difference of the behaviors between the children suffered from secondary deformity of cleft lip and the normal children,but in the age from 12 to 16, the children with the deformity showed more behavior problems with the social withdraw and the poor social relationships, compared with the normal children. CONCLUSION: The children with the secondary deformity after cleft lip repair in adolescence could have the tendency to suffer from the behavior problems, especially showing the social withdraw and the poor social relationships.

Adolescent↗
PubMedDate not supplied

The Aberrant Behavior Checklist and the Behavior Problems Inventory: convergent and divergent validity.

This study was designed to compare and cross-validate two rating instruments [the Aberrant Behavior Checklist (ABC) and the Behavior Problems Inventory (BPI)] for assessing maladaptive behavior. The BPI assesses three types of behavior problems: Self-Injurious Behavior (SIB), Stereotyped Behavior and Aggressive/Destructive Behavior. The ABC assesses five domains including these three. We collected data on 226 adults, mostly with severe or profound mental retardation, from a medium-sized developmental center. Individuals with elevated BPI scores generally had higher ABC scores; however, the extent of covariation differed across subscales. Similarly, multiple regression analyses showed that BPI subscales significantly but selectively predicted ABC subscale scores. Measures of differential diagnostic value (positive and negative predictive power, sensitivity, specificity and overall correct diagnostic efficiency) confirmed the anticipated partial overlap between instruments. Both instruments were used to rate participants with and without a Diagnosis of Stereotyped Movement Disorder. BPI, SIB and Stereotypy subscale composite had stronger positive predictive power than the ABC Stereotypy scale, while the ABC had higher negative predictive power and greater overall diagnostic efficiency. Thus, the ABC and the BPI cross-validated one another where expected, and they diverged for subscales thought to have little relationship.

Adaptation, Psychological↗
PubMed2006

Behavioral family intervention for children with developmental disabilities and behavioral problems.

The outcomes of a randomized clinical trial of a new behavioral family intervention, Stepping Stones Triple P, for preschoolers with developmental and behavior problems are presented. Forty-eight children with developmental disabilities participated, 27 randomly allocated to an intervention group and 20 to a wait-list control group. Parents completed measures of parenting style and stress, and independent observers assessed parent-child interactions. The intervention was associated with fewer child behavior problems reported by mothers and independent observers, improved maternal and paternal parenting style, and decreased maternal stress. All effects were maintained at 6-month follow-up.

Australia↗
PubMed2003

Treating boys with low school achievement and behavior problems: comparison of two kinds of intervention.

Children with low school achievement frequently have behavior problems and interpersonal difficulties that pose a risk for psychosocial maladjustment. 39 boys were assessed and randomly assigned to one of two group treatment conditions: (a) interpersonal cognitive problem-solving for whom training was provided through oral and written language activities that met children's social and academic needs and (b) a language workshop, during which only academic difficulties were treated. Parents of children in both groups received group attention. Posttreatment assessments indicated that boys in both conditions showed significant improvements on school achievement and behavior problems, as they were measured by behavior scales reported by mothers and by an academic achievement test. Children in the problem-solving group improved significantly more than the other group on most measures. These results suggest that work with interpersonal cognitive problem-solving skills combined with reading and writing activities is a useful means to produce improvements in child behavior and school achievement.

Adolescent↗
PubMed2002

Sexual behavior problems in sexually abused children: a preliminary typology.

OBJECTIVE: The goal was to develop an empirically derived typology for sexually abused children exhibiting sexual behavior problems to assist practitioners in differential assessment, treatment, and case planning. METHOD: Data were systematically gathered from the clinical records of 100 sexually abused children, aged 3 years to 7 years, enrolled in two treatment programs. Twelve indexes were created corresponding to major areas of child and family history, functioning, and treatment response. After initial sorting into subgroups based on the presence or absence of interpersonal sexual behavior problems, further subdivision was based on hierarchical cluster analysis. RESULTS: Five distinctive sexual behavior profiles emerged: (1) developmentally expected; and developmentally problematic (2) interpersonal, unplanned, (3) self-focused, (4) interpersonal, planned (noncoercive), and (5) interpersonal, planned (coercive). Elements of the child's sexual abuse experience, opportunities to learn/practice problematic sexual behavior, and familial variables best differentiated between the types. CONCLUSIONS: The five types differed not only in child sexual behavior but in most areas of child and family functioning, including treatment outcome. The findings offer support for the development of an empirically-based typology for children with sexual behavior problems utilizing a range of variables which go beyond typical classification systems based on offender and victim characteristics.

Canada↗
PubMed1999

Impact of social influences and problem behavior on alcohol use among inner-city Hispanic and black adolescents.

OBJECTIVE: Inner-city black and Hispanic adolescents might be at great risk for alcohol use. Yet the etiology of drinking among these adolescents receives little attention. The purpose of this study was to examine the impact of social influences and problem behavior on alcohol use among Hispanic and black adolescents. The impact of these factors was also tested separately for girls and boys to determine the differences in etiology of alcohol use depending on gender. METHOD: A large sample of black and Hispanic seventh-grade students (N = 4,847, 52% female) self-reported alcohol use, demographic characteristics (gender, family structure, age, ethnicity and socioeconomic status), social influences to drink (peer norms, adult norms, their friends' use, their mother's use, their father's use, their siblings' use, and perceived availability of alcohol), and problem behaviors (cigarette smoking, marijuana use, getting into trouble). Teams of three to five data collectors administered the questionnaire following standardized protocol. These data were collected in class during a regular 40-minute period. RESULTS: Logistic regressions indicated that social influences to drink from friends, peers, and family and problem behaviors including cigarette smoking and marijuana use were related to alcohol use across and within gender. Getting into trouble predicted drinking for boys but not girls. CONCLUSIONS: Based on these findings, adolescent alcohol prevention programs need to include an awareness of the many social influences to drink, modify incorrectly perceived peer norms for drinking, involve family members in the prevention program and address an array of problem behaviors within one prevention intervention.

Adolescent↗