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Externalizing behavior problems and academic underachievement in childhood and adolescence: causal relationships and underlying mechanisms.

Conceptual and measurement issues surrounding externalizing behavior problems and academic underachievement, the strength and specificity of the covariation between these domains, and the viability of explanatory models that link these areas are reviewed. In childhood, inattention and hyperactivity are stronger correlates of academic problems than is aggression; by adolescence, however, antisocial behavior and delinquency are clearly associated with underachievement. Whereas investigations with designs that allow accurate causal inference are scarce, unidirectional paths from 1 domain to the other have received little support. Indeed, the overlap of externalizing problems with cognitive and readiness deficits early in development suggests the influence of antecedent variables. Low socioeconomic status, family adversity, subaverage IQ, language deficits, and neurodevelopmental delay are explored as possible underlying factors.

Adolescent↗

Verbal self-regulation over time in preschool children at risk for attention and behavior problems.

This study is a prospective, longitudinal attempt to explore behavioral self-regulation, private speech, and speech-action coordination in a sample of behaviorally at-risk preschool children. Preschoolers (N = 72) were classified at age 3 years into a behaviorally at-risk group or a comparison group on the basis of preschool teacher behavioral ratings. Children were videotaped on four different occasions across the span of almost 2 years as they completed problem-solving tasks, and private speech, task performance, executive functioning, and speech-action coordination were analyzed. Children identified 2 years earlier as being hard to manage were at risk for continued behavior problems at elementary school entry. Behaviorally at-risk children consistently used more spontaneous private speech than comparison children across all observations. Both groups of children demonstrated a pattern of increasing silence with task success over time. No group differences were observed in children's speech-action coordination at age 5 years. Intraindividual developmental changes in private speech for both groups were associated with task performance, speech-action coordination, and executive functioning at age 5, but not with teacher- and parent-reported problem behavior.

Attention↗

Mother-child interaction, private speech, and task performance in preschool children with behavior problems.

The purpose of the present study was to explore patterns of mother-child interaction, children's private speech use, and behavioral self-regulation among a sample of preschool children identified by their preschool teachers as evidencing behavior problems. Forty preschoolers were classified into two groups (behaviorally at-risk and a matched comparison group) on the basis of teacher ratings of impulsivity, inattention, and hyperactivity. Children completed a magnet board puzzle task once in collaboration with their mother and once individually, and maternal and child speech and behavior were coded from videotapes. Although there were no group differences in children's behavior or speech during the collaborative session, nor were there differences in children's individual task performance or on-task attention, mother-child interaction involving behaviorally at-risk children was characterized by more other-regulation, negative control, less praise, and less physical withdrawal over time, compared to interactions involving comparison children. Behaviorally at-risk children, compared to controls, used more overt, task-relevant private speech during individual problem solving. Partially internalized private speech use among at-risk preschoolers was positively associated with task performance. Group differences rather than similarities prevailed in terms of the relations between maternal behavior, child speech, and child performance.

Adult↗

Early externalizing behavior problems: toddlers and preschoolers at risk for later maladjustment.

The early emergence and developmental implications of externalizing behavior problems in toddlers and preschoolers are discussed with an emphasis on which young children are truly at risk for continuing problems. The extant literature is reviewed with a focus on the stability of early externalizing behavior and the diverse pathways that young children, primarily boys, with early-emerging problems may follow. Findings from a number of studies, both epidemiological and high risk, suggest that the small subgroup of boys with multiple risk factors that include especially high levels of early hyperactivity and aggression, and high levels of negative parenting and family stress, are most likely to evidence continuing problems at school entry. Sociodemographic and neighborhood influences are also discussed, as are implications for future research and policy.

Adjustment Disorders↗

Stages of change and decisional balance for 12 problem behaviors.

This integrative study investigated the generalization of the transtheoretical model across 12 problem behaviors. The cross-sectional comparisons involved relationships between two key constructs of the model, the stages of change and decisional balance. The behaviors studied were smoking cessation, quitting cocaine, weight control, high-fat diets, adolescent delinquent behaviors, safer sex, condom use, sunscreen use, radon gas exposure, exercise acquisition, mammography screening, and physicians' preventive practices with smokers. Clear commonalities were observed across the 12 areas, including both the internal structure of the measures and the pattern of changes in decisional balance across stages.

Adult↗

Case study: behavioral treatment of obsessive-compulsive disorder in a boy with comorbid disruptive behavior problems.

Comorbid psychiatric conditions often complicate the treatment of childhood obsessive-compulsive disorder (OCD). Behavioral treatment of OCD using exposure plus response prevention for a boy with disruptive behavior disorders and two previous unsuccessful medication trials is described. Treatment was adapted to his developmental level, his mother was highly involved in treatment, and a contingency management program contained his disruptive behavior so that he could participate in therapy. Posttreatment and 2- and 6-month follow-up measures indicated marked improvement in OCD symptoms. The possibility of successful behavioral treatment of OCD in medication-free children with disruptive behavior problems is highlighted.

Attention Deficit and Disruptive Behavior Disorder↗

Sexual activity and problem behaviors among black, urban adolescents.

This article focuses on whether sexual activity is best considered in the same paradigm as adolescent substance use and assault or separately. Among black, inner-city adolescents (N = 705), followed longitudinally since first grade, 3 questions were examined: (1) how these 3 behaviors co-occur, (2) their early family and school precursors, and (3) their relations with adolescent school behavior and parental supervision. The 3 most frequent patterns were compared: no problem behaviors, only sexual activity, and the combination of sexual activity, heavy substance use, and/or assault. In general, the multiproblem adolescents differed from the other adolescents in their behavior and parental supervision. While sex-only males were similar to the no-problem males, sex-only-females differed from the no-problem girls in their family origins. These results suggest that by examining adolescent behaviors in their co-occurring combinations in epidemiologically defined populations, variations in pathways to deviance can be better understood.

Achievement↗

Feeding and drinking behavior problems.

The physiologic and behavioral basis of normal canine and feline feeding is given in detail. Abnormalities of ingestive behavior include obesity and anorexia in both species, flank or blanket sucking in Doberman Pinschers, coprophagia and stone chewing in dogs, and wool chewing in cats. Drinking behavior is discussed briefly, and the abnormalities of hypernatremia (a failure of thirst) and psychogenic polydipsia and polyphagia are reviewed.

Animals↗

Sexual behavior problems in preteen children: developmental, ecological, and behavioral correlates.

A large sample of 2-12 year old children (N = 2311) was studied to determine the relationship between three sexually intrusive behavior items (SIBs) measured by the Child Sexual Behavior Inventory (CSBI) and a range of developmental, ecological, and behavioral correlates. The variables studied included age, gender, race, family income, single parent status, maternal education, family sexual behaviors, physical abuse, sexual abuse, domestic violence, social competence of the child, and three scales from the CBCL (Internalizing, Externalizing, and PTSD). Sexual abuse was not the primary predictor of SIB, but a model incorporating family adversity, modeling of coercive behavior, child behavior, and modeling of sexuality predicted a significant amount of variance.

Child↗

Comparison of self-reported emotional and behavioral problems in Turkish immigrant, Dutch and Turkish adolescents.

OBJECTIVE: The aim of this study was to compare self-reported emotional and behavioral problems for Turkish immigrant, native Dutch and native Turkish adolescents. METHOD: A total of 379 Turkish immigrant adolescents living in the Netherlands, and 1039 Dutch adolescents from the general population completed the Dutch translation of the Youth Self-Report (YSR); 2151 Turkish adolescents from the general population completed the Turkish translation of the YSR; parents of Turkish immigrant adolescents filled in the Turkish translation of the Child Behavior Checklist (CBCL/4-18). RESULTS: Turkish immigrant adolescents scored themselves significantly higher than Dutch adolescents on five of the 11 YSR syndromes, most markedly on the Anxious/Depressed, Withdrawn and Internalizing scales. Dutch adolescents scored themselves higher than immigrant adolescents on the Somatic Complaints and Delinquent Behavior scales. Turkish immigrant adolescents scored themselves higher than Turkish adolescents on five of the 11 scales, most markedly on the Delinquent Behavior scale. Total problems scores for Turkish immigrant adolescents were higher than for Dutch and Turkish adolescents. Turkish immigrant adolescents scored themselves higher than their parents assessed them on seven of the 11 scales. CONCLUSION: Turkish immigrant adolescents reported more problems in comparison to their Dutch and native Turkish peers. Different patterns of parent-child interaction, family values and delay of Dutch language skills are considered to be responsible for these differences in scores.

Adolescent↗

Behavior problems of clinic children: relation to parental marital status, age and sex of child.

Behavior problems of 703 children seen in a clinical setting were examined for interactions between and effects of family type (i.e., parental marital status) and age and sex of child. Significant differences were found based on family type, with children of separated, divorced, and remarried parents having more problems. Expected interactions between marital status and age and sex of child were not obtained, although results support prior research with regard to the effects of age and sex.

Adaptation, Psychological↗

Gender differences in cognitive vulnerability to depression and behavior problems in adolescents.

This study assessed gender differences in cognitive variables as an explanation for gender differences in depression and behavior problems; 856 adolescents (491 females and 365 males), aged 14-17, completed the Irrational Beliefs Scale for Adolescents, the Social Problem Solving Inventory-Revised Short Form, the adolescent version of the Burnett Self-Talk Inventory, and the Youth Self Report. Female adolescents' lower levels of positive thinking and higher scores on negative problem orientation, need for approval and success, and self-focused negative cognitions partially mediated gender differences in depressive symptoms. Males' higher scores on justification of violence beliefs and the impulsivity/carelessness style of problem solving partially accounted for differences in delinquent behavior. The influence of need for approval and success on depressive symptoms was higher among adolescents at ages 14-15 than among older adolescents. Justification of violence did not influence delinquent behavior among girls at age 14-15.

Adolescent↗

A mental health clinic for toddlers with developmental delays and behavior problems.

A mental health clinic was developed for toddlers with developmental disabilities and significant behavior problems from families living in poverty. The clinic was a collaborative effort between a community-based Birth-to-Three agency and a university. The purpose of this clinic was threefold: to provide direct mental health services for these young children, to train graduate students to work with this population, and to begin to contribute to the limited research available in this area. This paper describes the clinical intake procedures and outcomes for the 81 children served by the clinic over a 2-year period. Referral concerns included tantrums, aggression, oppositional behaviors, hyperactivity, and self-injury. The children came from a diverse group of families living in poverty; single mothers with less than a high school education headed most of the households. The clinical intake included direct observations of parent-child interactions, child behavior assessments, and parental interviews and self-report measures. For the present sample, 77% of the children met the criteria for a developmental disability and nearly 70% also met the criteria for a psychiatric disorder. The most common diagnosis was oppositional defiant disorder. Discussion regarding the challenges inherent in working with families of toddlers with developmental delays and psychiatric disorders living in low-income circumstances is included.

Ambulatory Care Facilities↗

Problem behavior in international adoptees: III. Diagnosis of child psychiatric disorders.

This study is a clinical extension of two previous epidemiological studies on problem behavior in international adoptees. In depth pictures were obtained by clinical interviews of 132 14-year-old international adoptees and their parents. Children were selected on the basis of previously obtained Child Behavior Checklist (CBCL) scores. Clinical severity ratings and DSM-III-R diagnoses were obtained. The correlations of r = 0.63 and r = 0.45 between clinical severity ratings and CBCL problem and competence scores, respectively, indicated that the results from the authors' extensive epidemiological survey and the clinical evaluation, which took place more than 10 months later, converged. The results showed that the CBCL may be used in epidemiological studies to obtain an estimate of the prevalence of psychiatric disorders in children. The 28% prevalence rate of psychiatric disorders in this sample of 14-year-old international adoptees (22% rate for girls, 36% for boys) was somewhat higher than for general population samples reported in comparable studies. Conduct disorders were elevated in the sample. The behavior of disordered adopted children was characterized by antisocial behaviors, poor relationships, and problems of affect.

Adolescent↗

Low birth weight, developmental milestones, and behavioral problems in Chinese children and adolescents.

This study examined the association of low birth weight (LBW) and developmental milestones with behavioral and emotional problems in a general population sample of 3344 Chinese children and adolescents aged 6-16 years in 1997. Parents completed a self-administrated questionnaire including information about birth weight and developmental milestones (i.e. lifting the head up, tooth eruption, speech, walking and bedwetting cessation), and the Child Behavioral Checklist (CBCL). Teachers completed the Teacher's Report Form (TRF) to assess classroom behavior problems. Results indicated that LBW and delayed developmental milestones were significantly associated with an increased risk for almost all parent- and teacher-reported behavioral problems after controlling for the potential effects of child's gender, age and birth order, parental ages at birth, education, occupation, complications at birth and number of children in the family. LBW was significantly associated with delay in achieving all developmental milestones including lifting of the head, tooth eruption, sitting without support, walking without help, speech as saying words with meaning, and bedwetting cessation. It is concluded that LBW and delayed early childhood development may predict the occurrence of a wide range of behavioral and emotional problems in later childhood and adolescence.

Adolescent↗

The relation between behavior problems and peer preference in different classroom contexts. Conduct Problems Prevention Research Group.

This study tested two alternative hypotheses regarding the relations between child behavior and peer preference. The first hypothesis is generated from the person-group similarity model, which predicts that the acceptability of social behaviors will vary as a function of peer group norms. The second hypothesis is generated by the social skill model, which predicts that behavioral skill deficiencies reduce and behavioral competencies enhance peer preference. A total of 2895 children in 134 regular first-grade classrooms participated in the study. Hierarchical linear modeling was used to compare four different behaviors as predictors of peer preference in the context of classrooms with varying levels of these behavior problems. The results of the study supported both predictive models, with the acceptability of aggression and withdrawal varying across classrooms (following a person-group similarity model) and the effects of inattentive/hyperactive behavior (in a negative direction) and prosocial behavior (in a positive direction) following a social skill model and remaining constant in their associations with peer preference across classrooms. Gender differences also emerged, with aggression following the person-group similarity model for boys more strongly than for girls. The effects of both child behaviors and the peer group context on peer preference and on the trajectory of social development are discussed.

Child↗

Toileting concerns, parenting stress, and behavior problems in children with special health care needs.

This study examined the relationship between toileting concerns, behavior problems, and parenting stress in parents of children with special health care needs (CSHCN). Participants included parents of 99 males and 71 females aged 4 to 12 years with neural tube defects (NTD), developmental-behavioral disabilities (DBD), or history of perinatal intraventricular hemorrhage (IVH). Parents completed the Achenbach Child Behavior Checklist (CBCL) and the Parenting Stress Index-Short Form (PSI-SF). Parents expressing toileting concerns on the CBCL reported significantly more personal distress and more externalizing problems versus those with continent children. Variation within subsamples suggested that expectations based on nature of disability may be a factor in parent adjustment. Direct assessment and intervention of toileting issues should be a high priority in secondary stress prevention with CSHCN and their families.

Activities of Daily Living↗