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PubMed2005

Screening for preschool posttraumatic stress disorder with the Child Behavior Checklist.

OBJECTIVE: To examine the psychometric properties and utility of a Child Behavior Checklist-Posttraumatic Stress Disorder (CBCL-PTSD) Scale to screen for posttraumatic stress disorder (PTSD) in traumatized preschool children. METHOD: Data for this study were drawn from a study of young child trauma and consisted of 62 traumatized children, 23 months through 6 years of age. The children's mothers were interviewed about PTSD symptoms and then completed the Child Behavior Checklist (CBCL). RESULTS: The modified CBCL-PTSD correlated highly with the number of PTSD symptoms from the interview (r = 0.66). The CBCL-PTSD scale predicted PTSD symptoms above and beyond the internalizing and externalizing scales of the CBCL. A cutoff score of nine on this scale possessed the best sensitivity and specificity in classifying those traumatized children who met diagnostic criteria for PTSD. CONCLUSION: The modified CBCL-PTSD scale could be a useful cost-effective tool to screen for PTSD in traumatized, preschool-age children.

Child↗
PubMed1998

Behavior problems in children with diabetes: disentangling possible scoring confounds on the Child Behavior Checklist.

OBJECTIVE: The Child Behavior Checklist (CBCL; T. M. Achenbach, 1991), when used to assess the behavior of children with diabetes, may contain confounds because some behavioral items can have a physiologic etiology, and may skew reports of behavioral disturbance. METHODS: Two techniques were used to disentangle possible scoring confounds in the behavioral ratings of children with and without diabetes: (1) the Somatic Complaints scale was deleted, or (2) Diabetes Items, identified a priori with 89% agreement by nine medical personnel, were deleted. RESULTS: As expected, with traditionally scored protocols, children with diabetes obtained higher Internalizing and Total Behavior Problem scores than controls. This group difference persisted whether the Somatic Complaints scale or the Diabetes Items were deleted. CONCLUSIONS: Compared to controls, children with diabetes obtained mildly elevated scores on six of the eight CBCL scales, regardless of scoring method, suggesting that their mildly elevated behavioral profile is not confounded by physiologic symptomatology.

Adolescent↗
PubMed2004

Gender and alcohol moderate caregiver reported child behavior after prenatal cocaine.

OBJECTIVE: The concurrence of prenatal alcohol exposure with other drug exposure, low socioeconomic status and environmental risk factors may obscure associations, if any, between prenatal cocaine exposure and child outcomes. This study evaluates the effects of prenatal cocaine exposure on child behavior in analyses stratified by gender and prenatal alcohol exposure status. METHODS: Maternal alcohol, cigarette, and illicit drug use were prospectively assessed by interview during pregnancy and postnatally. Maternal and neonatal urine were tested for drug exposure as clinically indicated. Caregiver report of child behavior was assessed with the Achenbach Child Behavior Checklist (CBCL). Dichotomous cocaine exposure was characterized as no (negative history and biologic markers), and any (positive history and/or biologic markers during pregnancy and/or positive urine screen at delivery from either mother or infant). RESULTS: Prenatal cocaine exposure was associated with adverse effects on offspring behavior that were moderated by the gender of the offspring as well as prenatal alcohol exposure. For girls without prenatal alcohol exposure, 6.5% of the unique variance in behavior was related to prenatal cocaine exposure. For these girls, the odds of scoring in the abnormal range for Aggression was 17 times control levels (95% confidence limits 1.4 to 203). These findings, though significant, have wide confidence intervals and need to be replicated in larger cohorts and on longitudinal follow-up.

Aggression↗
PubMed2006

Do parenting and the home environment, maternal depression, neighborhood, and chronic poverty affect child behavioral problems differently in different racial-ethnic groups?

OBJECTIVE: To determine whether the processes through which parenting practices, maternal depression, neighborhood, and chronic poverty affect child behavioral problems are similar or different in minority and nonminority children in the United States. METHODS: Data from 884 white, 538 black, and 404 Latino families with children who were 6 to 9 years of age in the National Longitudinal Survey of Youth were analyzed. The outcome, child behavioral problems, was measured using the Behavior Problems Index externalizing and internalizing subscales. The effects of chronic poverty, neighborhood, maternal depression, and parenting on the outcome were analyzed using multigroup structural equation modeling. RESULTS: Chronic poverty affected child behavioral problems indirectly through the other variables, and parenting practices had direct effects in each racial/ethnic group. The effects of maternal depression were partially mediated through parenting in the white and Latino samples but were direct and unmediated through parenting practices in the black sample. Neighborhood effects were present in the white and black samples but were not significant for the Latino sample. CONCLUSIONS: Chronic poverty, neighborhood, maternal depression, and parenting practices have effects on child behavioral problems in white, black, and Latino children, but the processes and mechanisms through which they exert their effects differ among the groups. The differences may be related to social stratification mechanisms as well as sociocultural differences in family and childrearing practices.

Black People↗
PubMedDate not supplied

Relationship between patterns of infant temperament, child behavior ratings, and interactions during toddlerhood.

This longitudinal study examined the relationship of temperament ratings during infancy, subsequent child behavior problems, and mother-child interaction. The authors considered the effect of change in mothers' perceptions of their infants' temperament during infancy (e.g., from easy to difficult or from difficult to easy) on subsequent developmental outcomes. Data from a predominantly middle-class Caucasian sample of 49 mother-child dyads are presented here. Findings revealed that children with discontinuities in 4 and 8-month ratings on the Revised Infant Temperament Questionnaire (e.g, Easy/Difficult or Difficult/Easy) had significantly higher problem and intensity scores on the Eyberg Child Behavior Inventory than those with stable temperament ratings (Carey & McDevitt, 1978a). No significant differences were found in maternal behaviors between mothers of children rated easy or difficult at 4 or 8 months. These results suggest that continuity of infant temperament ratings is an important factor for consideration in subsequent maternal identification of toddler behavior problems, and that difficult temperament alone may not predict such problems.

Adult↗
PubMed2000

Maternal depressive symptoms and child behavior problems in a nationally representative normal birthweight sample.

OBJECTIVE: To evaluate the association between maternal depressive symptoms and child behavior problems in a nationally representative sample of U.S. mothers of normal birthweight babies. METHODS: We analyzed data from the 1988 National Maternal and Infant Health Survey (NMIHS) and a 1991 follow-up survey. Depressive symptoms were measured at both surveys using the CES-D, and child behavior problems were assessed by maternal self-report at follow-up. RESULTS: Approximately 28% of the 5303 mothers reported depressive symptoms at a mean of 17 months after delivery, as did 20% at 36 months. In multivariate analyses, women with depressive symptoms at either or both surveys were significantly more likely than women without depressive symptoms to report that their children had frequent temper tantrums or difficulty getting along with other children, and were difficult to manage, unhappy, or fearful. Compared to women without depressive symptoms, the risks of reporting three out of the five child behavior problems for women with depressive symptoms were OR = 1.6 (CI = 1.1-2.1), 1988 only; OR = 2.3 (CI = 1.6-3.3), 1991 only; and OR = 3.6 (2.6-5.0), both 1988 and 1991. CONCLUSIONS: Study findings indicate that a substantial proportion of mothers of young children in the United States experience depressive symptoms and that their children are at significantly increased risk of maternally reported behavior problems. Our results suggest that efforts to identify and treat depression in new mothers should be increased and that mothers whose children are found to have behavior problems should be assessed for depression.

Adolescent↗
PubMed1975

Parental use of "positive contact" in child-rearing: its relationship to child behavior patterns and other variables.

In an investigation of child-rearing styles maternal use of "positive contact" was measured by asking the mother how often she played with the child, praised the child, and the like, and combining the responses into a score. Home observations on a sample of families revealed that mothers scoring above the mean used fewer communications in the form of directives and "unmodified power" and more communication in the form of praise and social conversation than mothers scoring below the mean. The mother's use of positive contact was related to her educational level, the birth order of the child and number of children in the family, the father's use of positive contact, and to a friendly outgoing pattern of child behavior. There was no relation to the mother's use of physical punishment, her protectiveness, her tendency to comply with the child's demands, or her child-rearing ideology and other attitudes. Child care workers are in a strategic position to educate parents about the importance of this kind of contact, especially with later-born children in large families.

Child Behavior↗
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↗
PubMed2004

Parenting correlates of child behavior problems in a multiethnic community sample of preschool children in northern Norway.

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 child's cultural context and gender into account when assessing parenting influences on behavioral problems in children.

Arctic Regions↗
PubMed2005

Child behavior and quality of life in pediatric obstructive sleep apnea.

OBJECTIVE: To assess behavior and quality of life in children with obstructive sleep apnea (OSA) undergoing tonsillectomy and adenoidectomy compared with control children. DESIGN: Prospective controlled study. SETTING: Hospital-based pediatric otolaryngology practice. PARTICIPANTS: Forty-two children (25 boys and 17 girls; mean [SD] age, 5.8 [2.5] years) with OSA confirmed by positive findings on polysomnography undergoing tonsillectomy and adenoidectomy and 41 control children (29 boys and 12 girls; mean [SD] age, 7.3 [3.8] years) with no history of snoring undergoing unrelated elective surgery. INTERVENTIONS: Parents completed the standardized Child Behavior Checklist and a validated pediatric OSA quality-of-life survey before and 3 months after surgery. MAIN OUTCOME MEASURES: Child Behavior Checklist T scores and score classifications and quality-of-life survey mean scores. RESULTS: Change in mean total problem T score was significantly greater in the OSA group (from 51.6 at baseline to 48.3 at follow-up) than in controls (from 45.5 at baseline to 46.7 at follow-up) (P = .03). The improvement in total T score classification (normal vs borderline or abnormal) was significant for children with OSA compared with control children (P = .009). Children with OSA had significant improvements in the quality-of-life survey mean total score and all individual domain scores compared with controls (P<.001). CONCLUSIONS: Behavioral and emotional difficulties are found in children with documented OSA compared with control children, and they improve after treatment. Large improvements in disease-specific quality of life are also found. Scores on a standardized measure of behavior assessment demonstrated significant correlation with scores on a validated quality-of-life instrument.

Adenoidectomy↗
PubMed1984

Child behavior toward the parent: a factor analysis of mothers' reports of disabled children.

The current study evaluated the generalizability of a parent-child rearing inventory designed for normal children and parents to a group of parents of disabled children. A total of 101 mothers of multihandicapped children completed a questionnaire (Parent Report of Child Behavior) reporting their child's behavior toward them in five areas: Positive Relationship, Detachment, Obedience, Independence, and Control Problems. Factor analysis of these mothers' responses revealed a qualitatively different set of underlying factors as contrasted to the original normative group. For mothers in this study, a positive relationship with their disabled child was contingent upon a combination of compliant behaviors (obeying rules, doing things independently, actively trying to please), all of which are likely associated with general child competence. The disabled child's age, intellectual level, degree of physical impairment, and number of nonhandicapped sibs influenced maternal report of child behavior.

Adolescent↗
PubMed2001

The Child Behavior Checklist for group care workers: a study regarding the factor structure.

In this study we examined the factor structure of the Child Behavior Checklist (CBCL) filled out by group care workers. Group care workers' judgements were collected on 846 children and adolescents treated in various residential settings in The Netherlands. Using confirmatory factor analysis, we were able to show that the original CBCL factor model based on parental judgments of child behavior also fits for the judgments of group care workers. This means that the well known 8 narrow-band syndromes (Withdrawn, Somatic Complaints, etc.) as well as the 2 broad-band syndromes (Internalizing and Externalizing) can be used to interpret the CBCL scores of group care workers. This confirmation of the CBCL factor structure is a first step to add a group care worker version to the CBCL family. However, as a second step, normative data need to be gathered to further enhance the use of the CBCL for group care workers.

Adolescent↗
PubMed1993

The effect of maternal depression on maternal ratings of child behavior.

There have been continuing concerns about the extent to which maternal depression may influence maternal reports of child behavior. To examine this issue, a series of structural equation models of the relationships between maternal depression and errors in maternal reports of child behavior was proposed and tested. These models assumed that (a) maternal depression was unrelated to maternal reporting behavior; (b) maternal depression causally influenced maternal reporting accuracy; (c) maternal depression was correlated with reporting accuracy. These models were fitted to data on maternal depression and multiple-informant (mother, teacher, child) reports of conduct disorder and attention deficit behaviors for a birth cohort of 12- and 13-year-old New Zealand children. The results of model fitting suggested the presence of small to moderate correlations (r = +.13 to +.40) between maternal depression and maternal reporting errors, indicating the presence of a tendency for increasing maternal depression to be associated with a tendency for mothers to over-report child behavior problems. However, independently of any effects of maternal depression on maternal reporting errors there was evidence of small but significant associations (r = .10 to .17; p < .05) between maternal depression and child conduct disorder and attention deficit behaviors.

Adolescent↗
PubMed2001

Family environment, child behavior, and medical indicators in children with kidney disease.

Effects of family environment on child behavior symptoms and medical indicators in children with one of three kidney diseases were examined. Parents (n = 41) of children with nephrotic syndrome, chronic renal insufficiency, or kidney transplant completed family environment and child behavior questionnaires. Medical indicators (utilization and medications) were collected from medical records. A model including child age, diagnostic group, and family environment variables successfully predicted all outcomes except internalizing behavior. Higher family conflict predicted more externalizing symptoms and higher number of prescribed medications; higher family cohesion predicted fewer hospitalizations. Nontraditional family structure predicted higher number of prescribed medications. Results are discussed as they relate to a stress and resistance framework, need for research on direction of effect, and clinical recommendations.

Adaptation, Psychological↗
PubMed2000

Impact of tonsillectomy and adenoidectomy on child behavior.

OBJECTIVE: To measure the impact of tonsillectomy and adenoidectomy (T&A) on children's behavioral and emotional problems using a standardized assessment. DESIGN: Prospective study. SETTING: Tertiary care children's hospital. PATIENTS: Thirty-six children, aged 2 through 18 years, with symptoms of nighttime snoring, observed apneas, and daytime mouth breathing and physical examination results demonstrating 3+ or 4+ tonsils scheduled for T&A. INTERVENTION: Parents completed a standard survey of their children's symptoms of sleep apnea and a standardized measure of children's competencies and problems, the Child Behavior Checklist for ages 2 through 3 years or 4 through 18 years, before T&A and 3 months postoperatively. MAIN OUTCOME MEASURE: The Child Behavior Checklist total problem score. RESULTS: The preoperative Child Behavior Checklist total problem score was consistent with abnormal behavior for 10 children (28%). After T&A (n = 15), only 2 scores were abnormal, but the change was not statistically significant. In contrast, the mean total problem score was 7.5 points lower after surgery (95% confidence interval, 5.1-9.7), indicating a significant decrease (P<.001, matched t test). CONCLUSIONS: This pilot study demonstrates a high prevalence (28%) of abnormal behavior in children undergoing T&A for chronic upper airway obstruction. Scores on a standardized measure of behavior improve following T&A, but larger studies with increased statistical power are needed to clarify the degree of improvement and its clinical importance.

Adenoidectomy↗