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PubMed1987

Families and the origins of child behavior problems.

This article reviews recent research into the relationship between family variables and child behavior. Although a diversity of factors may be associated with the development and maintenance of conduct/oppositional disorders in children, of primary importance are the moment-to-moment interactions that the child has with his or her primary caregivers. These are often marked by coercive, aggressive behaviors that may be functional for parents and children within the family system. However, the likelihood that parents will engage in coercive interactions with the child is also related to the latter's personal adjustment, which, in turn, is often dependent upon the parents' perceptions of the quality of marital and social support available to them. The goal for clinicians working with families of oppositional/conduct-disordered children is to retain the demonstrated efficacy of direct intervention into parent-child interactions while developing methods of assessment and treatment that attend to broader family variables, for example, marital disorder, interfering in-laws, and social isolation that may be functionally related to the occurrence of coercive parent-child interactions.

Child↗
PubMed2006

Genes and developmental stabiltiy of aggressive behavior problems at home and school in a community sample of twins aged 7-12.

Though behavioral genetic studies of aggression have implicated heritable and environmental factors, there is limited understanding of how these factors influence aggression across different settings and over time. Ratings for 732 twins were collected from parents and teachers during middle childhood and early adolescence. Total aggression scores on the Child Behavioral Checklist (CBCL) and Teacher Report Form (TRF) were examined at each age, across both settings, and developmentally. In this sample, aggressive behavior was moderately to largely heritable at each age within the home (.76-.84) and school (.42-.61). Across each age, ratings by parents and teachers were moderately correlated (.19-.36). Genetic and environmental effects that were limited to a particular setting were important etiological factors for aggressive behavior consistently within each setting, while only genetic factors influenced levels of aggression across both settings. Stability during these ages was due to genetic effects common to each age and the persistence of child-specific environmental experiences within each setting. These results suggest that genetic and environmental influences on children's aggressive behavior are largely setting specific. Levels of aggression seen consistently across both settings are due to genetic influences. Developmentally stable levels of aggressive behavior result from genetic influences common to all ages and individual environmental influences whose effects persist across ages.

Aggression↗
PubMed1982

Dentists' perceptions of problem behaviors in patients.

Our sample of 376 dentists in general practice provided a number of useful insights into the problems that dentists experience with their patients. For general problems of patient cooperation, the frequency of occurrence and annoyance to the dentist were related. High on the list in both categories were maintaining poor oral hygiene, missing or being late for appointments, and not paying bills. Not providing an accurate history ranked first in bother to the dentist but appears to occur infrequently. When specific chair problems were considered, an inverse relationship was found between frequency of occurrence and bother to the dentist. Showing fear was the most frequent behavior but ranked lowest in bother. Grabbing the dentist's hand ranked first in bother but last in frequency of occurrence. Some annoying patient behaviors, such as those that devalue, criticize, or question the dentist's performance, are attempts to cope with anxiety. Viewed in this fashion, the incidence of fear-related behaviors may be higher than actually perceived by dentists. Because such behaviors are likely to result in feelings of personal assault on the dentist's part, they are likely to have a deleterious effect on the dentist-patient relationship. Dentists who are able to avoid feeling threatened by patient hostility may be able to successfully resolve the potential conflict to the mutual benefit of both dentist and patient. The actual problems that dentists have with their patients have been neglected and need extensive research. Our study is a first attempt to outline the boundaries of this area. Even these descriptive findings point to crucial elements in dentist-patient relationships. We hope that our findings will lead to further research on the dentist in the dentist-patient equation as well as to practical means of coping with the problems that patients present.

Attitude of Health Personnel↗