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PubMed2005

Inattention/hyperactivity and aggression from early childhood to adolescence: heterogeneity of trajectories and differential influence of family environment characteristics.

Inattention/hyperactivity and aggressive behavior problems were measured in 335 children from school entry throughout adolescence, at 3-year intervals. Children were participants in a high-risk prospective study of substance use disorders and comorbid problems. A parallel process latent growth model found aggressive behavior decreasing throughout childhood and adolescence, whereas inattentive/hyperactive behavior levels were constant. Growth mixture modeling, in which developmental trajectories are statistically classified, found two classes for inattention/hyperactivity and two for aggressive behavior, resulting in a total of four trajectory classes. Different influences of the family environment predicted development of the two types of behavior problems when the other behavior problem was held constant. Lower emotional support and lower intellectual stimulation by the parents in early childhood predicted membership in the high problem class of inattention/hyperactivity when the trajectory of aggression was held constant. Conversely, conflict and lack of cohesiveness in the family environment predicted membership in a worse developmental trajectory of aggressive behavior when the inattention/hyperactivity trajectories were held constant. The implications of these findings for the development of inattention/hyperactivity and for the development of risk for the emergence of substance use disorders are discussed.

Adolescent↗
PubMed2000

Competence and behavioral/emotional problems among Taiwanese adolescents as reported by parents and teachers.

OBJECTIVE: To investigate competence and behavioral/emotional problems among nonreferred adolescents in Taiwan, using a Chinese version of the Child Behavior Checklist (CBCL-C) and the Teacher's Report Form (TRF-C). The psychometric properties of these instruments and cross-cultural differences were also examined. METHOD: Parents of 854 junior high school students aged 12 to 16 years in Taipei, Taiwan, were asked to complete the CBCL-C. Among these students, 162 had their teachers' ratings of the TRF-C. RESULTS: The internal consistency and 1-month test-retest reliability were satisfactory for both the CBCL-C and TRF-C, which were moderately correlated. Both exploratory and confirmatory factor analysis provided some support for the validity of Achenbach's cross-informant model. Parents' reports showed that compared with their American counterparts, Taiwanese adolescents tended to have lower scores on most competence scales, higher scores on scales that reflect covert behavior problems, and lower scores on scales that reflect more overt behavior problems. However, teachers' reports showed no significant differences on most competence and behavior problem scales. CONCLUSION: The CBCL-C and TRF-C are useful tools for assessing the mental health status of Taiwanese adolescents. The cross-cultural differences in adolescent behavior problems are discussed.

Achievement↗
PubMedDate not supplied

Physicians' attention to parents' concerns about the psychosocial functioning of their children.

BACKGROUND: Epidemiological data indicate that approximately 20% of children have psychosocial problems, yet less than 2% of children are seen by mental health specialists each year. Primary care physicians tend to identify children with psychosocial problems when parents discuss concerns with them. OBJECTIVE: To examine factors related to physicians' attention to parental disclosures. DESIGN: Parents reported the psychosocial functioning of themselves and their children. Physicians reported the psychosocial functioning of 75 children and whether the parent disclosed psychosocial concerns to them. SETTING: Ambulatory care clinic of a community-based, university-affiliated, residency training program. PARTICIPANTS: Seventy-five parents of children aged 2 to 16 years who presented for routine primary care, and 26 physicians. MAIN OUTCOME MEASURES: Beck Depression Inventory (parental distress), Eyberg Child Behavior Inventory (child behavior problems), physician and parent report. RESULTS: Physicians identified 50.0% of children with clinically significant behavior problems. Logistic regression indicated that parental disclosure was the only significant predictor of physician identification (P < .002). When children had clinically significant behavior problems, physicians were more likely to report disclosures by parents (45.0% vs 5.7% for parents of children with and without behavior problems, respectively). Physicians were more likely to report parental disclosure when parents reported personal psychosocial distress (38.9% for distressed vs 5.7% nondistressed parents). CONCLUSIONS: Parental disclosure of concerns was a better predictor of physician identification of child psychosocial problems than was the presence of child behavior problems. Physicians responded more frequently to the disclosures of potential problems by parents of children with clinically significant psychosocial problems. They also attended more frequently to disclosures about behavior problems when the parent was also experiencing psychosocial distress.

Adaptation, Psychological↗
PubMed2005

Adolescent suicidality: who will ideate, who will act?

Responses to the 1999 Youth Risk Behavior Survey including suicide ideation, attempt, medically treated attempt, and six problem behaviors were analysed. Youth across the spectrum ideated. Overwhelmingly, the 17% of youth with more than three problem behaviors were the youth who acted; they accounted for 60% of medically treated suicidal acts. Compared to adolescents with zero problem behaviors, the odds of a medically treated suicide attempt were 2.3 times greater among respondents with one, 8.8 with two, 18.3 with three, 30.8 with four, 50.0 with five, and 227.3 with six. A count of problem behaviors offers a reliable way to identify suicide risk.

Adolescent↗
PubMed2004

Need for and use of mental health services among parents of children in the head start program.

This study examined the prevalence of psychosocial difficulties and use of mental health services among 290 parents of children in the Head Start program. Data on demographic characteristics, child behavior problems, parents' difficulties, home environment, child behavior, and use of health services were collected. A total of 161 parents (56 percent) had identifiable psychosocial difficulties, and 41 (14 percent) reported use of mental health services in the previous 12 months. Child behavior problems, unmet need for mental and physical health services, and less optimal home environments were associated with parents' psychosocial difficulties. Parents who had an unmet need for mental health services were more likely to report behavior problems among their children.

Child↗
PubMed2002

Relations among children's perceptions of maternal behavior, attributional styles, and behavioral symptomatology in maltreated children.

This investigation examined relations among perceptions of mothers, attributional style, and counselor-rated behavior problems in 187 school age children (88 maltreated, 99 nonmaltreated). Hypotheses regarding the presence of higher levels of internalizing and externalizing behavior problems in maltreated children were confirmed. Attributional style was found to function as a moderator of externalizing behavior problems, suggesting that attributional style exerts a protective role against the harmful effect of child maltreatment. Perceptions of mothers were found to operate as a mediator of both internalizing and externalizing symptomatology, with maltreated children with less positive perceptions of their mothers exhibiting greater internalizing and externalizing behavior problems. These findings advance knowledge of how cognitive processes contribute to behavior problems in maltreated children and possess implications for prevention and intervention efforts.

Adaptation, Psychological↗
PubMed1981

[Etiology of behavior disorders in children: a study of children in inpatient psychiatric treatment (author's transl)].

The behavior problems of 144 behaviorally disturbed children are described who were treated as inpatients between 1966 and 1973. The problems were classified with the multiaxial classification system for psychiatric disorders in childhood. In addition, they were evaluated with a psychopathology assessment inventory developed by the authors. Data on somatic and psychosocial factors were also recorded. Specific behavior disorders were associated with specific somatic and psychosocial factors. The extent to which behavior could be modified during in patient treatment depended on the kind and severity of the behavior problems bu only to a small extent on somatic and psychosocial factors. On the other hand, parenteral cooperativeness had a significant influence on therapeutic outcome. The multiaxial classification system was validated by the ratings on the psychopathology assessment inventory. The reasons for certain difficulties in classifying behavior problems in children are discussed.

Adolescent↗
PubMed1994

Dental behavior management problems in Swedish children.

4505 Swedish children aged 4-11 yr were surveyed regarding dental behavior management problems (BMP) and dental health. Dental charts were retrieved from clinics in the Public Dental Service in Göteborg, and data were then compiled regarding BMP, action against BMP, caries, fillings, use of local anesthetics, and number of missed appointments. Behavior management problems were found in 10.5% of the children, and were more common in the younger children, among children who missed appointments, and in children who received restorative treatment without local anesthetics. The BMP children had more carious and fewer filled surfaces. In 43.4% of the cases with BMP the strategy chosen was postponement of dental treatment or no measure taken.

Age Factors↗
PubMed1980

An observation methodology for the study of interactive clinical problem-solving behavior in primary care settings.

A methodology that is adequate for a generalized description of the interactive problem-solving behavior of client and clinician must accommodate all potential types of clinical issues and client-clinician relationships. It must also be applicable to the behavior of the client as well as that of the clinician. Furthermore, behavior must be analyzable in terms of the phase of problem-solving logic that applies at the time the behavior is observed. The development, specifications, structural factors and procedures of administration of an observational methodology that is based on a 7-phase paradigm of verbal problem-solving behavior are described. Acceptable levels of consistency of coding are achievable using the methodology. Coder agreement over all phase categories was 84.8 per cent. Results of 2-way ANOVA procedures showed that the type of clinical encounter observed affected the proportion of data coded in each of the problem-solving phase categories whereas, on the whole, the identity of the coder did not. The methodology may be articulated with other methods for the study of primary care and has both research and instructional applications.

Adult↗
PubMed1986

The impact of temperament in a school setting: an epidemiological study.

The authors present the results of an epidemiological study on a large non-clinical population-based sample of French speaking seven year-old children (N = 596) whose aim was to verify if a relation exists between temperament and outward-type or inward-type behavior problems in school. The Thomas and Chess' Parent Temperament Questionnaire, filled out twice by the parents over a four-week interval, was used to determine temperament. The Conners Teacher Questionnaire, filled out twice by the teachers over a four-week interval, was used to determine behavior problems in school. Five points emerge from this study. First, "difficult" temperament 'per se' is not associated either with outward-type or inward-type behavior problems in school. Second, a temperamental pattern of high activity and high approach with new stimuli predisposes boys to present outward-type behavior problems in school. Third, the temperamental traits of low adaptability or withdrawal with new stimuli predisposes girls to inward-type behavior problems in school. Fourth, the study demonstrates the importance of verifying if the associations between temperament and behavior problems are stable since, in the comparisons between results of the test with those of the retest, several of the associations found in one occasion failed to be replicated at the other. Fifth, the different influences of temperament according to sex emphasize the need to study boys and girls separately. Future studies should take into account interactions between parents/teachers and child temperament since these sex-related different influences of temperament could be related to the sex-related different attitudes of caretakers.

Child↗
PubMed2006

Patterns of traffic offenses from adolescent licensure into early young adulthood.

PURPOSE: This article examines adolescent psychosocial and problem behavior characteristics as predictors of traffic offenses from licensure to early young adulthood. METHODS: Data for this study were from a school-based sample that was surveyed in 10th and 12th grades, and again in early young adulthood. In addition, state driver history records were obtained for each participant in the study and provided a complete traffic offense history. RESULTS: Models adjusted for driving exposure showed varying patterns of prediction for men and women across three types of ticketed moving violations (offenses): minor offenses, serious offenses, and alcohol offenses. Although which predictors were significant varied across gender and type of offense, results suggested that more positive psychosocial adjustment predicted lower numbers, greater decreases, and a lower likelihood of increases in offenses from licensure through the early 20s. CONCLUSIONS: Based on this research, implications for intervention include providing parents with the tools and knowledge needed to effectively supervise their teens' driving during the first years of licensure. Also potentially important for their broad positive effects on problem behaviors, including problem driving, are programs that strengthen adolescents' bonds to conventional social institutions and increase their attachment to the people who represent those institutions. Future research should examine the longitudinal sequencing of associations among psychosocial and problem behavior variables, including problem driving.

Accidents, Traffic↗
PubMed2005

A prospective study of the effects of behavioral symptoms on the institutionalization of patients with dementia.

BACKGROUND: Reports in the literature on the effects of behavioral problems in patients with dementia on the decision to institutionalize the patient have shown conflicting results. Few studies have taken into account the possibility that specific behavioral problems may have differential effects on the decision to institutionalize the patient. Moreover, it is probably not patient behavior itself that causes nursing home placement (NHP), but caregivers' emotional reaction to it. The aim of the present study was to examine the impact of specific behavioral subsyndromes and caregivers' emotional reaction on NHP. METHODS: A total of 119 patients with dementia and their informal caregivers were followed up for 2 years. Time to NHP was measured in months from the date of the baseline interview to the date of NHP. Behavioral disturbances in the patient and caregivers' emotional reactions were measured with the Neuropsychiatric Inventory (NPI). Cox regression analyses were used to determine the probability that caregivers would institutionalize the patient when patient behavioral problems or caregiver distress were present at baseline. RESULTS: Forty-one percent of the patients were institutionalized during the 2-year follow-;up. Caregiver distress related to patient behavior was a significant predictor of NHP, while behavior in itself did not predict NHP. Contrary to our expectations, we did not find a differential impact of specific aspects of problem behavior. Children caregivers, especially daughters, were associated with shorter time to NHP compared to spouses. CONCLUSIONS: Our findings indicate that the caregiver's emotional reaction to patient behavior is more important than problem behaviors per se in the decision to institutionalize patients. Interventions aimed at teaching caregivers strategies to better manage difficult patient behaviors may provide caregivers with the necessary resources to continue care at home. Future interventions need to account for the specific needs and problems of different caregiver groups.

Aged↗
PubMed2003

Concurrent and 2-year longitudinal relations between executive function and the behavior of 1st and 2nd grade children.

Abstract Concurrent and 2-year longitudinal relations were investigated between two indicators of children's ( n =60; mean age = years 11 months) executive function, inhibitory control and sequencing ability, and behavior problem symptomatology. Dependent measures were parent and teacher reported internalizing and externalizing behavior. Hierarchical multiple regression analyses demonstrated few significant concurrent associations between either inhibitory control or sequencing ability, and behavior problem symptoms. In contrast, baseline inhibitory control predicted decreased teacher reported externalizing, and parent reported externalizing and internalizing behavior problems over a 2-year period. Baseline sequencing ability also predicted decreased teacher reported externalizing and parent reported internalizing behavior over this same time period. Results suggest that some aspects of executive function in early elementary grade-school children may be more strongly associated with change in behavior over time than concurrent behavior. Implications of these findings for the prevention of behavior problems are discussed.

Child↗
PubMed2006

Emotional, developmental, and behavioral health of American children and their families: a report from the 2003 National Survey of Children's Health.

BACKGROUND: Recent children's health surveys have documented a high prevalence of emotional, developmental, and behavioral problems among children. Data from the 2003 National Survey of Children's Health provide new insights into these problems and their association with family function and community participation. These issues have become a current focus of the World Health Organization. METHODS: Answers to questions of interest from the 2003 National Survey of Children's Health were reported using estimates and SEs of rates. Statistical comparisons of rates with chi2 tests at the 0.05 level were made when relevant. RESULTS: The most commonly diagnosed problems among children 6-17 years of age were learning disabilities (11.5%), attention-deficit/hyperactivity disorder (8.8%), and behavioral problems (6.3%); among preschoolers, speech problems (5.8%) and developmental delay (3.2%) were most common. One in 200 children was diagnosed with autism. In contrast, rates of parental concerns about emotional, developmental, or behavioral problems were much higher; for example, 41% of parents had concerns about learning difficulties and 36% about depression or anxiety. Children with developmental problems had lower self-esteem, more depression and anxiety, more problems with learning, missed more school, and were less involved in sports and other community activities. Their families experienced more difficulty in the areas of childcare, employment, parent-child relationships, and caregiver burden. CONCLUSIONS: The most recent National Survey of Children's Health mirrored results of previous surveys regarding rates of diagnosed emotional, developmental, and behavioral problems, including an escalating diagnosis of autism among children. Reported rates of parental concerns about these problems were much higher, suggesting possible underdiagnosis of children's problems. Children with chronic problems had diminished family functioning, more school absences, and less participation in community activities compared with other children. Their parents experienced more difficulty with childcare, employment, and parenting skills. A change in treatment emphasis is needed, away from an exclusive focus on a child's developmental and behavioral problems to one that addresses the impacts of these problems on the family and community participation. A new approach to the way these issues are addressed and managed has the potential to enhance the quality of life for a child, as well as the parents, and to produce more meaningful and tangible solutions to these complex and increasingly evident problems.

Adolescent↗
PubMed2005

Effects of web-based psychoeducation on self-efficacy, problem solving behavior, stress responses and job satisfaction among workers: a controlled clinical trial.

This study examined effects of web-based psychoeducation on self-efficacy, problem solving behavior, stress responses and job satisfaction. The program was based on social cognitive theory and was primarily aimed at increasing knowledge of stress, self-efficacy, and the use of problem solving behavior. A total of 225 employees were invited to participate in the study. Participants were assigned to an intervention (n=112) or waiting list control group (n=113). Those in the intervention group were asked to access the website and to complete learning within 1 month. To investigate the intervention effect, the change score in the outcome variable was calculated by subtracting the score at pre-intervention from that at post-intervention (1 week after completion of the learning period). Then, the difference in the scores between groups was examined using analyses of covariance (ANCOVA) with the pre-intervention score as the covariate. We detected a marginally significant difference between groups in changes in job satisfaction from pre- to post-intervention (p=0.081). Participants in the intervention group showed an increase in job satisfaction score, while those in the waiting list control group showed a decrease in it. No significant differences were detected between groups in the other indicators (p>.10). We detected significant or marginally significant intervention effects on self-efficacy, problem solving behavior, stress responses, and job satisfaction among males and younger individuals, and those who had initially higher job strain and higher interest in managing stress. Further research is required with longer time periods (controlled follow-up) and a broader sample to fully determine the intervention effect.

Adult↗
PubMed1997

Contributions of maternal identity and lifestyle to young children's adjustment.

Early child behavior problems have been related to later child adjustment. Therefore, it is important to study factors, such as maternal characteristics, which may affect early child behavior. Existing science stresses the import of maternal identity formation as a key aspect of the early mother-child relationship; however, recent evidence also shows that mothers' health-related lifestyles are salient to preschool children's healthy adjustment. The relative contributions of these two influences on children's behavioral adjustment were compared in a longitudinal mail study of new mothers. The sample consisted of two cohorts of mothers (6 or 12 months postpartum at recruitment) systematically selected (every third name) from published birth announcements in a midwestern newspaper. Maternal identity and lifestyle were both measured when children were 6 to 12 months and were used to predict child behavioral problems 2 years later (N = 122). Using path analysis, the influence of maternal identity and lifestyle on child behavior problems was tested within one model with maternal age, education, family income, and social desirability statistically controlled. The model provided an acceptable fit to the data. The hypothesis that maternal identity would be related to child behavior problems was not supported; however, maternal lifestyle was significantly related to child behavior problems. These findings support the relationship between the mother's health-related lifestyle and her young child's adjustment.

Adult↗
PubMed2006

Developmental antecedents of late adolescence substance use patterns.

This longitudinal study examined antecedents of substance use behavior among 176 (53% male) adolescents. Adolescents were classified as (a) abstainers (n = 19), (b) experimenters (n = 65), (c) at-risk youth (n = 63), and (d) abusers (n = 29) based on their reported substance use behavior at age 17.5. Parental behavior, peer competence, and problem behavior, measured from early childhood through age 16, were examined as predictors of substance use patterns. Multinomial logistic regression models revealed that early maternal hostility, externalizing behavior problems in first grade and at age 16, internalizing behavior in first grade and at age 16, and parental monitoring at age 16 significantly differentiated substance use groups. The study provides evidence that experiences occurring early in development, in addition to those that occur later in development, can play a pivotal role in setting the stage for late adolescent substance use behavior.

Adolescent↗