The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: A meta-analysis.

In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital quality, parenting, and adolescent internalizing problems: A three-wave longitudinal study.

The present 3-wave, 3-year longitudinal study examined direct and indirect associations between marital quality, parenting, and adolescent internalizing problems, taking into account bidirectional associations between these concepts. Data were used from 428 Dutch families, consisting of 2 biological parents and 2 adolescents with mean ages of 13.4 and 15.2 years (at Time 1). Results from structural equation modeling analyses showed that low marital quality at Time 1 was directly related to adolescent internalizing problems at Time 2 in oldest siblings. However, support was not found for any indirect associations through parenting or for longitudinal associations from adolescent internalizing problems to parents' marital quality. Results are discussed in terms of implications for understanding the mechanism by which marital quality is related to adolescent internalizing problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of the Incredible Years parent, child, and teacher training programs on children's co-occurring internalizing symptoms.

The Incredible Years (IY) Series includes separate group interventions to improve parenting interactions, teacher classroom management, and child social-emotional regulation. Although originally developed to treat early onset conduct problems, IY targets many of the proposed mechanisms and risk factors for internalizing distress in early childhood. Prior studies have demonstrated the effects of the IY parent intervention on co-occurring depressive symptoms. We attempted to extend these findings by examining the unique and combined effects of IY interventions on children's co-occurring internalizing symptoms. One-hundred and fifty-nine families with children ages 4- to 8-years-old were randomly assigned to parent training (PT); parent plus teacher training (PT + TT); child training (CT); child plus teacher training (CT + TT); parent, child, plus teacher training (PT + CT + TT); or a waiting list control group. Children who received any of the intervention components were more likely to have lower mother-rated internalizing symptoms at posttreatment compared to children in a wait-list control group. Implications for future research and for designing interventions and prevention strategies for children with internalizing symptoms are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Maternal depression and parenting in relation to child internalizing symptoms and asthma disease activity.

This study tested a hypothesized model of the relationship between maternal depression and child psychological and physical dysfunction mediated by parenting and medication adherence. A sample of 242 children with asthma, aged 7 to 17, participated with their mothers. Maternal depression was assessed by self-report, and parenting was observed during family interaction tasks. Internalizing symptoms were assessed by self- and clinician reports. Asthma disease activity was assessed according to National Heart Lung and Blood Institute guidelines, and medication adherence was evaluated with a 24-hr recall method. Structural equation modeling indicated that negative parenting partially mediated the relationship between maternal depression and child internalizing symptoms. Child internalizing symptoms, in turn, mediated the associations between both maternal depression and negative parenting and asthma disease activity. Medication adherence did not mediate the link from maternal depression to disease activity. Thus, maternal depression was linked to child psychological dysfunction both directly and indirectly via negative parenting but linked to physical dysfunction only indirectly through psychological dysfunction. These findings suggest that diagnosing and treating depression in mothers of children with asthma would enhance child well-being both psychologically and physically. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Theraplay in the Chinese world: An intervention program for Hong Kong children with internalizing problems.

The primary objective of this study was to evaluate the effectiveness of Theraplay on reducing internalizing problems among young children. Described as at-risk for developing internalizing disorders, 46 children were randomly allocated to either the Theraplay condition or the wait-list control condition. A standardized measure of internalizing symptoms was completed before and after an 8-week period. Results showed that children from the Theraplay condition showed significantly fewer internalizing symptoms when compared to the waitlist group. Qualitative feedback from mothers and children were gathered to further understand the experience of Theraplay activities on the participants. Limitations and suggestions for future research directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specificity of relations between children's control-related beliefs and internalizing and externalizing psychopathology.

The authors examined the specificity of the relation between 3 types of control-related beliefs and internalizing and externalizing psychopathology in a sample of 290 clinic-referred children aged 7 to 17 years. Self-reported beliefs about control (the capacity to cause an intended outcome), contingency (the degree to which a desired outcome can be controlled by a relevant behavior), and competence (an individual's ability to produce the relevant behavior) across 3 domains (academic, behavioral, and social) showed more specific relations with psychopathology than have been previously reported. Among children with externalizing psychopathology, internalizing psychopathology may be specifically associated with increased self-critical awareness about their conduct; externalizing psychopathology may attenuate the specific negative relation between internalizing psychopathology and control-related beliefs in the social domain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of the RECAP intervention program for children with concurrent internalizing and externalizing problems.

The authors evaluated the efficacy of RECAP, a psychosocial intervention developed to treat concurrent internalizing and externalizing problem in children. Participants included 93 4th-grade children assigned to the treatment group or a no-treatment control group. The school-based program, which lasts the 9-month academic year, provides individual, group, classroom, teacher, and parent training in the RECAP skills-development curriculum, which was derived from empirically supported treatment programs for nonconcurrent internalizing and externalizing problems. Outcome assessments included parent-, teacher-, self-, and peer reports. A mixed hierarchical linear models analysis indicated that, overall, treatment children's rate of improvement in both internalizing and externalizing problems was significantly greater than that for control participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of internalizing, externalizing, and academic adjustment among children of deployed military service members.

Parental deployment during military conflicts has the potential to impact child adjustment. As increased numbers of military Service members have children, it is critical to understand the association between military deployment and child adjustment. In order to resolve inconsistencies in the existing literature, we performed a meta-analytic review of 16 studies that report associations of military deployment with internalizing, externalizing, and academic adjustment among children. Results indicate a small association between deployment and poorer adjustment. This association varied across several features of the studies. Age moderation was such that the associations are strongest in middle childhood and weakest during adolescence. The method that adjustment was assessed also moderated this association, such that maladjustment was evident primarily with parents' reports. Study design also moderated associations, such that comparisons to civilian controls indicated associations with maladjustment, whereas comparisons to nondeployed military and prepost comparisons did not. These findings summarize the existing quantitative literature to indicate that parental deployment has a negligible association with child maladjustment and provide a foundation for future research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reciprocal relationships between parent and adolescent internalizing symptoms.

Previous investigations of the association between parent and adolescent internalizing problems have been largely restricted to the unidirectional effect of parent symptoms on their children. This study therefore aimed to investigate potential reciprocal relationships between parent and adolescent internalizing symptoms. One-hundred and seventy-seven adolescents ages 14 to 18 years and their parents (172 mothers, 124 fathers) completed measures of depressive and anxiety symptoms at two time points, 6 months apart. Results supported reciprocity between maternal and adolescent internalizing symptoms but not between paternal and adolescent internalizing symptoms. In addition, the relationship between maternal symptoms and later adolescent symptoms was found to be partially mediated by maternal parenting self-esteem. The study highlights the potential impact of adolescent internalizing problems on maternal well-being, a phenomenon previously neglected in the literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital conflict, maternal and paternal parenting, and child adjustment: A test of mediation and moderation.

Parenting was examined as a mediator of associations between marital and child adjustment, and parent gender was examined as a moderator of associations among marital, parental, and child functioning in 226 families with a school-age child (146 boys). Parenting fully mediated associations between marital conflict and child internalizing and externalizing behaviors. Parent gender did not moderate associations when data from the full sample or families with girls only were evaluated. Parent gender did moderate associations when families with boys were evaluated, with the association between marital conflict and parenting stronger for fathers than mothers. A trend suggested fathers' parenting may be more strongly related to internalizing behavior and mothers' parenting may be more strongly related to externalizing behavior in boys. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Marital and severe parent-to-adolescent physical aggression in clinic-referred families: Mother and adolescent reports on co-occurence and links to child behavior problems.

This study examined the interplay of marital and severe parental physical aggression, and their links to child behavior problems, in 232 families of clinic-referred adolescents. Combined reports from mothers and adolescents indicated that two thirds of adolescents exposed to marital aggression in the past year had also experienced parental aggression. Mothers and fathers who used and/or were victims of marital aggression were both more likely to direct aggression toward their adolescent. Mother and youth reports of marital aggression were tied to each party's report of greater externalizing problems and to youth reports of greater internalizing problems. Severe parental aggression uniquely predicted maternal reports of both behavior problems, after controlling for marital aggression; the reverse was not true. Also, adolescents exposed to both types of family aggression did not display greater maladjustment than those subjected to only one type of family aggression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Within-child associations between family income and externalizing and internalizing problems.

Within-child associations between family income and child externalizing and internalizing problems were examined using longitudinal data from the NICHD Study of Early Child Care and Youth Development (2004a, 2004b; N = 1,132). Variations in income effects were estimated as a function of whether families were poor, whether mothers were partnered, and the number of hours mothers and their partners were employed. On average, children had fewer externalizing problems during times when their families' incomes were relatively high than during times when their families' incomes were relatively low; the estimated benefits of increased income were greatest for children who were chronically poor. For both externalizing and internalizing problems, income was most strongly associated with problems when chronically poor children's mothers were partnered and employed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linking dimensional models of internalizing psychopathology to neurobiological systems: Affect-modulated startle as an indicator of fear and distress disorders and affiliated traits.

Integrative hierarchical models have sought to account for the extensive comorbidity between various internalizing disorders in terms of broad individual difference factors these disorders share. However, such models have been developed largely on the basis of self-report and diagnostic symptom data. Toward the goal of linking such models to neurobiological systems, we reviewed studies that have employed variants of the affect-modulated startle paradigm to investigate emotional processing in internalizing disorders as well as personality constructs known to be associated with these disorders. Specifically, we focused on four parameters of startle reactivity: fear-potentiated startle, inhibition of startle in the context of pleasant stimuli, context-potentiated startle, and general startle reactivity. On the basis of available data, we argue that these varying effects index differing neurobiological processes related to mood and anxiety disorders that are interpretable from the standpoint of dimensional models of the internalizing spectrum. Further, we contend that these empirical findings can feed back into and help reshape conceptualizations of internalizing disorders in ways that make them more amenable to neurobiological analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance-Abusing Parents' Attitudes Toward Allowing Their Custodial Children to Participate in Treatment: A Comparison of Mothers Versus Fathers.

Attitudes of substance-abusing fathers (N = 214) and mothers (N = 106) entering outpatient treatment toward allowing their custodial children to participate in individual- or family-based interventions were examined. Only 129 parents (40%) reported they would be willing to allow their children to participate in treatment. A significantly greater proportion of mothers reported they would assent to their children participating (N = 58 [55%]) compared with fathers (N = 71 [33%]). Factors associated with parents' attitudes toward their children participating included parents' (a) referral source into treatment, (b) level of psychiatric distress, and (c) substance use frequency in the previous year. Thus, parental reluctance to allow their children to participate appears to be a significant barrier in efforts to intervene with these at-risk children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of paternal and maternal depressive symptoms on child internalizing symptoms and asthma disease activity: Mediation by interparental negativity and parenting.

This study tested a hypothesized model of the relationships among parental depressive symptoms, family process (interparental negativity and negative parenting behavior), child internalizing symptoms, and asthma disease activity. A total of 106 children with asthma, aged 7 to 17, participated with their fathers and mothers. Parental depressive symptoms were assessed by self-report. Interparental and parenting behaviors were observed and rated during family discussion tasks. Child internalizing symptoms were assessed by self-report and by clinician interview and rating. Asthma disease activity was assessed according to National Heart, Lung and Blood Institute guidelines. Results of structural equation modeling generally supported interparental negativity and negative parenting behavior as mediators linking parental depressive symptoms and child emotional and physical dysfunction. However, paternal and maternal depressive symptoms play their role through different pathways of negative family process. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Parent and Child Psychological Factors in Pediatric Syncope and Other Somatic Symptoms.

The authors examined associations among parental and child adjustment, child syncope, somatic, and school problems. Participants were children (N = 56) ages 7-18 years with syncope. Measures included syncope severity, parental distress, and children's internalizing symptoms. For children diagnosed negative for neurocardiogenic syncope (NCS), their fathers' and their own psychological symptoms were positively associated with the severity of syncope, whereas their mothers' functioning was negatively associated with the severity of syncope. Also, for the negative NCS group, fathers' psychological functioning was associated with children's nonsyncope somatic complaints but not with their school problems. For the positive NCS group, few significant father-child associations were found, but several significant positive associations were revealed between mothers' psychological symptoms and their children's syncope as well as somatic and school problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Language impairment and psychopathology in infants, children, and adolescents.

Reviews the book, Language impairment and psychopathology in infants, children, and adolescents by Nancy J. Cohen (see record 2001-05782-000). Approximately half of the children referred to mental health clinics for social-emotional problems have, on testing, been shown to have co-occurring language impairment. Conversely, about the same percentage of children originally seen for difficulties with language are later diagnosed with social-emotional problems. It is this overlap that Nancy Cohen explores in this concise and immensely readable book. We view this book as a broad and integrative first step that ought to be followed with more depth in specific areas. Thus, although much remains to be done, this book provides an excellent overview of a complex literature and will encourage interesting new clinical and research endeavours. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of parent behavior-management training on child depressive symptoms.

The present study tested the impact of a parent behavior-management intervention on child depressive and internalizing symptoms. One hundred eighty-one children were randomly assigned to receive a videotape modeling parenting intervention, the Incredible Years, or to a wait-list control group. Children who received the intervention were more likely to have lower mother-rated mood and internalizing symptoms at post-treatment, compared with children in a wait-list control group. The effect sizes observed in the present intervention fell in the small-to-medium range for the sample as a whole, and some evidence supported the authors' hypothesis that effects would be strongest for children with baseline internalizing symptoms in the clinical range. Subsequent analyses also revealed that perceived changes in parenting effectiveness mediated the effect of treatment on children's post-treatment internalizing symptoms. The finding was consistent with study hypotheses and social learning explanations of child internalizing symptoms that guided selection of putative mechanisms. Implications for counseling psychologists and for designing interventions and prevention strategies for children with internalizing symptoms are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rethinking environmental contributions to child and adolescent psychopathology: A meta-analysis of shared environmental influences.

Behavioral genetic research has concluded that the more important environmental influences result in differences between siblings (referred to as nonshared; e2), whereas environmental influences that create similarities between siblings (referred to as shared; c2) are indistinguishable from zero. However, there is mounting evidence that during childhood and adolescence, c2 may make important contributions to most forms of psychopathology. The aim of the meta-analysis was to empirically confirm this hypothesis. The author examined twin and adoption studies (n = 490) of internalizing and externalizing psychopathology prior to adulthood. Analyses revealed that c2 accounted for 10%–19% of the variance within conduct disorder, oppositional defiant disorder, anxiety, depression, and broad internalizing and externalizing disorders, regardless of their operationalization. When age, informant, and sex effects were considered, c2 generally ranged from 10%–30% of the variance. Importantly, c2 estimates did not vary across twin and adoption studies, suggesting that these estimates reflect actual environmental influences common to siblings. The only exception was attention-deficit/hyperactivity disorder, which appeared to be largely genetic (and particularly nonadditive genetic) in origin. Conceptual, methodological, and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)