Psychosocial Child Research Articles

Screening for psychosocial distress amongst war‐affected children: cross‐cultural construct validity of the CPDS

Large-scale psychosocial interventions in complex emergencies call for a screening procedure to identify individuals at risk. To date there are no screening instruments that are developed within low- and middle-income countries and validated for that purpose. The present study assesses the cross-cultural validity of the brief, multi-informant and multi-indicator Child Psychosocial Distress Screener (CPDS). The CPDS data of total samples in targeted catchment areas of a psychosocial care program in four conflict-affected countries (Burundi n = 4193; Sri Lanka n = 2573; Indonesia n = 1624; Sudan n = 1629) were studied to examine the cross-cultural construct validity of the CPDS across settings. First, confirmatory factor analyses were done to determine the likelihood of pre-determined theory-based factor structures in each country sample. Second, multi-sample confirmatory factor analyses were done within each country sample to test measurement equivalence of the factor structure as a measure of construct validity. A 3-factor structure reflecting the theoretical premises of the instrument (e.g., child distress, child resilience and contextual factors) was found in the samples from Burundi, Sri Lanka and Indonesia, albeit with context specific deviations. The robustness of the 3-factor structure as an indicator of construct validity was confirmed within these three samples by means of multi-sample confirmatory factor-analyses. A 3-factor structure was not found in the Sudan sample. This study demonstrates the comparability of the assessment by the CPDS of the construct 'non-specific psychosocial distress' across three out of four countries. Robustness of the factor structure of the CPDS within different samples refers to the construct validity of the instrument. However, owing to context-specific deviations of inter-item relationships, the CPDS scores cannot be compared cross-culturally, a finding that confirms the need for attention to contextual factors when screening for non-specific psychosocial distress.

Increasing Parent-Pediatrician Communication about Children's Psychosocial Problems

To examine the differential effects of two scoring procedures for a parent-completed measure, the Pediatric Symptom Checklist (PSC), designed to assess children's behavioral and emotional functioning, on parent-pediatrician communication concerning psychosocial issues. Prior to their medical appointment, 174 parents of children aged 4-16 were assigned to one of three experimental conditions: (1) typical medical care control, (2) Staff-Scored PSC administration, or (3) Parent-Scored PSC administration. Following the appointment, parent perception of parent-pediatrician communication was assessed. For children with more emotional and behavioral problems, participants in the Parent-Scored group and the Staff-Scored group had better parent-pediatrician communication scores than those in the control group. Both the Staff-Scored and Parent-Scored administrations of the PSC improved parent-pediatrician communication on psychosocial issues. The Parent-Scored PSC removed the scoring burden on the medical personnel.

Family Structure and Children's Psychosocial Outcomes

This article examines the influence of family structure on children's short-term psychosocial behavioral outcomes, including emotional disorder, conduct disorder, and prosocial behavior. The analysis uses five waves of data (1994-2003) from Canada's National Longitudinal Survey of Children and Youth to model how living in a cohabitational household (two biological parents) and how experiencing cohabitation dissolution influence children's behaviors, comparing these effects to outcomes observed in children from married biological-parent households. The findings indicate that growing up in a married biological-parent household does not offer a clear advantage. Most differences in behavioral problems across family structure associate with household demographics, low-income status, family dysfunction, and parental nurturance. As such, this study contributes two important findings. First, the results do not support the hypothesis that nonmarital cohabitation represents an undesirable child-rearing environment. Second, cohabitation dissolution has a nonsignificant effect on children's behaviors, which is surprising considering that divorce has a well-established harmful effect.

Repressive Adaptation in a Nonclinical Sample: Consistent and Inconsistent Reports of Child Psychosocial Functioning Across Informants

Using multiple indicators (self-report, parent report, school grades, and disciplinary referrals), we compared the psychosocial functioning of children across Weinberger's (1990) and Weinberger, Schwartz, and Davidson's (1979) repressive adaptive style (RAS) groups. Participants included 134 children ages 10 to 13 years that were recruited from public schools and 117 of their caregivers. Relative to nonrepressors, we hypothesized repressors to evidence lower levels of self-reported distress but higher parent-reported distress on the Behavior Assessment System for Children (BASC; Reynolds & Kamphaus, 1992). Summary scores from the BASC self-report differed significantly between repressors and nonrepressors in the expected directions. No significant group differences in parent-reported distress or school functioning emerged. Consistent with Phipps (2005), results question the predominant assumption that the RAS is associated with risk of psychosocial difficulties in children.

Preliminary Evaluation of Children's Psychosocial Rehabilitation for Youth with Serious Emotional Disturbance

Objective: This article introduces and evaluates children's psychosocial rehabilitation, a home- and community-based treatment for children with serious emotional disturbance. Method: In an open-trial design, the author used repeated-measures analysis of variance and Wilcoxon signed-rank tests to assess pre—post outcome ratings for 218 participants, ages 3 to 18, on the Child and Adolescent Functional Assessment Scale or the Preschool and Early Childhood Functional Assessment Scale. Average treatment time was 13 months. Results: Participants improved significantly in psychosocial functioning and psychological symptoms, with effect sizes ranging from large to small. Improvements were clinically significant for 78% of participants. Conclusions: Children's psychosocial rehabilitation shows promise as an empirically based treatment for serious emotional disturbance.

Child Psychosocial Adjustment and Parenting in Families Affected by Maternal HIV/AIDS

Child adjustment and parenting were examined in twenty-three 9–16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of programs targeting parenting skills to prevent or ameliorate child difficulties.

Development and validation of the child psychosocial distress screener in Burundi.

In non-Western countries, efficient and contextually valid methods of community screening are scarce. The present study describes the validation of a new, brief, 7-item multi-informant screener for conflict-affected children (Child Psychosocial Distress Screener; CPDS). To determine concurrent validity, the CPSD was administered to 65 children and their teachers. CPDS scores were compared with indication for psychosocial treatment based on an in-depth clinical assessment by a psychiatrist and psychologist. Construct validity was assessed by testing the measurement equivalence of the CPDS in a community sample (N = 2,240) in Burundi. The CPDS identifies indication for treatment with an accurateness of .81(sensitivity of .84; specificity of .60). Test?retest reliability of the instrument is good (.83). A robust and invariant factor structure provides evidence for the construct validity of the CPSD. The CPDS appears to be a useful multidimensional tool that measures nonspecific child psychosocial distress, detecting children with an indication for treatment. Because of brevity and the ability to be administered by nonspecialists, the CPDS can be an appropriate instrument to screen large populations of conflict-affected children.

Communication Patterns in Medical Encounters for the Treatment of Child Psychosocial Problems: Does Pediatrician–Parent Concordance Matter?

This study examined how pediatrician–parent social status concordance related to communication patterns in medical encounters during which children received treatment for psychosocial problems indicating attention deficit disorder or attention deficit hyperactivity disorder. Using data from 28 pediatric medical encounters occurring in a large southeastern metropolitan city during 2003, we focused on concordance according to race, gender, and education, and its relation to laughter, concern, self-disclosure, question asking, and information-giving utterances, and patient-centeredness. Results indicated that race-concordant pediatricians and parents frequently laughed, whereas parents asked many biomedical questions in gender-concordant encounters. Education-concordant pediatricians and parents expressed concern repeatedly, exchanged biomedical information freely, and shared communication control. Pediatricians also self-disclosed when interacting with college-educated parents.

The psychosocial consequences for children of mass violence, terrorism and disasters

Children and families are now in the front line of war, conflict and terrorism as a consequence of the paradigm shift in the nature of warfare and the growth of terror as a weapon. They are as vulnerable as are adults to the traumatizing effects of violence and mass violence. Furthermore, employing children as soldiers is not new, but it is continuing and young people are also perpetrators of other forms of violence. This paper summarizes a selection of the literature showing the direct and indirect psychosocial impacts on minors of their exposure to single incident (event) and recurrent or repetitive (process) violence. Additionally, children's psychosocial and physical development may be affected by their engagement with violence as victims or perpetrators. Several studies point to positive learning from certain experiences in particular communities while many others show the potential for lasting negative effects that may result in children being more vulnerable as adults. The spectrum of response is very wide. This paper focuses on resilience but also provides access to several frameworks for planning, delivering and assuring the quality of community and family-orientated and culture-sensitive responses to people's psychosocial needs in the aftermath of disasters of all kinds including those in which children and young people have been involved in mass violence.

Asking for Help with Child Psychosocial Problems

s: Abstracts of Papers Accepted for Presentation at the Annual Meeting of the Society for Developmental and Behavioral Pediatrics: Poster Session, Sunday, September 17, 2006, 6: 00 p.m. - 7: 00 p.m.: Abstract # 57

Coparent Support and Conflict in African American Single Mother-Headed Families: Associations With Maternal and Child Psychosocial Functioning

This longitudinal investigation examined main and interactive effects of coparent support and conflict on mother and child adjustment in 248 low-income, African American, single mother-headed families. The findings indicated that coparent conflict was a more robust predictor of mother and child maladjustment both cross-sectionally and longitudinally than was coparent support. Moreover, findings revealed that coparent conflict and support interacted to predict one parenting behavior, monitoring, both cross-sectionally and longitudinally. Coparent relationships characterized by high levels of support and low levels of conflict were associated with the highest levels of parental monitoring behavior, whereas coparent relationships characterized by low levels of support and high levels of conflict were associated with the lowest levels of monitoring. The findings highlight the importance of examining both positive and negative aspects of coparent relationships in this at-risk, but understudied, group.

Primary Care Clinicians' Use of Standardized Tools to Assess Child Psychosocial Problems

Children's psychosocial problems are prevalent but often inaccurately diagnosed. This study investigated primary care clinicians' (PCCs) use of standardized tools for psychosocial problems among children in whom they reported finding a problem. The data consisted of 21 065 unique visits by children ages 4 to 15 years in 204 practices. Parents completed questionnaires before seeing the PCCs, who completed a survey after the visit. This analysis included 3934 children who were recognized by PCCs as having one or more psychosocial problems. The primary outcome was the PCCs' usage of a tool to assess child psychosocial problems. PCCs used a tool in 20.2% of visits where a psychosocial problem was recognized, whereas 50% of PCCs never used such tools. Tools were less likely to be used by female PCCs and family practitioners and were less likely to be used with girls and African American children. Tools were more frequently used with children with attention problems, during visits for psychosocial problems, and when the PCC knew about the problem before the visits. PCCs use standardized tools infrequently to screen for, confirm, or monitor psychosocial problems.

Parents' and Children's Perceptions of Parental Behavior: Associations with Children's Psychosocial Adjustment in the Classroom

Objective. We examined correspondence in parents' and children's perceptions of parenting and associations between these perceptions and children's social adjustment in the classroom. Design. The sample included 214 children (M age = 9) from third to fifth grades and their parents. Children and parents reported on parenting behavior. Results. Parents' self-reports and children's reports about parents showed systematic differences, with parents perceiving themselves as more supportive than children perceived them to be. Direction of discrepancy between child and parent reports appeared to be more important than size of discrepancy in predicting child outcomes. Hierarchical regression analyses showed that parents' self-perceptions of parenting and children's perceptions of parenting were predictive of different measures of child psychosocial adjustment. Conclusions. The results of this study support the assumption that parents' self-perceptions and children's perceptions of parenting provide unique views of the family and unique relations to children's psychosocial adjustment.

The Relation of Social Capital to Child Psychosocial Adjustment Difficulties: The Role of Positive Parenting and Neighborhood Dangerousness

Substantial research attention has focused on the psychosocial adjustment problems of children and adolescents residing in disadvantaged neighborhoods. However, less attention has been directed to neighborhood factors within disadvantaged neighborhoods that may facilitate child psychosocial adjustment. An expanded model, assessing how social capital, neighborhood dangerousness, and positive parenting relate to child psychosocial adjustment difficulties, was estimated using structural equation modeling (Lisrel 8.3). Participants included 130 African American mothers and their children (mean age = 12.9 years) residing in inner city New Orleans, LA. The model examined 3 avenues through which social capital (e.g., support, neighborhood cohesion) may relate to fewer child psychosocial adjustment difficulties: a direct relation; through its relation to positive parenting; and through its relation to neighborhood dangerousness. Results indicate that social capital related to child psychosocial adjustment difficulties through positive parenting and neighborhood dangerousness, but not directly. Overall, the proposed model fit the observed data reasonably well. The results suggest that social capital in disadvantaged neighborhoods is important in indirectly facilitating child psychosocial adjustment and should be incorporated into assessment and intervention practices.

Positive parenting and child psychosocial adjustment in inner-city single-parent African American families. The role of maternal optimism.

The primary purposes of this study were to examine whether maternal optimism is related to positive parenting and child adjustment and whether it contributes beyond maternal depressive symptoms to our understanding. The participants were 141 African American single mothers and one of their children. Findings revealed that maternal optimism was associated with positive parenting and this association was only partially mediated by maternal depressive symptoms. Maternal optimism was not associated with child psychosocial adjustment, but positive parenting was associated with lower levels of both internalizing and externalizing difficulties. The utility of understanding the link between maternal optimism and parenting for prevention and intervention efforts aimed at enhancing quality of life and subsequent child adjustment is discussed, as well as directions for future research on maternal optimism.

Telling the Children: Disclosure of Maternal HIV Infection and Its Effects on Child Psychosocial Adjustment

We present descriptive information pertaining to mothers' decision to disclose their HIV infection status to their children, examine correlates of disclosure, and compare mother and child reports of psychosocial adjustment difficulties as a function of disclosure. In contrast to prior studies, a longitudinal (pre-disclosure to post-disclosure) design was used. Participants were 99 inner-city African American mothers and one of their non-infected children. At the last assessment, a majority (68%) of children were not aware of their mother's HIV status; however, most mothers planned to disclose eventually. Of the children who knew their mother's HIV status, almost all had been told by their mothers. Mothers reported a significant increase in child behavior problems and a decrease in mother-child relationship quality from pre- to post-disclosure. Children reported a significant increase in their understanding of HIV/AIDS, but no significant behavioral changes. Clinical implications of the findings and directions for future research are discussed.

An Evaluation of Nonresponse Bias in Peer, Self, and Teacher Ratings of Children's Psychosocial Adjustment

An Evaluation of Nonresponse Bias in Peer, Self, and Teacher Ratings of Children's Psychosocial Adjustment

An Evaluation of Nonresponse Bias in Peer, Self, and Teacher Ratings of Children's Psychosocial Adjustment

The last decades have shown a rapid increase in nonresponse rates. For this reason it is important to study nonresponse and think about it critically. In this article we investigated whether nonresponse affected estimates of the levels of adjustment problems in children and the correlations between these outcomes. The nonresponse was caused by parents who refused permission to interview their children at school, parents who did not return a questionnaire, teachers who did not complete the questionnaire, and parents who refused to participate in an in-depth study, with nonresponse rates of 9%, 69%, 25%, and 46% respectively. The sample consisted of 1282 children aged 4 5 years and the dependent measures were peer-rated sociometric status, self-rated wellbeing at school, and teacher-rated behaviour problems. Despite considerable nonresponse in some conditions our results showed hardly any evidence for bias. This suggested that bias cannot simply be inferred from the amount of nonresponse and that standard rules such as "nonresponse rates higher than 50% are not acceptable" lack a scientific basis. Instead, we argue that to assess nonresponse bias the specific conditions and analyses of the study will need to be considered and special measures may be required.

Role of Theory in Child Psychosocial Intervention and Research: Introductory Comments

(1999). Role of Theory in Child Psychosocial Intervention and Research: Introductory Comments. Journal of Clinical Child Psychology: Vol. 28, No. 4, pp. 490-492.

Maternal Factors Associated with Sexually Abused Children's Psychosocial Adjustment

The potential influence of maternal adjustment and parenting style on children's psychological adjustment following sexual abuse was examined. A battery of standardized parent and child self-report instruments were administered to 100 sexually abused children and their nonoffending mothers. The results of a series of multiple regression analyses indicated that the maternal self-reported depression significantly contributed to the expression of both post-traumatic stress disorder (PTSD) symptoms and parent-reported internalizing behavior problems in sexually abused children. In addition, children's perceptions of their mothers' parenting style as rejecting rather than accepting contributed to the children's self-reported levels of depression. Children's perceptions of maternal use of guilt and anxiety-provoking parenting methods contributed to increased levels of PTSD symptoms and parent-reported externalizing behavior problems. These findings are discussed in terms of their research and treatment implications.