Disruptive Behavior Symptoms Research Articles

Relationship between Traumatic Experiences, Circadian Preference and ADHD Symptoms in Adolescents with ADHD Residing in Institutional Care: A Controlled Study

ABSTRACT Circadian preference, describes biological and behavioural characteristics that influence the ability to plan daily activities according to optimal waking times. It is divided into three main categories: morning, evening and intermediate. In particular, the evening chronotype is associated with conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Post Traumatic Stress Disorder (PTSD). This study was conducted in three groups aged 14–18 years: The first group consisted of 34 adolescents diagnosed with ADHD who had been in institutional care for at least two years and had not used medication in the last six months. The second group included 29 adolescents with ADHD living with their families who had not used medication in the last six months. The third control group consisted of 32 healthy adolescents. The study utilized sociodemographic data forms, the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) to measure ADHD symptoms, the Childhood Chronotype Questionnaire (CCQ), and the Childhood Trauma Questionnaire (CTQ). In institutionalized adolescents with diagnosed ADHD, ADHD and disruptive behavior symptoms were more severe. Increased trauma scores were associated with higher ADHD and disruptive behaviour symptom severity and evening chronotype. In the conducted mediation analysis, evening chronotype was identified as a full mediator in the relationship between trauma symptoms and ADHD symptoms, while it was determined as a partial mediator in the relationship between trauma symptoms and PTSD symptoms. In conclusion, traumatic experiences in institutionalized adolescents with diagnosed ADHD may exacerbate ADHD and disruptive behavior symptoms. Evening chronotype is associated with ADHD and disruptive behavior symptoms, and therefore, the chronotypes of these adolescents should be assessed. Chronotherapeutic interventions may assist in reducing inattention, hyperactivity, and behavioral problems.

Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial.

Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5% of children and 2.5% of adults worldwide. Comorbidities are frequent, and Oppositional Defiant Disorder (ODD) reaches 50%. Family environment is crucial for the severity of behaviors and for prognosis. In middle-income countries, access to treatment is challenging, with more untreated children than those under treatment. Face-to-face behavioral parent training (PT) is a well-established intervention to improve child behavior and parenting. A clinical trial was designed to compare PT-online and face-to-face effects to a waiting list group. Outcomes were the ADHD and ODD symptoms, parental stress and styles, and quality of life. Families were allocated into three groups: standard treatment (ST), ST + PT online, and ST + Face-to-Face PT. We used repeated measures ANOVA for pre × post treatment analysis corrected for multiple comparisons. Parent training was effective in reducing symptoms of ADHD (p = 0.030) and ODD (p = 0.026) irrespective of modality (p = 1.000). The combination of ST and PT was also associated with better quality of life in the physical domain for patients (p = 0.009) and their parents (p = 0.050). In addition to preliminary data, online intervention seems effective for parenting and improving social acceptance of children. The potential to reach many by an online strategy with a self-directed platform may imply effectiveness with a low cost for public health to support parents' symptoms management.

Anxiety and Disruptive Behavior Symptoms and Disorders in Preschool-Age Offspring of Parents With and Without Bipolar Disorder: Associations With Parental Comorbidity

Objective: We examined the relative contribution of parental bipolar disorder (BPD) and psychiatric comorbidities (disruptive behavior disorders [DBD] and anxiety disorders) in predicting psychiatric symptoms and disorders in 2-5-year-old offspring. Methods: Participants were 60 families with a parent with BPD and 78 offspring and 70 comparison families in which neither parent had a mood disorder and 91 offspring. Parent and offspring diagnoses and symptoms were assessed using standardized diagnostic interviews and measures, with offspring assessors masked to parental diagnoses. Results: Offspring of parents with BPD had significant elevations in behavioral, mood and anxiety disorders and symptoms. Both parental BPD and DBD contributed to elevations in child disruptive behavioral symptoms, whereas child anxiety symptoms were more strongly predicted by comorbid parental anxiety. Parental BPD was a stronger predictor than comorbid DBD of child DBDs. Conclusion: Some of the elevated risk for disorders in preschoolers is accounted for by parental comorbidity.

Developmental trajectories of anger and sadness dysregulation in childhood differentially predict later borderline symptoms.

Difficulties with emotion regulation are integral to borderline personality disorder (BPD) and its hypothesized developmental pathway. Here, we prospectively assess trajectories of emotion processing across childhood, how BPD symptoms impact these trajectories, and whether developmental changes are transdiagnostic or specific to BPD, as major depressive (MDD) and conduct disorders (CD) are also characterized by emotion regulation difficulties. This study included 187 children enriched for those with early symptoms of depression and disruptive behaviors from a longitudinal study. We created multilevel models of multiple components of emotional processing from mean ages 9.05 to 18.55 years, and assessed the effect of late adolescent BPD, MDD, and CD symptoms on these trajectories. Linear trajectories of coping with sadness and anger, and quadratic trajectories of dysregulated expressions of sadness and anger were transdiagnostic, but also exhibited independent relationships with BPD symptoms. Only inhibition of sadness was related to BPD symptoms. The quadratic trajectories of poor emotional awareness and emotional reluctance were also independently related to BPD. Findings support examining separable components of emotion processing across development as potential precursors to BPD, underscoring the importance of understanding these trajectories as not only a marker of potential risk but also potential targets for prevention and intervention.

Effectiveness of Clinic-Based Brief Behavioral Intervention (BBI) in Long-term Reduction of ADHD Symptoms Among Preschoolers.

Preschoolers commonly experience symptoms of ADHD and disruptive behavior problems. Behavioral parent management training (PMT) is an evidence-based intervention for addressing both ADHD and disruptive behaviors in this population; however, many PMT programs are burdensome in length and have limited data regarding long-term effectiveness for ADHD specific outcomes. This study examined outcomes up to 1year following completion of a brief behavioral intervention (M = 6.51 sessions) for preschoolers. Participants were children aged 2-6years with clinically significant disruptive behaviors and their parents. Results demonstrated significant improvements in parent-reported child hyperactivity and inattention from pre-to-post intervention, with sustained improvement at 6months and 1year post intervention. Teacher-reported hyperactivity and inattention also showed significant improvements from pre-to-post intervention, which were maintained across time points. These results were also found among a subset of participants with clinically significant ADHD symptoms at baseline. This study highlights the long-term effectiveness of a brief PMT program to address symptoms of ADHD and disruptive behaviors in preschoolers. Findings support the recommendation to offer PMT as a first-line intervention for preschoolers with ADHD symptoms to reduce the need for early intervention with stimulant medication and address comorbid disruptive behaviors.

The Prevalence of Psychotic Symptoms, Violent Ideation, and Disruptive Behavior in a Population With SARS-CoV-2 Infection: Preliminary Study.

BackgroundThe COVID-19 disease results from infection by the SARS-CoV-2 virus to produce a range of mild to severe physical, neurological, and mental health symptoms. The COVID-19 pandemic has indirectly caused significant emotional distress, triggering the emergence of mental health symptoms in individuals who were not previously affected or exacerbating symptoms in those with existing mental health conditions. Emotional distress and certain mental health conditions can lead to violent ideation and disruptive behavior, including aggression, threatening acts, deliberate harm toward other people or animals, and inattention to or noncompliance with education or workplace rules. Of the many mental health conditions that can be associated with violent ideation and disruptive behavior, psychosis can evidence greater vulnerability to unpredictable changes and being at a greater risk for them. Individuals with psychosis can also be more susceptible to contracting COVID-19 disease.ObjectiveThis study aimed to investigate whether violent ideation, disruptive behavior, or psychotic symptoms were more prevalent in a population with COVID-19 and did not precede the pandemic.MethodsIn this preliminary study, we analyzed questionnaire responses from a population sample (N=366), received between the end of February 2021 and the start of March 2021 (1 year into the COVID-19 pandemic), regarding COVID-19 illness, violent ideation, disruptive behavior, and psychotic symptoms. Using the Wilcoxon rank sum test followed by multiple comparisons correction, we compared the self-reported frequency of these variables for 3 time windows related to the past 1 month, past 1 month to 1 year, and >1 year ago among the distributions of people who answered whether they tested positive or were diagnosed with COVID-19 by a clinician. We also used multivariable logistic regression with iterative resampling to investigate the relationship between these variables occurring >1 year ago (ie, before the pandemic) and the likelihood of contracting COVID-19.ResultsWe observed a significantly higher frequency of self-reported violent ideation, disruptive behavior, and psychotic symptoms, for all 3 time windows of people who tested positive or were diagnosed with COVID-19 by a clinician. Using multivariable logistic regression, we observed 72% to 94% model accuracy for an increased incidence of COVID-19 in participants who reported violent ideation, disruptive behavior, or psychotic symptoms >1 year ago.ConclusionsThis preliminary study found that people who reported a test or clinician diagnosis of COVID-19 also reported higher frequencies of violent ideation, disruptive behavior, or psychotic symptoms across multiple time windows, indicating that they were not likely to be the result of COVID-19. In parallel, participants who reported these behaviors >1 year ago (ie, before the pandemic) were more likely to be diagnosed with COVID-19, suggesting that violent ideation, disruptive behavior, in addition to psychotic symptoms, were associated with COVID-19 with an approximately 70% to 90% likelihood.

Systematic Review and Meta-analysis: Psychosocial Treatments for Disruptive Behavior Symptoms and Disorders in Adolescence

Disruptive behavior disorders (DBDs) represent a common motive for referral among youths. This meta-analysis aimed at estimating the efficacy of psychosocial interventions for adolescents with DBDs. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review of MEDLINE/PubMED/PsycINFO/Cochrane Central Register of Controlled Trials was conducted. Eligible studies were randomized controlled trials (RCTs) administering psychosocial interventions to adolescents with DBD, published before April 5, 2020. From the initial set of 6,006 records, 17 RCTs involving 18 cohorts (16 publications) were subjected to a random-effect meta-analysis (involving sensitivity, subgroup, and meta-regression analyses). Primary and secondary outcomes were externalizing symptoms at RCT endpoint (ie, standardized mean difference [SMD]) and acceptability (drop-out odds ratio [OR]), respectively. Risk of bias was assessed using the Risk of Bias 2 tool. A total of 17 RCTs, involving 1,954 adolescents, were included. The mean age was 14.09 (SD 1.33) years; 61% were male. The mean RCT duration was 12 weeks, with a mean follow-up of 8 (SD 3.98) months. Concern over risk of bias emerged in 12 studies, with high concern in 6. Psychosocial interventions had a large effect size at RCT endpoint (SMD= 0.98, 95% CI=-0.55 to-1.38, k= 18) and were acceptable (drop-out OR= 1.29, 95% CI= 0.62 to 2.70, k= 13). However, this beneficial effect did not persist at follow-up (SMD=-0.36, 95% CI= 0.06 to-0.78, k= 10). Family format was the most effective variable. No other clinically significant moderator was found. Psychosocial interventions involving the families of DBD adolescents are effective and acceptable in the short term. Future studies should focus on strategies to achieve their long-term efficacy.

Evaluation of the Developmental Trauma and Attachment Program for Decreasing Disruptive Behavior Among Adolescents in a Residential Setting

This evaluation inspected the degree of symptom improvement associated with the Developmental Trauma and Attachment Program for decreasing disruptive behavior symptoms among youth in residential treatment following traumatic experiences within domestic and international adoption and foster care systems. Participants were 82 youth (M age = 14.03 years) who were predominately born in the United States (n = 55) with 27 identifying with international domiciles. Analyses of pre–post data contrasts indicated statistically significant decreases in disruptive behavior symptoms from admission to discharge associated with small and medium effect sizes. Nearly 1 in 4 participants reported clinically significant changes associated with treatment, with about 1 in 3 reporting improvements, but not within the clinically significant range. Limitations to the generalization of findings and recommendations for future investigations are provided.

Pandemic parenting: A pilot study of in-person versus internet-DOCS K-5 for caregivers of school-age children with disruptive behaviors.

Behavioral parent training (BPT) programs are needed to address disruptive behavior disorders among school-aged children. Given the prolonged COVID-19 pandemic and associated mental health consequences, adapting BPTs to telehealth modalities is necessary to ensure continued services to children and families. This pilot study evaluated the use of a telehealth vs in-person modality to deliver the Developing Our Children's Skills K-5 (DOCS K-5) BPT. Participants were caregivers of children enrolled in elementary school exhibiting disruptive behaviors who participated in either in-person DOCS K-5 (n = 21) or internet-DOCS K-5 (i-DOCS K-5; n = 34). Pre- and post-intervention outcome measures were collected for child disruptive behavior, parenting stress, and caregiver symptoms of depression while consumer satisfaction was assessed at post-test only. Multiple linear and Poisson regression models were performed to assess the effect of session modality on the outcomes. Child disruptive behavior, parenting stress and depression, and consumer satisfaction scores were not significantly different across groups, even after adjusting for baseline characteristics. The results of this study provide preliminary evidence that the i-DOCS K-5 modality is as effective as the in-person program. Study findings may be beneficial to practitioners treating school-age children and utilizing telehealth interventions during the COVID-19 pandemic and onward.

The role of perceived threats on mental health, social, and neurocognitive youth outcomes: A multicontextual, person-centered approach.

Perceived threat in youth's environments can elevate risk for mental health, social, and neurocognitive difficulties throughout the lifespan. However, few studies examine variability in youth's perceptions of threat across multiple contexts or evaluate outcomes across multiple domains, ultimately limiting our understanding of specific risks associated with perceived threats in different contexts. This study examined associations between perceived threat in youth's neighborhood, school, and family contexts at ages 9-10 and mental health, social, and neurocognitive outcomes at ages 11-12 within a large US cohort (N = 5525) enrolled in the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Latent profile analysis revealed four distinct profiles: Low Threat in all contexts, Elevated Family Threat, Elevated Neighborhood Threat, and Elevated Threat in all contexts. Mixed-effect models and post hoc pairwise comparisons showed that youth in Elevated Threat profile had poorer mental health and social outcomes 2 years later. Youth in the Elevated Family Threat profile uniquely showed increased disruptive behavior symptoms, whereas youth in the Elevated Neighborhood Threat profile predominantly displayed increased sleep problems and worse neurocognitive outcomes 2 years later. Together, findings highlight the importance of considering perceptions of threat across multiple contexts to achieve a more nuanced developmental picture.

DISRUPTIVE BEHAVIORS AMONG ELEMENTARY SCHOOL STUDENTS

One of the negative behaviors that often appears among elementary school students is disruptive behavior. Symptoms of disruptive behaviors are the behaviors related to learning activities, the behaviors that interfere with students' rights in learning, psychologically and physically unsafe behaviors, and the behaviors that cause property damages at schools. This article aims to provide insightful knowledge, especially for parents and teachers, about disruptive behavior and understand it so that parents and teachers can reinforce it and the children avoid disruptive behavior. The research method in this article is a literature review. This article contains definitions, causes, and symptoms of disruptive behavior. In addition, this article provides some solutions and tips for teachers and parents on how to deal with children who behave disruptively. One of the strategies to deal with disruptive behavior is guidance and counseling services based on a developmental approach. There are several forms of intervention to overcome disruptive behavior that practitioners of clinical and developmental therapy have carried out with different target focuses, namely on children, parents, and the environment. These interventions are necessary so that the opportunity to take advantage of childhood development can be appropriately realized.

BUILDING ORGANIZATIONAL SKILLS AND EXECUTIVE FUNCTIONS IN YOUTH WITH ADHD: A WORKSHOP ON EMPIRICALLY SUPPORTED TREATMENTS THAT WORK FOR CHILDREN AND ADOLESCENTS

Participants will be provided with content to effectively treat youth with ADHD using 2 efficacious treatments: one for children and one for teens. The lead authors of the manuals used in the RCT will present. Participants will learn methods for identifying children with ADHD who show impaired executive functioning (EF) and deficits in organization, time management, and planning (OTMP). Participants will learn how to engage youth and parents, guide parents in behavior management, build skills in youth, and obtain teacher support. Many youths with ADHD have impairing deficits in EF and OTMP by 2 clinical research teams. Organizational skills training (OST) for children and Supporting Teens’ Autonomy Daily (STAND) for teens address the gaps that youth with ADHD demonstrate. This Workshop provides training in 2 specialized treatments that address deficits in OTMP skills and EF. Participants will learn about OTMP and EF deficits and how to use these interventions. Participants will learn about treatment sessions, observe demonstrations of treatment, and practice treatment components in lecture, discussions, quizzes, and video demonstrations. The Workshop will be divided into 2 sections; practices for children first and teens second. Special content will focus on adaptations for telepsychiatry delivery and addressing virtual school demands. The results of the RCT comparing OST to a waitlist control found improvements in organizational skills, homework problems and family conflict, and academic productivity. The RCT for STAND found significant differences between STAND and treatment as usual. STAND participants were better organized and showed reduced disruptive behavior and ADHD symptoms, and their parents used contingency management strategies more often, and teens engaged in actions that contributed to improved grade point averages (GPAs). OST and STAND are efficacious in building skills for youth with ADHD. Skills improvements are associated with improved home and school functioning. This Workshop teaches how to apply these interventions.

Neural Responses to Fluoxetine in Youths with Disruptive Behavior and Trauma Exposure: A Pilot Study.

Objective: A preliminary investigation of the impact of a serotonergic agent (fluoxetine) on symptom profile and neural response in youths with disruptive behavior disorders (DBDs) and a history of trauma exposure.Methods: There were three participant groups: (i) Youths with DBDs and trauma exposure who received fluoxetine treatment for 8 weeks (n = 11); (ii) A matched group of youths with DBDs and trauma exposure who received routine regular follow-up in an outpatient clinic (n = 10); and (iii) Typically developing youths (n = 18). All participants conducted an expression processing functional magnetic resonance imaging task twice, 8 weeks apart: (pretreatment and post-treatment for youths with DBDs).Results: Youths with DBDs and trauma exposure who received fluoxetine treatment compared to the other two groups showed: (i) significant improvement in externalizing, oppositional defiant disorder, irritability, anxiety-depression, and trauma-related symptoms; (ii) as a function of fearful expression intensity, significantly decreased amygdala response and increased recruitment of regions implicated in top-down attention control (insula cortex, inferior parietal lobule, and postcentral gyrus) and emotional regulation (ventromedial prefrontal cortex [vmPFC]); and (iii) correlation between DBD/irritability symptom improvement and increased activation of top-down attention control areas (inferior parietal lobule, insula cortex, and postcentral gyrus) and an emotion regulation area (vmPFC).Conclusions: This study provides preliminary evidence that a serotonergic agent (fluoxetine) can reduce disruptive behavior and mood symptoms in youths with DBDs and trauma exposure and that this may be mediated by enhanced activation of top-down attention control and emotion regulation areas (inferior parietal lobule, insula cortex, and vmPFC).

The relationships of parent- and child-related psychiatric conditions with oppositional defiant disorder and conduct disorder symptoms in children with ADHD

ABSTRACT This cross-sectional study evaluated the impacts of maternal and paternal affective temperament traits, maternal and paternal ADHD, depression and anxiety symptoms, parenting styles, child’s depression and anxiety disorder symptoms, and child’s autistic traits on the oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms of children with attention-deficit/hyperactivity disorder (ADHD). Analysis showed a positive relation of maternal anxious and irritable temperament and child inattention, hyperactivity–impulsivity and obsessive-compulsive disorder (OCD) scores on ODD scores. However, there was a negative relationship between parental acceptance/involvement and ODD scores. Regarding CD scores, maternal irritable and paternal cyclothymic and hyperthymic temperament scores and child ODD and autistic trait scores showed a positive relationship, whereas maternal ADHD showed a negative relationship on CD scores. Certain parental affective temperaments, parenting styles, child’s OCD and autistic traits, and maternal ADHD may be important for the severity of disruptive behavioral disorder symptoms in children with ADHD.

Digital Interventions to Promote Health and Well-Being of Older Adults

The population of older adults is on the rise and so is their adoption of technology. According to the Pew Research Center, growing numbers of older adults are using smartphones, tablets, and the internet. Technology can also be an innovative and accessible way to deliver interventions that promote positive health outcomes. But implementing and evaluating digital interventions, especially those targeted to cognitively frail or otherwise vulnerable older adults, is not easy. The first presentation in this international interdisciplinary symposium sets the stage for discussing some of the barriers encountered. Specifically, it addresses the issue of compliance of adults with Mild Cognitive Impairment (MCI) while using internet-based cognitive behavioral therapy for sleep disturbance. The second presentation described a digital tool to screen and interview older adults in a hospital emergency department who may be experiencing mistreatment. This is followed by a study of use of voice assistant reminders to help aging adults adhere to daily completion of a diary to self-monitor pain symptoms. The fourth presentation describes a feasibility study of a digital screen-based device to calm long-term care home residents exhibiting disruptive Behavioral and Psychological Symptoms of Dementia. Symposium speakers and participants will be encouraged to dialogue on how some of the implementation and evaluation barriers described might be overcome or avoided as well as to share success stories from their own research on digital interventions for older adults living at home, in congregate housing or in hospital settings.

Development of the parental self-efficacy scale for preventing challenging behaviors in children with autism spectrum disorder.

Almost all children with autism spectrum disorder (ASD) have experienced challenging behavior, including disruptive and aggressive behavior symptoms to both themselves and others. In conjunction with appropriate strategic parenting, challenging behavior can be prevented by empowering children's sociality and optimizing their environment. However, a means of measuring such parenting has yet to appear. This study developed the Parental Self-Efficacy Scale for Preventing Challenging Behaviors in Children with Autism Spectrum Disorder (PASEC) and evaluated its reliability and validity. Self-administered questionnaires were distributed to 1,344 parents of children with ASD at all 521 child development support centers in Japan. Confirmed construct validity of the PASEC was determined using confirmatory factor analysis. Internal consistency of the PASEC was calculated using Cronbach's alpha. The self-efficacy subscale of the Parenting Sense of Competence (PSOC) was administered to assess criterion-related validity of the PASEC. In total, 260 parents provided valid responses. Exploratory and confirmatory factor analyses identified six items from two factors: empowerment of children's sociality and optimization of children's environment. The final model showed goodness-of-fit index, 0.981; adjusted goodness-of-fit index, 0.944; comparative fit index, 0.999; and root mean square error of approximation, 0.019. Cronbach's alpha for the entire PASEC was 0.82; that for each factor was above 0.70. The correlation coefficient between the self-efficacy subscale of the PSOC and the entire PASEC was r = 0.52 (P <0.001). The PASEC demonstrated adequate reliability and validity to assess parents' self-efficacy for preventing challenging behavior for children with ASD. That scale can help prevent challenging behavior; it can contribute to improving the mental health of parents and children with ASD as well as to primary prevention of child maltreatment and abuse.

Evaluating a Brief Behavioral Parenting Program for Parents of School-aged Children with ADHD

SYNOPSIS Objective. Typical parenting programs require considerable time inputs, which can be a significant barrier to program access. Here we assessed whether a brief behavioral parenting program, 1-2-3 Magic, would be effective in reducing disruptive behavior and ADHD symptoms in school-aged children with ADHD and dysfunctional parenting in their parents. Design. Fifty-seven parents of children aged 6–12 years were randomly allocated to the treatment group (n= 28) or waitlist-control group (n= 29). Treatment-group parents participated in the 1-2-3 Magic group program over three consecutive weeks. Treatment-group data were collected at pre-, post-intervention, and 6-month follow-up, and control-group data were collected at pre- and post-intervention, with child and parental behavior change assessed using the Eyberg Child Behavior Inventory, Parent Stress Index, and Conners. Results. Parents in the treatment-group reported less child disruptive behavior, reduced child ADHD symptom severity, and less dysfunctional parenting at post-intervention compared with controls. Post-intervention results indicated that the major intervention effects were maintained at the 6-month follow-up. Conclusions. Findings provide preliminary treatment efficacy for this brief behavioral parenting intervention for school-aged children with ADHD and their parents.

Responsive Parenting Buffers the Impact of Maternal PTSD on Young Children

SYNOPSISObjective. This study investigates maternal responsive parenting behaviors as a theorized buffer to the detrimental impact of maternal PTSD symptoms on young children’s depression and anxiety symptoms, disruptive behavior, and stress-related symptoms. Design. A multi-ethnic sample of 242 trauma-exposed mothers and their preschool-aged children was assessed. Maternal responsive parenting behaviors were observed during standardized parent-child interactions. Maternal and child mental health symptoms were reported by mothers. Results. Maternal PTSD symptoms were associated with their responsive parenting behaviors and predicted children’s mental health symptoms. Responsive parenting was inversely associated with children’s depression and stress-related symptoms. Moderation analyses revealed an interactive effect of maternal symptoms and responsive parenting on preschool children’s disruptive behavior and stress-related symptoms. Conclusions. Responsive parenting behaviors can mitigate the ill effects of maternal PTSD symptoms. Nurturing relationships buffer the impact of maternal PTSD. Helping parents’ to sensitively respond to their young children’s distress can support positive outcomes in children.

FAKTOR AYAH DAN IBU YANG BERKONTRIBUSI TERHADAP MUNCULNYA GEJALA PERILAKU DISRUPTIF REMAJA

Disruptive behavior according to DSM 5 is a pattern of behavior that violates the rights of others, aggression, property destruction and or that leads individuals to experience significant conflicts with violations of social norms or authority figures. This study aims to examine the significance of two factors derived from the family towards the emergence of disruptive behavior that are the family expressed emotion and perceived of parentchild relationships. There are 237 teenagers was participated in this study (aged 15-18 years old) who lived with their parent obtained from the scaling of SDQ, LEE and PACQ. The result of the regression indicated the two predictors explained 5,3% of variance (adjusted R2 = .053, F(3.235) = .013, p&lt;.05). The implications of this study are the family expressed emotion and perceived of parent-child relationships are two factors that can contributed to the emergence of disruptive behavior symptoms in adolescent, although if analyzed separately perceived of parent-child relationships towards a mother has no effect.

Mental Health and Functional Competence in the Cape Town Adolescent Antiretroviral Cohort.

The impact of HIV and antiretrovirals (ART) on long-term mental health in perinatally infected children has not been well studied in sub-Saharan Africa where HIV is most prevalent. Cape Town, South Africa. We investigated mental health measures, including depression, anxiety, attention-deficit hyperactivity disorder, motivation, disruptive behavior, and functioning in perinatally infected adolescents (PHIV+) stable on ART within the Cape Town Adolescent Antiretroviral Cohort. Two hundred four adolescents living with HIV (median age 10 years; mean CD4 953) and a sample of 44 uninfected adolescents were enrolled. The Beck Youth Inventories, Children's Motivation Scale, Conner's Parent's Rating Scale, and Child Behavior Checklist were administered. Among PHIV+, we explored independent associations between HIV-related stigma, recent life stressors, sociodemographic, clinical, and caregiver-related variables, and mental health measures. PHIV+ had poorer functional competence, self-concept and motivation, higher levels of disruptive behavior, depression and attention-deficit hyperactivity disorder symptoms and clinically significant anger and disruptive behavior. Within the PHIV+ group, the loss of both biological parents was associated with higher levels of disruptive behavior. Within the PHIV+, factors associated with mental health symptoms and poorer functioning were mostly sociodemographic factors, HIV-related stigma, and life stressors. Age of initiation of ART was associated with self-concept, and failing first-line ART with internalizing and externalizing behavior problems. PHIV+ are likely to face future physical and psychological health consequences related to the functional competence challenges they face if mental health care is not made a priority in the fight against HIV.