Externalizing Problem Scores Research Articles

Prediction of adolescent outcome in children with disruptive behaviour disorders

In this preliminary study we explored the predictive influence of various family, psychological, demographic, and neurobiological characteristics on the persistence of antisocial behaviour in adolescence. Existing data were combined with case-records in a sample of 47 disruptive behaviour disordered (DBD) children who had been treated in in-patient and/or day-treatment units when they were between seven to 12 years old. Parent-rated and self-rated externalizing problem scores and the presence of a DBD diagnosis served as the outcome measures in adolescence. We used linear regression analyses to examine the predictors of adolescent outcome. A lower basal skin conductance level (SCL) was repeatedly found to predict poor adolescent outcome, either when rated by parents or by participants themselves. In addition, comorbid attention-deficit hyperactivity disorder, one aspect of performance on the door-opening task, and a mother of low socioeconomic status also predicted that a child would have more antisocial problems in adolescence, depending on the type of outcome measure. Results of this study support the fearlessness theory, according to which low activity of the autonomous nervous system, as manifested by low SCL, is related to the effectiveness of socializing punishment and accordingly to poor socialization and adolescent outcome.

A 2‐year follow‐up of orphans’ competence, socioemotional problems and post‐traumatic stress symptoms in traditional foster care and orphanages in Iraqi Kurdistan

This paper aims to compare orphans' development in two different care systems. Based on age, sex, psychological trauma scores, competence and psychological problem scores, two comparable samples were found representing orphans in the traditional foster care (n = 94) and the orphanages (n = 48) in a middle-large city in Iraqi Kurdistan. At an index interview, Child Behaviour Checklist (CBCL), Harvard-Uppsala Trauma Questionnaire for Children and Post-traumatic Stress Symptoms for Children (PTSS-C) were administered to the caregivers. After 1 year the CBCL, and after 2 years both the CBCL and the PTSS-C, were-re-administered, consecutively. Although both samples revealed significant decrease in the means of total competence and problem scores over time, the improvement in activity scale, externalizing problem scores and post-traumatic stress disorder-related symptoms proved to be more significant in the foster care than in the orphanages. While the activity scale improved in the foster care, the school competence deteriorated in both samples, particularly among the girls in the orphanages. The improvement of boys' activity scores in the foster care, and deterioration of girls' school competence in the orphanages were the most significant gender differences between samples over time. Even if the two orphan care systems showed more similarities than differences, the foster care revealed better outcomes over time. The results are discussed in relation to gender, age, socio-economic situation, cultural values and the characteristics of each care system.

Early mother?infant interaction, parental mental health and symptoms of behavioral and emotional problems in toddlers

This study examined the associations of deviant features in early mother–infant interaction and parental psychopathology with symptoms of behavioral/emotional problems in the child 2 years later. Fifty mother–infant dyads were assessed in the study; mother–infant interaction was videotaped at infant’s 8–11 weeks of age, parental psychopathology was assessed by a structured diagnostic interview. At 2 years the symptoms of behavioral/emotional problems were investigated by CBCL questionnaires. The results suggest that the mother’s hostility and/or intrusiveness in early mother–infant interaction and parental psychopathology are related to and predict behavioral/emotional symptoms in the child but their influence varies. Father’s psychiatric problems predicted high internalizing, externalizing and total problem scores and mother’s psychiatric problems before the pregnancy predicted high externalizing scores in the child at 2 years. Mother’s hostility and/or intrusiveness in early mother–infant interaction predicted high externalizing and total problem scores.

Adopted children's problem behavior is significantly related to their ego resiliency, ego control, and sociometric status.

Many studies have documented that adopted children are at higher risk for behavior problems, but less is known about the correlates of their problem behavior. The correlates of parent-reported and teacher-reported problem behavior in 7-year-old internationally adopted children (N = 176) were investigated by examining these children's ego resiliency, ego control, and sociometric status, and exploring possible risks factors in the home and racial influences. Using the 25th percentiles lowest and highest scores on ego resiliency and ego control as cut-off criteria, we found that: (1) resilient children were almost free of behavior problems; (2) overcontrolling children showed predominantly internalizing behavior problems (33% at school, and 28% at home); (3) undercontrolling children showed high rates of externalizing behavior problems (50% at school, and 34% at home), and an elevated rate of comorbidity (21% at school, and 21% at home). Adopted children identified by peer report as controversial or rejected had significantly higher externalizing problem scores than popular, average or neglected adopted children. The adopted children did not experience much (racial) discrimination. Nevertheless, children who wished to be white (46%) presented more mother-reported behavior problems. Our findings replicate R.W. Robins et al.'s (1996) work on three types of personality functioning: resilients, overcontrollers and undercontrollers (identified by J. Block, 1971), extending the model from adolescent boys to school-aged boys and girls, adopted from Asia and South America. The wish to identify with white parents and white peers may constitute a potential risk factor for internationally adopted children in middle childhood.

Early mother–infant interaction, parental mental health and symptoms of behavioral and emotional problems in toddlers

This study examined the associations of deviant features in early mother–infant interaction and parental psychopathology with symptoms of behavioral/emotional problems in the child 2 years later. Fifty mother–infant dyads were assessed in the study; mother–infant interaction was videotaped at infant’s 8–11 weeks of age, parental psychopathology was assessed by a structured diagnostic interview. At 2 years the symptoms of behavioral/emotional problems were investigated by CBCL questionnaires. The results suggest that the mother’s hostility and/or intrusiveness in early mother–infant interaction and parental psychopathology are related to and predict behavioral/emotional symptoms in the child but their influence varies. Father’s psychiatric problems predicted high internalizing, externalizing and total problem scores and mother’s psychiatric problems before the pregnancy predicted high externalizing scores in the child at 2 years. Mother’s hostility and/or intrusiveness in early mother–infant interaction predicted high externalizing and total problem scores.

Recurrent Seizures and Behavior Problems in Children with First Recognized Seizures: A Prospective Study

Children with epilepsy have high rates of behavior problems. The purpose was to describe prospectively the association of seizures and behavior problems in children with new-onset seizures. Subjects were 224 children with new-onset seizures (aged 4-14 years) and 159 siblings (4-18 years). Caregiver's ratings of the behavior were collected 4 times: at baseline, and at 6, 12, and 24 months. During the 2-year period, 163 (73%) children had at least one additional seizure, and 61 (27%) had none. Data were analyzed by using repeated measures analysis of variance both with and without covariates [site, age, gender, race, caregiver education (years), and seizure medications]. On average, children had higher CBCL Total and Internalizing Behavior Problems scores across all times when experiencing recurrent seizures than when not experiencing recurrent seizures (Total Problems, p = 0.041, controlling for demographics and seizure medications). Siblings had significantly lower Total and Internalizing Problems scores than both children experiencing (Total Problems adjusting for covariates, p = 0.0001) and not experiencing recurrent seizures (p = 0.0004). Externalizing Problems scores were not significantly different among children with recurring seizures, children without recurring seizures, and siblings. Recurrent seizures significantly predicted behavior problems very early in the course of a seizure condition, even when key child, demographic, and seizure variables were controlled. Explanations for these findings include the possibilities that both seizures and behavior problems are caused by an underlying neurological disorder, that seizures per se disrupt behavior, or that children have negative psychological responses to seizure activity.

Predictors of Treatment Response in a Child Day Treatment Program

ABSTRACT Children enrolled in a day treatment program (n = 54) exhibited improved teacher-rated attention problem and clinician-rated global functioning scores, but not teacher-rated externalizing problem scores, at discharge. Chronological age predicted improvement regarding externalizing problems and global functioning, with younger children exhibiting greater progress in treatment. Children high on Proactive or Proactive/Reactive, but not Reactive-only, aggression made significantly less improvement in externalizing problems at discharge compared to children who were relatively low on both subtypes. A non-significant trend was found for children's aggression acceptability scores to predict increased externalizing problems at discharge. This study adds to the growing literature establishing important differences between proactive and reactive subtypes of aggressive behavior.

Conflict Negotiation Tactics in Romantic Relationships in High School Students

To investigate how teenagers deal with conflict in romantic relationships, 869 high school students (mean age 16, range 14–19), experienced in romantic relations, completed a conflict tactic scale (adapted from Rands et al., 1981, and Straus, 1979). A principal components analysis revealed six factors, which in descending frequency of use were Compromise, Distraction, Avoidance, Overt Anger, Seeking Social Support, and Violence. Conflict tactics varied as a function of demographic characteristics. Specifically, older teens used Compromise more than younger; girls used Compromise and Overt Anger more and Distraction less than boys; African-Americans used Violence more and Compromise less than European-Americans, whereas Asian-Americans used Distraction and Avoidance more than European-Americans. To assess predictors of conflict tactics, teens also completed scales assessing self-esteem (Rosenberg, 1965), immature and mature defense mechanisms (Araujo and Steiner, 1998, under review) and internalizing and externalizing problem behaviors (Achenbach, 1966). Each of these was singly and jointly associated with the use of conflict tactics. In multiple regression analyses, the externalizing problem score best predicted Overt Anger and Violence in dealing with romantic conflict, the internalizing problem score best predicted Avoidance and Distraction; whereas the mature defense mechanism score was the best predictor of seeking Social Support and Compromise.