Externalizing Behavior Problems Research Articles

Racial/Ethnic differences in the association between parental wealth and child behavior problems

The associations between wealth and child development outcomes have been well documented. However, little research has investigated how these associations vary by race/ethnicity. This study examines the association between parental wealth and child internalizing/externalizing behavior problems across race/ethnicity using longitudinal data. Data were drawn from the National Longitudinal Survey of Youth 1979 and its Child and Young Adults Supplement. Three racial/ethnic groups were examined: Non-Hispanic White, Non-Hispanic Black, and Hispanic. The primary outcome was the child behavior problem index (BPI). We constructed a median-dichotomized standardized BPI measure in addition to using the antisocial subscale and depression/anxiety subscale. Parental wealth, defined as net worth, was calculated as assets minus debt. Three-level logistic regression was used. We first conducted the analyses using the whole sample, then followed with subgroup analyses stratified by race/ethnicity. Wealth was negatively associated with all the BPI indicators in the whole sample analysis. For Non-Hispanic White children, wealth had an incremental, consistent association with child behavior problems. Wealth was only protective against internalizing and externalizing behavior problem indicators among Black children from families in the higher levels of wealth. There were no significant associations between parental wealth and child behavior problems for Hispanic children. This study examined racial/ethnic differences in the relationship between parental wealth and child behavior problems. Findings indicate that whereas wealth is associated with lower levels of child behavior problems, there are racial/ethnic differences in the association. Implications for asset-building policy and programming are discussed.

부모의 양육태도와 유아 문제행동의 메타분석: 메타구조방정식 모형의 적용

This study aims to apply a meta-structural equation modeling to analyze the relationship between parents’ parenting attitudes and young children’s problem behavior and what kind of causal relationship exists between parents’ parenting attitudes and young children’s problem behavior. To achieve research questions, the researchers searched for various databases and analyzed 42 theses and 33 journals from 2000 to June 2023. When examining the intercorrelations between variables, positive parenting attitude and intrinsic problem behavior, positive parenting attitude and external problem behavior showed medium levels of negative effect sizes, negative parenting attitude and intrinsic problem behavior, and negative parenting attitude and external problem behavior showed medium levels of positive effect sizes. Positive and negative parenting attitudes showed large negative effect sizes, and intrinsic and external problem behaviors showed large positive effect sizes. When examining the meta-structural relationship, parents’ positive parenting attitudes showed small negative effect sizes on young children’s intrinsic and external problem behaviors, and parents’ negative parenting attitudes showed medium levels of positive effect sizes on young children’s intrinsic and external problem behaviors. This study is meaningful in that it sought ways to lower the problem behavior of young children by examining the relationship between parents’ parenting attitudes and young children’s problem behavior.

Gestational PBDE concentrations, persistent externalizing, and emerging internalizing behaviors in adolescents: The HOME study

BackgroundPolybrominated diphenyl ethers (PBDEs) are ubiquitous environmental chemicals used as flame retardants in commercial and consumer products. Gestational PBDE concentrations are associated with adverse behaviors in children; however, the persistence of these associations into adolescence remains understudied. ObjectiveWe estimated the association of gestational PBDE serum concentrations with early adolescent self- and caregiver-reported behaviors at age 12 years and determined the consistency with previously observed associations in childhood with caregiver-reported behaviors in a prospective pregnancy and birth cohort. MethodsWe measured maternal serum concentrations of five individual PBDE congeners and created a summary exposure variable (∑5BDE: 28, −47, −99, −100 and −153) during pregnancy. At age 12 years, we assessed behaviors for 237 adolescents using self- and caregiver-reports with the Behavioral Assessment System for Children-3 (BASC3). We used multivariable linear regression models to estimate covariate-adjusted associations of lipid standardized, log10-transformed gestational PBDE concentrations with BASC3 scores. We obtained estimates and 95% confidence intervals through a bootstrapping approach. We evaluated potential effect measure modification (EMM) of adolescent sex by examining sex-stratified regression models and estimating the EMM p-values. ResultsGestational PBDE concentrations were positively associated with adolescent-reported BASC3 composite indices for inattention & hyperactivity (BDE-28, -47, −99, −100, ∑5BDE), internalizing problems (BDE-28, -47, −99), functional impairment (BDE-28, ∑5BDE), and emotional symptoms (BDE-28). Gestational PBDE concentrations were positively associated with caregiver-reported BASC3 composite indices for externalizing problems (BDE-28, -47, −99, −100, −153, ∑5BDE) and behavioral symptoms (BDE-99). For caregiver reported behaviors, we observed stronger associations with gestational BDE concentrations among males, especially for executive functioning (BDE-28, -47, −99, −100, ∑5BDE). DiscussionGestational PBDE serum concentrations were associated with self-reported internalizing and externalizing behavior problems in early adolescence. Caregiver-reported externalizing behaviors recognized during childhood remain associated with gestational PBDE concentrations and persist into early adolescence. Internalizing behaviors were less recognized by caregivers.

Contamination bias in the estimation of child maltreatment causal effects on adolescent internalizing and externalizing behavior problems.

When unaddressed, contamination in child maltreatment research, in which some proportion of children recruited for a nonmaltreated comparison group are exposed to maltreatment, downwardly biases the significance and magnitude of effect size estimates. This study extends previous contamination research by investigating how a dual-measurement strategy of detecting and controlling contamination impacts causal effect size estimates of child behavior problems. This study included 634 children from the LONGSCAN study with 63 cases of confirmed child maltreatment after age 8 and 571 cases without confirmed child maltreatment. Confirmed child maltreatment and internalizing and externalizing behaviors were recorded every 2 years between ages 4 and 16. Contamination in the nonmaltreated comparison group was identified and controlled by either a prospective self-report assessment at ages 12, 14, and 16 or by a one-time retrospective self-report assessment at age 18. Synthetic control methods were used to establish causal effects and quantify the impact of contamination when it was not controlled, when it was controlled for by prospective self-reports, and when it was controlled for by retrospective self-reports. Rates of contamination ranged from 62% to 67%. Without controlling for contamination, causal effect size estimates for internalizing behaviors were not statistically significant. Causal effects only became statistically significant after controlling contamination identified from either prospective or retrospective reports and effect sizes increased by between 17% and 54%. Controlling contamination had a smaller impact on effect size increases for externalizing behaviors but did produce a statistically significant overall effect, relative to the model ignoring contamination, when prospective methods were used. The presence of contamination in a nonmaltreated comparison group can underestimate the magnitude and statistical significance of causal effect size estimates, especially when investigating internalizing behavior problems. Addressing contamination can facilitate the replication of results across studies.

Effects Of Parental Alienation: A Phenomenological Study

Parental alienation is a growing concern today. Many children grow up without the care and love of their parents. As a result, there are feelings of emotional rejection felt by the children, and some lead to a life of delinquency. This research aims to discover the effects of parental alienation and coping mechanisms of alienated children toward a better life. It utilized a qualitative research method through a phenomenological approach through an interview of four alienated children. The study reveals that the participants who have experienced parental alienation suffer from internal and external behavioral problems and search for their identity after reaching adulthood, which also leads to devastating complex trauma and low self-esteem. With this, parental alienation calls for a child protection response since it can be a form of collective abuse and the custodial parents may safeguard the child’s relationship with an alienated parent to avoid negative views through counseling or focused group discussion, the Department of Social welfare and Development (DSWD) and Children Protection Desk (WCPD) can implement a Family Bridge Program an educational and experiential workshop that helps unreasonably alienated children and adolescents adjust to living with a parent they claim to hate or fear

Promoting Healthy Screen Media Use in Young Children With Externalizing Behavior Problems Through an Adapted Parenting Intervention: Results of an Open Trial

In this article, we describe the development of an adapted parenting intervention for caregivers of preschoolers with externalizing behavior problems, which integrates content around screen media use into an existing evidence-based parenting intervention. We also present results of an open trial examining the feasibility, acceptability, and initial outcomes of the adapted intervention in a sample of 10 low-income caregivers of children with externalizing behavior problems who were attending a community-based therapeutic summer program. Caregivers attended a once weekly (1.5-hour) intervention group, which was embedded in an 8-week community-based therapeutic program for children with externalizing behavior, and completed questionnaires at pretest, posttest, and 1 month following the intervention, and completed interviews about their experiences. Caregiver satisfaction with the adapted intervention was high, and fidelity and attendance measures suggested the intervention was feasible. Preliminary results showed postintervention improvements in caregivers’ skills in managing screen media use, including increases in caregiver self-efficacy to manage and set limits around screen media use. Results suggest that leveraging existing parenting interventions to promote healthy media use habits may be a promising avenue to maximize reach to families with children with externalizing behavior.

어머니의 사회경제적 배경에 따른 양육 특성이 유아의 문제행동에 미치는 영향

Objectives The purpose of this study is to investigate the discrimination of mothers' parenting characteristics according to socioeconomic background and analyze the effects of parenting characteristics on the young children's problem behaviors.
 Methods It was analyzed the socioeconomic background, parenting characteristics, and problem behavior of 2,150 mothers with 5-year-old children, using the 7th panel data of the Panel Study on Korean Children. Using the program SPSS 21.0, the mean differences in parenting characteristics according to the mother's socioeconomic background were analyzed using t-test and one-way ANOVA. In addition, after analyzing the correlation between the mother's parenting characteristics and the young children's problem behavior, hierarchical multiple regression analysis was conducted to analyze the influence of the mother's parenting characteristics on the young children's problem behavior.
 Results Mothers' parenting characteristics differed depending on the mother's age, education level, and household income level, and the correlation between parenting characteristics and young children's problem behavior was low. As a result of analyzing the factors affecting children's internalizing problem behavior, the higher the income in the socioeconomic background, the less internalizing problem behavior, and among parenting characteristics, the higher the parenting stress and the less parent-child interaction, the more internalizing problem behavior increased. As a result of the analysis of externalizing problem behavior, it was found that for male young children, the greater the parenting stress, and the less paternalistic parenting behavior and parent-child interaction, the more the infant's externalizing problem behavior increased.
 Conclusions System establishment and policy support are required to minimize the interdependence and connection between socioeconomic background, parenting characteristics, and problem behavior. Additionally, because mothers' parenting stress has the greatest impact on their children's problem behavior, mothers should seek ways to reduce stress themselves. Additionally, a consensus on co-parenting must be formed at the community and government levels, breaking away from the framework that childrearing is the mother's responsibility.

Well-being and contexts of development of U.S. citizen children in Mexico following parental deportation or voluntary relocation.

When undocumented immigrant parents are deported from the United States, they must decide whether or not to take their U.S.-born and undocumented immigrant children with them, often to countries the children have never visited or know little about. Other parents do not wait to be deported by the government and decide to relocate to their home countries with or without their children. Both sets of families experience relocation but under different circumstances. These differences deserve exploration to understand the psychological and emotional effects on children's well-being. In this cross-sectional study, we explored differences in self-concept, internalizing and externalizing behaviors, as well as the perception of the home, school, and neighborhood contexts of 178 U.S. citizen children (USCC) whose parents returned to Mexico forcibly and voluntarily. Through snowball sampling, we recruited the sample from two bordering Mexican states, Michoacán and the State of Mexico. Significant estimated marginal mean differences in internalizing and externalizing behavior problems, unhappiness, as well as parent-child conflict and support were found between USCC who relocated due to a parental deportation and those USCC whose parents relocated to Mexico voluntarily. Implications for clinicians in Mexico and the United States include recognizing the reasons, timing, decisions, events, and contexts of relocation. Findings can help inform immigration policies, practices, and future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Externalisierendes Problemverhalten mit Freund:innen im Jugendalter: Welche Rolle spielen Faktoren der emotionalen Unbeteiligtheit?

ZusammenfassungEinleitungEine Erklärung dafür, dass Jugendliche externalisierendes Problemverhalten (regelverletzendes und dissoziales Verhalten) zeigen, sind affektive Beeinträchtigungen. Ein abgeflachter Affekt ist ein Kernmerkmal der Callous-Unemotional Traits (CU-Traits, dt.: emotionale Unbeteiligtheit). CU-Traits setzen sich aus den 3 Faktoren Callousness (Mangel an Empathie und Reue), Uncaring (gleichgültige Haltung ggü. der Erfüllung von Aufgaben und den Gefühlen anderer) und Unemotional (oberflächlicher oder abgeflachter Affekt) zusammen. Externalisierendes Problemverhalten findet im Jugendalter zumeist in Gruppen statt. Daher ist es wichtig, den Zusammenhang von CU-Traits und externalisierendem Problemverhalten zu betrachten, das explizit gemeinsam mit bzw. in Anwesenheit von Freund:innen gezeigt wird. Diese Perspektive fehlt bisher in der Forschung zu CU-Traits. Die vorliegende Studie hat das Ziel, diese Forschungslücke zu schließen.MethodeVon N = 169 Jugendlichen (54 % weiblich; M = 14,95 Jahre) wurden im Zeitraum von Juni 2021 bis März 2023 Selbstberichtsdaten mit einer online oder handschriftlich ausfüllbaren Fragebogenbatterie erhoben, die neben CU-Traits (ICU) auch Einschätzungen zu regelbrechendem und dissozialem Verhalten mit Freund:innen (CBCL: YSR 11–18 R) enthielten.ErgebnisseAusschließlich die Subskala Callousness trägt zur Erklärung von externalisierendem Problemverhalten mit Freund:innen bei (6 % Varianzaufklärung).DiskussionDie 3 Faktoren der CU-Traits sollten getrennt voneinander betrachtet werden. Außerdem scheint es bei der Untersuchung von externalisierendem Problemverhalten wichtig zu sein, ob es allein oder gemeinsam mit bzw. in Anwesenheit von Freund:innen gezeigt wird. Limitationen der Studie, Ideen für weiterführende Forschung und praktische Implikationen werden diskutiert.

Children and adolescents' quality of life in repeated cross-sectional studies during the COVID-19.

During the COVID-19 pandemic, internalizing and externalizing symptoms have impacted the quality of life of children and adolescents. This cross-sectional study evaluated children's quality of life using parental reports, observing associations with mental health problems and sociodemographic variables. Some behavioral measures were linked to lower quality of life, particularly depression symptoms, relationship problems, and inattention. Multiple regression models indicated that reduced children's quality of life (R2 = 36%) was associated with higher levels of internalizing (r = -0.46) and externalizing (r = -0.23) behavioral problems and younger parents (r = -0.08). Children with previous mental disorder diagnoses had lower quality of life than those without (p < 0.001). In summary, children's quality of life during the COVID-19 pandemic was linked to current mental health, parental age, and previous history of mental disorders.

The Influence and Mechanism of Witness of Parental Violence on Individual Violent Behavior

Domestic violence is a problem all over the world. The harm of domestic violence is very great. It not only destroys family harmony and marital relationship, but also has great harm to the future development of children. Children who witness parental violence also tend to behave more violently. This paper mainly collates the research on children's behavior after witnessing domestic violence for half a century, and finds that there is less research on an individual violence after witnessing domestic violence. Therefore, this paper summarizes the characteristics and impact of children's externalized behavior problems and focuses on their causes, and finds that the causes of these problems can be summarized as reduction of attachment, emotional regulation, attitude towards violence and social learning theory. The research results can improve researchers' understanding of the impact of witnessing parental violence on individual violent behavior and its mechanism, and provide theoretical support for intervention programs to reduce individual violent behavior.

Solutions Trial: Solution Focused Brief Therapy (SFBT) in 10–17-year-olds presenting at police custody: a randomised controlled trial

BackgroundWithin England, children and young people (CYP) who come into police custody are referred to Liaison and Diversion (L&D) teams. L&D teams have responsibility for liaising with healthcare and other support services while working to divert CYP away from the criminal justice system but have traditionally not provided targeted psychological interventions to CYP. Considering evidence that Solution Focused Brief Therapy (SFBT) leads to a reduction in internalising and externalising behaviour problems in CYP, the aim of this randomised controlled trial (RCT) was to determine whether there is a difference between services as usual (SAU) plus SFBT offered by trained therapists working within a L&D team, and SAU alone, in reducing offending behaviours in 10–17-year-olds presenting at police custody.MethodsDesign: two-arm individually RCT with internal pilot and process evaluation.Participants: N = approximately 448 CYP aged 10–17 years presenting at one of three police custody suites in the area served by Lancashire and South Cumbria NHS Foundation Trust (LSCFT) who are referred to the L&D team. Participants will be recruited and allocated to intervention:control on a 1:1 basis. Interviews will be performed with 30–40 CYP in the intervention arm, 15 CYP in the control arm, up to 20 parents/guardians across both arms, up to 15 practitioners, and up to 10 site staff responsible for screening CYP for the trial.Intervention and control: Those allocated to the intervention will be offered SAU plus SFBT, and control participants will receive SAU only.Primary outcome: CYP frequency of offending behaviours assessed through the Self-Report Delinquency Measure (SRDM) at 12 months post-randomisation.Secondary outcomes: criminal offence data (national police database); emotional and behavioural difficulties (self-report and parent/guardian reported); gang affiliation (self-report).Process evaluation: evaluation of acceptability and experiences of the CYP, parents/guardians, site staff and practitioners; fidelity of SFBT delivery.DiscussionThis two-arm individually RCT will evaluate the effectiveness of SFBT in reducing offending behaviours in CYP presenting at police custody suites within the area served by LSCFT. Our process evaluation will assess the fidelity of delivery of SFBT, the factors affecting implementation, the acceptability of SFBT in CYP aged 10–17 years and recruitment and reach. We will also examine systems and structures for future delivery, therefore assessing overall scalability.Trial registrationClinicalTrials.gov ISRCTN14195235. Registered on June 16, 2023.

Finding the balance: The influence of movement behaviours on childhood behaviour problems

Background and aimsThe Canadian 24-h movement guidelines have led to an increased focus on movement behaviours (sleep, screen, sedentary, and physical activity) throughout the day. MethodsWe examined the cross-sectional and longitudinal associations between 24-h movement behaviours and parent-reported levels of internalizing, externalizing, and total behaviour problems in a subset of the CHILD birth cohort study at ages 3 (N Age 3 = 541, 48.1% girls) through 5 (N Age 5 = 575, 49.6% girls). Physical activity, sedentary time, and sleep were measured using an accelerometer worn on the non-dominant wrist for seven days following a 24-h protocol. Screen time was measured via parent-report and date-matched to daily accelerometer recordings. Compositional isotemporal substitution models predicted change in behaviour problems with reallocating time between movement behaviours. ResultsCross-sectional analysis indicated that screen time relative to other movement behaviours was associated with greater externalizing behaviours at age 3 and greater internalizing and total problem behaviours at ages 3 and 5. This was supported in the longitudinal analysis, where increased screen time at 3 was associated with increased internalizing, externalizing, and total problem behaviours at 5. Cross-sectional reallocation from screen to non-screen sedentary time was associated with reductions in internalizing and total behaviour problems at 3 and 5 years and reductions in externalizing at 3. Contrary to previous findings, cross-sectional proportional increases in moderate-to-vigorous-intensity physical activity were associated with increased externalizing and total problem behaviours at 5. ConclusionsClinicians should prioritize supporting families to find a balanced approach rather than promoting specific movement behaviours.

The association between family functioning and problem behaviors among Chinese preschool left-behind children: the chain mediating effect of emotion regulation and psychological resilience.

The family environment has a significant impact on the psychological and behavioral development of children, especially those who are left behind in preschool and experience parent-child separation at a young age. These children face a greater risk of family dysfunction, which can lead to internalizing and externalizing problem behaviors. While numerous studies have established a connection between family functioning and problem behaviors, few have explored the underlying mechanisms driving this relationship. Our study seeks to address this gap by examining how emotion regulation and psychological resilience mediate the link between family functioning and problem behavior. The sample consisted of 940 preschool children (51.5% male, 48.5% female) with a mean age of 5.07 ± 0.80. The main guardians of the children were given the Family Assessment Device, Preschool Children's Emotion Regulation Scale, the Devereux Early Childhood Assessment for Preschoolers (2nd edition), and the Social Skills Improvement System-Rating Scales to assess their family functioning, emotion regulation, psychological resilience, and problem behavior respectively. Lower family functioning was associated with more severe problem behaviors in preschool left-behind children, and emotion regulation and psychological resilience partially mediated the relationship between family functioning and problem behaviors, respectively. In addition, emotion regulation and psychological resilience were also chain mediators between family functioning and problem behaviors. The study's findings highlighted the crucial role of emotional regulation and psychological resilience in the correlation between family functioning and problem behaviors. It is recommended that policymakers and educators place a high priority on the cultivation of internal psychological resources, such as emotional regulation and resilience, in preschool-aged children when designing interventions to address problem behaviors.

Understanding Trauma Symptoms Experienced by Young Men under Youth Justice Supervision in an Australian Jurisdiction

Exposure to adversity or maltreatment is known to correlate with high-risk behaviors that can increase the risk of contact with the criminal justice system; however, few studies have focused on the role of trauma symptoms and other behaviors that may develop in response to exposure to adverse life events. We also know far less about the role of these experiences in young men compared to young women who have been in contact with the youth justice system. In this study, we examine the associations between different patterns of trauma symptomatology and adverse childhood experienced (ACEs), substance use, behavioral difficulties, and re-offending in a sample of 141 young men under the supervision of a Youth Justice (YJ) agency in Australia. Trauma symptoms were reported by over ninety percent of participants, with Latent Class Analysis used to identify four subgroups of young men based on their clustering of trauma symptomatology: internalizing, externalizing, high, and low trauma symptoms groups. The characteristics of young men across these groups were, however, remarkably similar. Over four-fifths scored in the clinical range for substance use and externalizing behavior problems, while recidivism was reported in over three-quarters of young men across all groups. These findings have implications for the development of trauma-informed responses by specialist adolescent mental health services as well as for adult forensic services that seek to understand the developmental origins of psychopathology and offending behavior. There appears to be a strong rationale for more compassionate and trauma-informed justice system practices.

Pathways from prenatal cocaine exposure to adult substance use and behavior

This is a report from the most recent adult follow-up of the longest running cohort study of prenatal cocaine exposure (PCE), in which women were enrolled prenatally and offspring were assessed in infancy, childhood, adolescence, and young adulthood. In previous studies, PCE was linked to offspring behavior problems such as early substance use and externalizing behavior problems. The current analyses examine pathways from PCE to behavioral outcomes in offspring at the 25-year assessment. Prenatal cocaine exposure was moderate in this cohort; most women decreased or discontinued use after the first trimester. During the first and third trimesters, 38% and 11% used cocaine, respectively. This represents the most common pattern of PCE in non-treatment samples. At this phase, the adult offspring were, on average, 27.3 years old (range = 25–30), had 13.4 years of education, 83% were employed, 55% were Black, and 55% were female. Offspring who were exposed to cocaine during the first trimester were significantly more likely to use marijuana in the past year, report more arrests, and have poorer scores on a decision-making task, controlling for other prenatal substance exposure, demographic, and socioeconomic factors. In mediation analyses, there were indirect pathways from PCE to current marijuana use through early initiation of marijuana use and 21-year marijuana use, and through 15-year status offenses and 21-year marijuana use. There was also an indirect pathway from PCE to lifetime arrests through early initiation of marijuana use and 21-year Conduct Disorder, although the direct pathway from PCE to arrests also remained significant. These findings are consistent with those from previous phases and are an indication that there are detrimental associations with PCE that persist across developmental stages and into adulthood.

Effectiveness of Mental Health and Wellbeing Interventions for Children and Young People in Foster, Kinship, and Residential Care: Systematic Review and Meta-Analysis.

The mental health and wellbeing of children and young people who have been in care, primarily foster care, kinship care or residential care, remains a public health priority. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) synthesized evidence for the effectiveness of interventions targeting: subjective wellbeing; mental, behavioral and neurodevelopmental disorders; and suicide-related outcomes. Searches were conducted in 16 bibliographic databases and 22 websites between 1990 and 2022. This was supplemented by citation tracking, screening of relevant systematic reviews, and expert recommendation. We identified 35 interventions, with 44 evaluations via randomized controlled trials. Through meta-analyses, we found that interventions have a small beneficial impact on a variety of mental health outcomes in the short term (0-6 months). Interventions improved total social, emotional, and behavioral problems (d = -0.15, 95% CI [-0.28, -0.02]), social-emotional functioning difficulties (d = -0.18, 95% CI [-0.31, -0.05]), externalizing problem behaviors (d = -0.30, 95% CI [-0.53, -0.08]), internalizing problem behaviors (d = -0.35, 95% CI [-0.61, -0.08]); and depression and anxiety (d = -0.26, 95% CI [-0.40, -0.13]). Interventions did not demonstrate any effectiveness for outcomes assessed in the longer term (>6 months). Certainty of effectiveness was limited by risk of bias and imprecision. There was limited available evidence for interventions targeting subjective wellbeing and suicide-related outcomes. Future intervention design and delivery must ensure that programs are sufficient to activate causal mechanisms and facilitate change. Evaluation research should use a robust methodology.PROSPERO Registration: CRD42020177478.

Promoting healthy screen use in children with externalizing behavior

AbstractThe sharp rise over the past decade in young children's access to various forms of screen media (e.g., smartphones, tablets, TVs) has posed new and significant challenges to caregivers in managing children's use of this type of media. For caregivers of young children with externalizing behavior problems, managing children's time with screen media is especially important and challenging. In this article, we summarize evidence of bidirectional links between early externalizing behavior problems and unhealthy screen media use in young children and discuss the extent to which prior interventions have responded to the needs of caregivers of children with these problems. We propose a conceptual model for an intervention to promote healthy screen media use for children with externalizing behavior problems that leverages current behavioral parenting interventions.

Between- and within-child level associations between externalizing and internalizing behavior problems in a nationally representative sample of US elementary school children.

Both transactional and common etiological models have been proposed as explanations of why externalizing behavior problems (EBP) and internalizing behavior problems (IBP) co-occur in children. Yet little research has empirically evaluated these competing theoretical explanations. We examined whether EBP and IBP are transactionally related at the within-child level while also identifying antecedents commonly associated with between-child differences in underlying stability of both EBP and IBP across elementary school. We analyzed a nationally representative and longitudinal sample of US schoolchildren (N = 7,326; 51% male) using random-intercept cross-lagged panel modeling (RI-CLPM). We used teacher ratings of EBP and IBP as annually assessed from the spring of kindergarten (Mage  = 6.12 years) through the spring of 5th grade (Mage  = 11.09 years). Early childhood antecedents included child internal (i.e. inhibitory control, cognitive flexibility, working memory, and language/literacy) and external factors (i.e. parental warmth, harsh parenting, parenting stress, and maternal depressive symptoms). We found little evidence for within-child, transactional relations between EBP and IBP. Both types of behavior problems instead were substantially associated at the between-child level. Inhibitory control was the strongest common antecedent that explained this longitudinal overlap. Cognitive flexibility, working memory, language/literacy skills, and maternal depression contributed specifically to the stability of IBP. Measures of parenting were specific to the stability of EBP. Common etiological factors rather than transactional relations better explain the co-occurrence of EBP and IBP during elementary school. Inhibitory control is a promising target of early intervention efforts for schoolchildren at risk of displaying both EBP and IBP.

[Effect of Family Functioning on Adolescents' Internalizing and Externalizing Problem Behaviors: The Multiple Mediating Roles of Empathy and Emotional Competence].

To examine the mediating role of empathy and emotional competence in the association between family functioning and internalizing and externalizing problem behaviors among adolescents in China. In this study, we used the data from the June-July 2022 survey of Chengdu Positive Child Development (CPCD) cohort. All respondents were 5th-9th graders from six primary or secondary schools in Chengdu. The Achenbach Child Behavior Checklist (CBCL), the Chinese Family Assessment Instrument (C-FAI), the empathy subscale of the Chinese version of the Interpersonal Reactivity Index (C-IRI), and the emotional competence (EC) subscale of the Chinese Positive Youth Development Scale (CPYD) were used to evaluate the respondents' internalizing and externalizing problem behaviors, family functioning, empathy, and emotional competence, respectively. The average score derived from the total score of a scale divided by the number of entries in each dimension was used as the final score of the scale. Independent samples t-tests or one-way analysis of variance (ANOVA) were performed to examine the differences in family functioning, empathy, emotional competence, and internalizing and externalizing problem behaviors across student groups with different demographic characteristics (sex, grade, and region). Pearson correlation analysis was conducted to examine the relationship between family functioning, empathy, emotional competence, and internalizing and externalizing problem behaviors. AMOS 24.0 was used to validate the hypothesized model and structural equation modeling was used to analyze the mediating effects of empathy and emotional competence between family functioning and internalizing and externalizing problem behaviors among adolescents. A total of 3026 eligible participants were included, including 1548 (51.16%) male students and 1478 (48.84%) female students. Among the respondents, 798 (26.37%) were 5th graders, 738 (24.39%) were 6th graders, 567 (18.74%) were 7th graders, 614 (20.29%) were 8th graders, and 309 (10.21%) were 9th graders. In addition, 2064 (68.21%) of all respondents were from urban areas and 962 (31.79%) were from rural areas. The results of the difference analysis showed that the differences in adolescents' internalizing and externalizing problem behaviors were statistically significant between students of different grades (P=0.004), and that the differences in family functioning and empathy scores were also statistically significant between students of different grades (all P<0.001), whereas the differences in adolescents' internalizing and externalizing problem behaviors were not statistically significant between sexes and regions (P=0.919, 0.959). The results of correlation analysis showed that family functioning scores (the higher the score, the worse the family functioning) were significantly negatively correlated with empathy and emotional competence (r=-0.482, -0.432, P<0.01), and significantly positively correlated with internalizing and externalizing problem behaviors (r=0.220, P<0.01). Empathy was significantly positively correlated with emotional competence (r=0.402, P<0.01). Empathy and emotional competence were significantly negatively correlated with all the dimensions of internalizing and externalizing problem behaviors (r=-0.115, -0.305, P<0.01). Emotional competence partially mediated the relationship between family functioning and adolescents' internalizing and externalizing problem behaviors, with a mediation effect value being 0.042 (95% [confidence interval] CI: 0.031-0.057). Empathy and emotional competence had chain mediation effect between family functioning and adolescents' internalizing and externalizing problem behaviors, with the value of the mediation effect being 0.010 (95% CI: 0.007-0.014). Family functioning influences adolescents' internalizing and externalizing problem behaviors in a direct way and through the chain-mediating roles of empathy and emotional competence.