Externalizing Behavior Problems Research Articles

Differential associations of maternal behavior to preschool boys' and girls' executive function

Boys are more sensitive to environmental factors like parental behavior, an important predictor of executive function. This study examined whether the interaction between child sex and maternal behavior was associated with children's executive function in a manner consistent with the vulnerability or differential susceptibility model. Participants were 146 36-month-old children and their mothers. Maternal responsiveness and negative reactivity were coded during structured mother-child interactions. Executive function was operationalized as latent self-control and working memory/inhibitory control (WMIC). Structural equation modelling supported a sex by responsiveness interaction for self-control but not WMIC. Consistent with a vulnerability model, less responsiveness was associated with poorer self-control for boys relative to girls. Boys' self-control may be more vulnerable to the negative effect of unresponsive maternal behavior helping explain boys increased risk for externalizing behavior problems.

Psychometric Properties of the Korean Version of the Child Sexual Behavior Inventory

ABSTRACT This study examined the psychometric properties of the Korean version of the child sexual behavior inventory (CSBI) for children under 10 years of age. Participants comprised a community sample (CS) of 652 children aged three to nine years and 226 sexually abused (SA) children in the same age range. Parents rated the CSBI, the child behavior checklist (CBCL), and the traumatic symptom checklist for young children (TSCYC). We examined internal consistency as a measure of reliability and conducted ANOVA for discriminant and Pearson’s correlations for convergent and divergent validity. The reliability coefficient indicated internal consistency (α = .59–.97). There was a significant correlation between sexual behaviors and internalizing and externalizing behavior problems in both samples (r = 0.30–0.48, p < .001). The correlation between post-traumatic stress disorder symptoms and sexual concern in the SA sample was very high (r = 0.56–0.66, p < .001). There was a significant difference in sexual behavior between the CS and SA. These findings demonstrate the reliability and validity of the Korean version of the CSBI and its usefulness in identifying children suspected of sexual abuse. However, the research identified cultural differences in the sexual behavior of the CS.

Perceived Social Support and Alcohol Consumption during Adolescence: A Path-Analysis with Internalizing and Externalizing Behaviour Problems

ABSTRACT The aim of the current study was to investigate the relationship between adolescents’ social support, their internalising and externalising behaviour problems, and their alcohol consumption. Adolescents attending Grade 7–10 (N = 329), answered questionnaires regarding their perceived social support (from parents, teachers, classmates, and friends), internalising (emotional and peer problems) and externalising behaviour problems (hyperactivity and conduct problems), and alcohol consumption (monthly frequency of consumption, beverage consumption on the weekend, and problematic consumption). Building a structural equation model, we found negative associations between parent support and all internalising and externalising behaviour problem scales. Furthermore, social support from classmates was negatively associated with the internalising behaviour problem scales. In turn, peer problems were negatively associated with alcohol consumption, and conduct problems were positively associated with alcohol consumption. Both parent and teacher support had a direct effect on alcohol consumption, and parent support also had an indirect effect via behaviour problems. The findings highlight the importance of parents and teachers for alcohol consumption during adolescence.

The Impact of Children’s Externalizing Behavior Problems and Sense of Work Value as Perceived by Group Home Professionals on Turnover Intention

The Impact of Children’s Externalizing Behavior Problems and Sense of Work Value as Perceived by Group Home Professionals on Turnover Intention

Effects of Parental Internalizing and Externalizing Behavior Problems on Children's Limbic Brain Structures-An MRI Study.

Parental behavior problems have long-term effects on children’s limbic brain structures and functions. Parental behavior problems-related brain changes in children may lead to mental disorders and behavior dysfunction later in life. However, our understanding of the relationship between parental behavior and children’s brain structures is less obvious when children and adolescents are studied in a general population without mental disorders. The majority of studies on the relationship between parental behavior and adolescent brain structure have been focused on severe forms of the following parental behavior problems: (1) internalizing behavior associated with mood and anxiety disorders, and (2) externalizing behavior associated with substance use and violence. A few studies examined the effect of normative variations or subtle differences in parental behavior. Therefore, we utilized a large study—Adolescent Brain Cognitive Development (ABCD)—to determine relationships between normative variation in parental internalizing and externalizing behavior and limbic brain structures in children and adolescents without mental disorders. Quantile (median) regression models were used to compute associations between parental behavior and children’s limbic structures. We found that parental internalizing and externalizing behaviors are uniquely associated with children’s limbic structures after adjustment for biological confounders and parental socioeconomic status. Our findings indicate that normative parental behavior may have a significant early influence on limbic structures of normally developing children and adolescents. Accelerated or delayed limbic structure maturation may account for children’s and adolescents’ behavioral inadequacies and a risk of developing specific mood disorders or substance abuse problems later in life.

Gene-environment interaction using polygenic scores: Do polygenic scores for psychopathology moderate predictions from environmental risk to behavior problems?

The DNA revolution has energized research on interactions between genes and environments (GxE) by creating indices of G (polygenic scores) that are powerful predictors of behavioral traits. Here, we test the extent to which polygenic scores for attention-deficit/hyperactivity disorder and neuroticism moderate associations between parent reports of their children's environmental risk (E) at ages 3 and 4 and teacher ratings of behavior problems (hyperactivity/inattention, conduct problems, emotional symptoms, and peer relationship problems) at ages 7, 9 and 12. The sampling frame included up to 6687 twins from the Twins Early Development Study. Our analyses focused on relative effect sizes of G, E and GxE in predicting behavior problems. G, E and GxE predicted up to 2%, 2% and 0.4%, respectively, of the variance in externalizing behavior problems (hyperactivity/inattention and conduct problems) across ages 7, 9 and 12, with no clear developmental trends. G and E predictions of emotional symptoms and peer relationship problems were weaker. A quarter (12 of 48) of our tests of GxE were nominally significant (p = .05). Increasing the predictive power of G and E would enhance the search for GxE.

Observational Measurement of Attachment in Toddlers with Disruptive Behavior Using the Strange Situation Procedure and Attachment Q-Set

Child-caregiver attachment is important for healthy child development and is often targeted by relationship-based parenting interventions for young children. To assess the efficacy of these interventions, attachment must be measured accurately at multiple timepoints across the toddler years, coinciding with different stages of development. Among others, populations referred for treatment of externalizing behavior problems are of particular importance here. The Strange Situation Procedure (SSP) and Attachment Q-Set (AQS) are empirically-validated measures of child-caregiver attachment with unique strengths and weaknesses. However, there are no published investigations on concurrent relations between the two measures using clinically-referred, mental health populations. Previous research has reached mixed conclusions when comparing the observer-report AQS and SSP for children from other populations and based on child age. Using a clinical sample of 69 Australian mother-toddler dyads referred for disruptive behavior problems, this study examined associations among behavior problems, dichotomous SSP classifications of security and organization, AQS security scores, and child age. In line with hypotheses, a small to medium negative correlation between AQS security and externalizing behavior was found. Unexpectedly, no significant associations were found between dichotomous SSP security and externalizing behavior nor between SSP organization and externalizing behavior. Although AQS security scores and SSP classifications were not significantly correlated for the sample as a whole, there was a moderate positive correlation between the two measures for children aged 19–25 months. Implications for future research measuring attachment in this population, with relevance for relationship-based parenting intervention outcome studies are discussed.

Maternal, Paternal, and Peer Relationships Differentially Predict Adolescent Behavioral Problems.

The current study investigated how maternal, paternal, and peer social relationships predict adolescent behavioral problems using secondary data analyses of the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). We aimed to examine differences between maternal and paternal relationships in predicting adolescent behavioral problems, and we hypothesized that parental relationships would more strongly predict adolescent behavioral problems than peer relationship in mid-adolescence. Participants were 929 adolescents at their 14-year-old visit. Hierarchical multiple regressions and multiple regression models revealed the following: Maternal relationship quality predicted fewer adolescent externalizing and total behavioral problems; paternal relationship quality predicted fewer internalizing problems; and peer popularity predicted fewer externalizing and total behavioral problems. In conclusion, mother-adolescent relationship may be more important for externalizing behavioral problems and father-adolescent relationship may be more important for internalizing behavioral problems. In middle adolescence, parental relationships are still more important than peer relationship in predicting adolescent behavioral problems. Study limitations and implications for research, policy, and practice were discussed.

Association between Maternal Anxiety and Children's Problem Behaviors: A Systematic Review and Meta-Analysis.

Although numerous studies have found that maternal anxiety is a risk factor for the development of children’s problem behaviors, and there is a possible role of genes in the association between the two. And anxious mothers caring for their children can also affect the development of children’s problem behaviors. However, there is also considerable evidence from studies that refute this view. This study used a meta-analysis to explore the relationship between maternal anxiety and preschool children’s problem behaviors. Through literature retrieval and selection, in terms of the criteria for inclusion in the meta-analysis, 88 independent effect sizes (34 studies, 295,032 participants) were picked out as meta-analysis units. The test for heterogeneity illustrated that there was significant heterogeneity in 88 independent effect sizes, while the random effects model was an appropriate model for the subsequent meta-analysis. The publication bias test indicated that the impact of publication bias was modest but the major findings remained valid. In addition, in terms of the tentative review analysis and research hypotheses, the random effects model was used as a meta-analysis model. The research revealed that maternal anxiety was significantly positively correlated with preschool children’s internalizing problem behaviors, externalizing problem behaviors, and overall problem behaviors. The moderating effect analysis showed that region and gender of the child affected the relationship between maternal anxiety and children’s internalizing problem behaviors and externalizing problem behaviors, and region, child’s age and gender, mother’s age, and education level affected maternal anxiety and preschool children’s problems behavioral relationship. Hence, these results affirmed the role of maternal anxiety and emphasized the need to pay attention to the demographic characteristics and cultural background of the subjects during the research process and consider the generalizability of the conclusions under different circumstances.

Systematic Review and Meta-Analysis of the Effectiveness of Teacher Delivered Interventions for Externalizing Behaviors

This systematic review and meta-analysis explores the effectiveness of teacher interventions supporting children with externalizing behaviors based on teacher and child outcomes. A systematic search was conducted using 5 electronic databases. From 5714 papers, 31 papers that included interventions delivered directly to teachers and aimed to benefit either teachers and/or children with externalizing behaviors were included. The review focused on qualified teachers working with children aged 2–13. The results of the current meta-analysis revealed a positive effect of teacher intervention on teacher and child outcomes, including the increased use of teacher-appropriate strategies, as well as significant and moderate improvements in teacher–child closeness, and small reductions in teacher–child conflict. For child outcomes, the interventions reduced externalizing behavior problems and ADHD symptoms and enhanced prosocial behavior. Only one fully blinded analysis for conduct problems was possible and revealed a moderate but significant reduction in favor of intervention. These findings provide evidence to support the role of teacher interventions for both teachers and children with externalizing behaviors. Future research should include more PBLIND measurements so that MPROX findings can be confirmed. More research should be done to evaluate the influence of teacher interventions on teachers’ well-being.

Fathers’ parenting stress, parenting styles and children’s problem behavior: the mediating role of parental burnout

Parental duties can be overwhelming, particularly when parents lack sufficient resources to cope with parenting demands, leading to parental burnout. Research has shown that parental burnout is positively related to neglect and abuse behaviors towards their children; however, few studies have examined parental burnout within the family system, including examining parenting styles as an antecedent, and most research has ignored the potential influence of fathers’ parental burnout. This study aimed to explore the influence of fathers’ parenting stress and parenting styles on internalizing and externalizing problem behaviors in a sample of junior high school students and the mediating effect of parental burnout. Questionnaire data from 236 students (56.4% girls) and their fathers (age: M = 39.24, SD = 5.13) were collected on 3 different time points. Fathers were asked to report their parenting stress and parenting styles at Time 1, and parental burnout at Time 2, and students were asked to report their internalizing and externalizing behaviors at Time 3. The results indicated that: (1) fathers’ parenting stress and negative parenting styles were positively related to parental burnout, and fathers’ positive parenting styles were negatively related to parental burnout; (2) fathers’ parental burnout was positively related to children’s internalizing and externalizing problem behavior; and (3) fathers’ parental burnout could mediate the relationship between parenting stress, negative parenting styles, and internalizing and externalizing problem behavior. These results suggested that fathers’ roles in the parenting process were not negligible, and more attention should be given to prevention and intervention methods for fathers’ parental burnout.

Longitudinal Pathways from Mothers’ and Fathers’ Warmth and Control to Children’s Social and Academic Outcomes: The Mediating Role of Children’s Executive Functioning Difficulty

Objectives: This study examined longitudinal pathways from mothers’ and fathers’ warmth and control to children’s prosocial and externalizing problem behaviors as well as academic outcome. The study also explored whether children’s executive functioning difficulty plays the mediating role in the links between mothers’ and fathers’ parenting behaviors and children’s social and academic outcomes.Methods: Participants were 1,671 children and their parents which were retrieved from the Panel Study on Korean Children. Direct relations between parenting variables and children’s social and academic outcomes were examined. Indirect effects of children’s executive functioning difficulty were also investigated in these associations. Structural equation modeling was used to analyze the longitudinal relations among maternal and paternal parenting behaviors, children’s executive functioning difficulty, and their social and academic outcomes. The bootstrapping method was also used to examine the indirect effects of children’s executive functioning difficulty in the links between parenting variables and children’s social and academic outcomes.Results: Mothers' and fathers' warm parenting was negatively related to children’s executive functioning difficulty, which in turn predicted their subsequent prosocial and externalizing problem behaviors, as well as academic outcome. Moreover, indirect relations between parenting variables and children’s social and academic outcomes via children’s executive functioning difficulty were found.Conclusion: The result of this study suggests the importance of parental warmth in children's social and academic outcomes. The present results also emphasize the role of children’s executive functioning difficulty as the pivotal mechanism that explains how mothers’ and fathers’ warm parenting predicts subsequent children’s outcomes in social and academic domains.

Brain Waves Reflect Cognition-Emotion State as a Diagnostic Tool for Intervention in Dysfunctional States: A Real-World Evidence

Objective: This study aims to characterize electrical signals to establish a diagnosis of cognitive-emotional dysfunction and guide a successful therapeutic intervention. Therefore, the present study aimed to observe these frequency bands in a sample of dysfunctional neurological behaviors to establish a neural marker of neural dysfunction that helps diagnose and monitor treatment. &#x0D; Methods: A descriptive retrospective (extracted from the database) observational study design based on real-world historical data from routine clinical practice. According to DSM-5, low academic achievement (n =70), disruptive behavior (externalizing behavior problems) (n=70), and somatic syndrome disorder (n=70) were the subjects. The mean age of the sample was 14.13 (SD = 1.46; range 12-18), 31.5% women. The measuring instrument was the NeXus-10, which is suitable for acquiring a wide range of physiological signals. Brain electrical activity was recorded by using the quantitative electroencephalograph (qEEG) in accordance with the 10-20 International Electrode Placement System. In particular, the specific form of miniQ (mini-qEEG) was used.&#x0D; Results: A pattern record present in all cases were identified. The record refers to (a) activity along the midline, namely, Fz-Cz-Pz, (b) activity from the center (Cz) to back, namely, Pz-O1 and O2, (c) activity from the center (Cz) forward (Fz), and (d) comparison between hemispheres. The characteristics of theta, alpha, and beta waves define the characteristic pattern of neurological dysfunction. The reversal of the dysfunctional pattern coincided with the remission of the clinical symptoms after treatment, which occurred in 87,6% of the subjects. We define remission as not meeting DSM-5 criteria.&#x0D; Conclusion: This study suggests that miniQ register could be considered a simple and objective tool for studying neurological dysfunction. This dysfunction is explained according to current neurological knowledge of interactive cognition-emotion processing. MiniQ may be a cheap and reliable method and a promising tool for the investigation in the field.

Kindergarten academic and social skills and exposure to peers with pre-kindergarten experience

Pre-kindergarten (pre-k) is thought to have both direct and indirect effects on children's outcomes in early elementary school. Direct pre-k effectsconsistently include moderate to large gains in academic skills and sometimes include increases in problem behaviors that affect acquisition of skills in school. Indirect pre-k effects assume that having more pre-k attenders in classrooms motivates teachers to provide more challenging instruction and provide children with more academically skilled, but perhaps behaviorally challenged peers with whom they interact. To date, these indirect effects have not been carefully examined. This study used a district-wide cohort study of a pre-k program (n = 2572 children, 482 kindergarten classrooms) to examine whether the proportion of children in kindergarten classrooms with pre-k experience related to gains in children's academic, executive function, and social skills during kindergarten. Results indicated that schools with more pre-k attenders served more children from low-income families and children of color. The quality of instruction in classrooms with more pre-k attenders was rated as slightly higher in terms of instructional support and focus on abstract learning when school composition was not considered. Teachers reported less focus on teachers-parent coordination of home learning in classrooms with more pre-k attenders. Children with more classmates who attended pre-k, regardless of their own pre-k attendance histories, showed slightly larger gains in vocabulary and inhibitory control skills but also showed smaller increases in ability to manage frustration. When taken together, findings may indicate that peers influence young children's verbal and social skills, but do not support speculation that increasing pre-k exposure would improve reading or math skills overall or lead to more externalizing behavior problems.

Follow-up of infants with colic into childhood: Do they develop behavioural problems?

To assess whether infants with colic (IC) demonstrate persisting developmental dysregulation into childhood, manifested as behavioural problems, and to determine if these behavioural problems are associated with parenting factors. Preschool children with a history of IC at the age of 0-3 months, as defined by the Wessel criteria, were invited to participate in an observational follow-up study, in which their caregivers completed the Child Behaviour Checklist (CBCL). Raw scores and clinical-range scores on the internalising, externalising and total behavioural problems scales were compared with a Dutch normative sample using independent t-tests and Chi-square tests. For the clinical-range scores, multivariable logistic regressions (odds ratios [99% confidence interval, CI]) were used to adjust for confounders and to identify variables associated with behavioural problems. Two hundred and fifty-eight children with a history of IC (median age 5.1 (interquartile range, IQR 4.6-5.5) years, 51.9% boys) were included. The cases had a significantly higher adjusted risk (adjusted odds ratios (aORs) [99% CI]) of scoring in the clinical range of the emotionally reactive, internalising and total problems scale (2.96 [1.24-7.06]; 2.50 [1.35-4.62]; 2.98 [1.46-6.07], respectively). Internalising (P< 0.001), externalising (P< 0.001) and total (P< 0.001) behavioural problems in children with a history of IC were associated with higher parenting stress scores. Children with a history of IC demonstrated significantly more internalising behavioural problems at preschool age compared to the norm sample. Specific advice and support need to be available for parents to understand and regulate the behaviour of their child, from infancy to childhood.

Do the Temperamental Characteristics of Both Mother and Child Influence the Well-Being of Adopted and Non-Adopted Children?

(1) Background: For decades, the temperaments of infants and small children have been a focus of studies in human development and been seen as a potential contributor to children’s developmental patterns. However, less is known about the interplay between the temperamental characteristics of mothers and their children in the context of explaining variations in developmental outcomes. The aim of our study was to explore the associations—with or without genetic links—of the temperaments and psychological distress of mothers and the temperaments of children with behavioral problems in a group of internationally adopted children and their adoptive mothers and in a group of non-adopted children and their mothers. (2) Methods: Data (n = 170) were derived from the ongoing Finnish Adoption (FinAdo) follow-up study. The children included were under the age of 7 years; 74 were adopted internationally through legal agencies between October 2010 and December 2016, and the remaining 96 were non-adopted children living with their birth parents (biological group) recruited from day-care centers. We used Mary Rothbart’s temperament questionnaires to assess temperament, the Child Behavior Checklist (CBCL) to obtain data on the children’s behavioral/emotional problems and competencies, and the General Health Questionnaire (GHQ) to assess parental psychological distress. The study was approved by the Ethics Committee of the Hospital District of Southwest Finland, and written informed consent was obtained from the parents and the children themselves. (3) Results: The negative affectivities of both mothers and children were associated with the total CBCL and with both internalizing and externalizing problem behaviors after adjusting for age, gender, and adoption status. Both relationships remained significant when tested simultaneously, suggesting additive effects. Maternal negative affect was associated with problem behavior irrespective of child extraversion/surgency. Child extraversion/surgency was associated with lower levels of all internalizing behavioral problems when adjusted for maternal sociability. Child negative affect was associated with all behavioral problem measures irrespective of maternal sociability or maternal psychological distress. Maternal distress was associated with child problem behaviors only in children with low extraversion/surgency. (4) Limitations: The sample size was relatively small, and the information was gathered solely with questionnaires. (5) Conclusions: The results of the study may be clinically significant. Child negative affect, maternal negative affect, and maternal experienced distress, combined with low child extraversion/surgency, may increase the risk of child problem behaviors in both adoptees and non-adoptees.

Transactions between Problem Behaviors and Academic Performance in Early Childhood.

This study aimed to further the understanding of transactional relationships that exist between problem behaviors and academic performance in early childhood. Early academic and behavior difficulties increase the risk of school disengagement, academic failure, and dropout. Although children’s academic and behavioral difficulties have been shown to be intercorrelated, little research has focused on how the relationship reciprocates and progresses in early childhood. This study investigated how problem behaviors (i.e., externalizing and internalizing) influence and are influenced by academic performance (i.e., poor reading and math) from kindergarten to third grade. Participants included 18,135 students (51.22% boys) derived from a nationally representative sample in the Early Childhood Longitudinal Study, Kindergarten Class of 2011 (ECLS-K: 2011). Teacher ratings of children’s internalizing (low self-esteem, anxiety, loneliness, or sadness) and externalizing (fighting, arguing, showing anger, impulsively acting, and disruptive behaviors) problem behaviors, as well as direct assessments of children’s academic performance (reading and math), were collected yearly. Cross-lagged panel modeling (CLPM) was employed to examine reciprocal relationships between problem behaviors and academic performance over time from kindergarten to third grade. The results supported the transactional relationships in early childhood, with higher externalizing as well as internalizing problem behaviors predicting lower academic performance and lower academic performance predicting higher externalizing and internalizing problem behaviors. The implications for research, prevention, and early intervention regarding the progression of academic and behavioral problems are discussed.

Parental Phubbing, Self-Esteem, and Suicidal Ideation among Chinese Adolescents: A Longitudinal Mediational Analysis.

Parental phubbing refers to a phenomenon in which parents are distracted by their smartphones when they interact with their children. It has become a common concern and linked to adolescents' internalizing and externalizing behavior problems. However, much remains unclear about reciprocal associations among parental phubbing, self-esteem, and suicidal ideation and the potential mechanisms underlying these associations. To address these gaps, the current study tested bidirectional relationships among parental phubbing, self-esteem, and suicidal ideation, as well as the mediating role of self-esteem. In addition, the present study examined whether these relationships varied by extraversion, gender, and perceived economic stress across three time points using a cross-lagged design. A total of 2407 Chinese adolescents (50.23% girls, Mage = 12.75, SD = 0.58 at baseline) participated in the study. The results showed that parental phubbing was associated with self-esteem as well as with suicidal ideation, and there were bidirectional relationships between self-esteem and suicidal ideation. Self-esteem significantly mediated the association between parental phubbing and suicidal ideation. Extraversion moderated the link between parental phubbing and suicidal ideation as well as self-esteem and suicidal ideation during the first year. Gender and perceived economic stress did not play a moderating role. The results indicate that parental phubbing is a new risk factor for adolescents' suicidal ideation. Parents concerned about adolescents' self-esteem and suicidal ideation should focus on minimizing the frequency of smartphone use and teach adolescents some social skills to seek more sources of social support.

Predictors of psychological risk and resilience among Syrian refugee children.

War-exposed refugee children are at elevated risk for mental health problems, but a notable proportion appear resilient. We aimed to investigate the proportion of Syrian refugee children who can be considered resilient, and applied a novel approach to identify factors predicting individual differences in mental health outcomes following war exposure. The sample included 1,528 war-exposed Syrian refugee children and their primary caregiver living in refugee settlements in Lebanon. Children were classed as having low symptoms (LS) if they scored below clinically validated cut-offs for post-traumatic stress disorder (PTSD), depression and externalising behaviour problems. Children scoring above any cut-off were classified as having high symptoms (HS). Each LS child was matched with one HS who reported similar war exposure, to test what differentiates children with similar exposures but different outcomes. 19.3% of the children met our resilience criteria and were considered LS. At the individual level, protective traits (e.g. self-esteem; OR = 1.51, 95% CI [1.25, 1.81]) predicted LS classification, while environmental sensitivity (OR = 0.69, 95% CI [0.59, 0.82]), poorer general health (OR = 0.71, 95% CI [0.58, 0.87]) and specific coping strategies (e.g. avoidance; OR = 0.90, 95% CI [0.85, 0.96]) predicted HS classification. Social/environmental predictors included perceived social support (OR = 1.23, 95% CI [1.02, 1.49]), loneliness and social isolation (OR = 0.85, 95% CI [0.80, 0.90]), child maltreatment (OR = 0.96, 95% CI [0.94, 0.97]), and caregiver mental and general health (e.g. caregiver depression; OR = 0.94, 95% CI [0.92, 0.97]). Future research should take multiple dimensions of functioning into account when defining risk for mental health problems and consider the identified predictors as potential targets for interventions.

The impact of teachers’ self-efficacy and classroom externalising problem behaviours on emotional exhaustion: Between- and within-person associations

The impact of teachers’ self-efficacy and classroom externalising problem behaviours on emotional exhaustion: Between- and within-person associations