Internalizing Behavior Problems Research Articles

Bridging the Research-to-Practice Gap Through Effective Professional Development for Teachers Working With Students With Emotional and Behavioral Disorders

Students with emotional and behavioral disorders (EBD) experience a variety of externalizing and internalizing behavior problems, gaps in academic achievement, and increased rates of dropping out of school. Thus, it is essential that students with EBD receive evidence-based academic and behavioral supports from skilled and knowledgeable teachers to improve student outcomes. Unfortunately, teachers typically receive limited professional development in classroom management practices and other supports targeting the unique needs of students with EBD. In this manuscript, we describe (a) challenges in the field related to supporting students with EBD, (b) current practices in professional development, (c) a multitiered-system-of-support framework for organizing and providing professional development, and (d) the need for more research on efficient and effective professional-development supports for teachers of students with EBD.

Teacher Recognition, Concern, and Referral of Children’s Internalizing and Externalizing Behavior Problems

Identifying youth with mental health concerns and connecting them to effective intervention is important because poor mental health is related to lower educational achievements, substance abuse, violence, compromised health, and reduced life satisfaction. This study examined the ability of teachers (n = 153) to accurately identify mental health concerns among elementary children using vignettes scenarios depicting children with severe and moderate externalizing or internalizing behavior problems. Teachers were asked to rate the seriousness of the problem, their concern for the child’s well-being, and whether they felt the student needed school-based or community mental health services. Findings indicated that teachers can accurately identify students with severe externalizing and internalizing problems. However, they were less accurate and less likely to think students with moderate or subclinical symptoms needed services. Additionally, teachers perceived externalizing problems to be more serious and more concerning, than internalizing problems. In most cases, teachers’ concern for the child’s well-being, but not their perceived seriousness of the problem, predicted endorsement of referral to school and/or community-based mental health professionals, even when controlling for the child’s gender. Implications for practice and future research areas are discussed.

Dog Training Intervention Shows Social-Cognitive Change in the Journals of Incarcerated Youth.

There is limited research assessing the effectiveness of Animal-Assisted Therapy in at-risk adolescent populations. In a recent study, 138 adjudicated adolescents participated in a randomized controlled trial of an animal-assisted intervention, in which participants either trained shelter dogs (Teacher's Pet group) or walked the dogs (control group), with both groups participating in classroom work related to dogs (1). Journal writing was a part of class activities for all youth in the study. Conventional assessments of youth behavior made by staff or youth themselves did not demonstrate the expected differences between the groups favoring the dog training group, as youth in both groups showed a significant increase in staff and youth rated internalizing behavior problems and empathy from the beginning to the end of the project (1). However, subsequent analysis of the journal content from 73 of the adjudicated youth reported here, did reveal significant differences between treatment and control groups, favoring the Teacher's Pet group. Youth participating in the dog training intervention showed through their journal writing greater social-cognitive growth, more attachment, and more positive attitudes toward the animal-assisted intervention compared to youth in the control group. The 73 youth whose journals were available were very similar to youth in the larger group. Their results illustrate that journaling can be a useful method of assessing effects of similar animal-assisted interventions for at-risk youth. Writing done by youth receiving therapy appeared to promote self-reflection, desirable cognitive change, and prosocial attitudes that may signify improving quality of life for such youth. The expressive writing of participants could reveal important effects of treatment beyond the behavioral changes that are often the targeted outcomes of animal-assisted interventions.

Behavioural and emotional issues among primary school pupils with congenital colour vision deficiency in the Federal Territory of Kuala Lumpur, Malaysia: A case-control study.

Background: Congenital colour vision deficiency (CCVD) is an untreatable disorder which has lifelong consequences. Increasing use of colours in schools has raised concern for pupils with CCVD. This case-control study was conducted to compare behavioural and emotional issues among age, gender and class-matched pupils with CCVD and normal colour vision (NCV). Methods: A total of 1732 pupils from 10 primary schools in the Federal Territory of Kuala Lumpur were screened, of which 46 pupils (45 males and 1 female) had CCVD. Mothers of male pupils with CCVD (n=44) and NCV (n=44) who gave consent were recruited to complete a self-administered parent report form, Child Behaviour Checklist for Ages 4-18 (CBCL/ 4-18) used to access behavioural and emotional problems. The CBCL/ 4-18 has three broad groupings: Internalising, Externalising and Total Behaviour Problems. Internalising Problems combines the Withdrawn, Somatic Complaints and Anxiety/ Depression sub constructs, while Externalising Problems combines the Delinquent and Aggressive Behaviour sub constructs. Results: Results from CBCL/ 4-18 showed that all pupils from both groups had scores within the normal range for all constructs. However, results from the statistical analysis for comparison, Mann-Whitney U test, showed that pupils with CCVD scored significantly higher for Externalising Problems (U=697.50, p=0.02) and Total Behaviour Problems (U=647.00, p= 0.01). Significantly higher scores were observed in Withdrawn (U=714.00, p=0.02), Thought Problems (U=438.50, p<0.001) and Aggressive Behaviour (U=738.00, p=0.04). Odds ratios, 95% CI, showed significant relative risk for high Total Behaviour Problem (OR:2.39 ,CI:1.0-5.7), Externalising Problems (OR:2.32, CI:1.0-5.5), Withdrawn (OR:2.67, CI:1.1-6.5), Thought Problems (OR:9.64, CI:3.6-26.1) and Aggressive Behaviour (OR:10.26, CI:3.4-31.0) scores among pupils with CCVD. Conclusion: Higher scores among CCVD pupils indicates that they present more behavioural and emotional problems compared to NCV pupils. Therefore, school vision screenings in Malaysia should also include colour vision to assist in the early clinical management of CCVD children.

Identifying the evidence relevant to the proposed prohibition of the physical punishment of children and young people in Scotland: a systematic approach

BackgroundLegislation permitting the physical punishment of children and young people is incompatible with the UN Convention on the Rights of the Child. In 2017, the Scottish Government consulted on a Bill to safeguard the wellbeing of children and young people ensuring that they were as equally protected from assault as adults by ending the legal position that physical punishment could be justified. NHS Health Scotland submitted a response to this consultation that was informed by robust evidence, which we report here. MethodsWe adopted a systematic approach to identify evidence in response to nine consultation questions. Questions included consideration of: the advantages, disadvantages, and sustainability of giving children and young people equal protection by prohibiting all physical punishment; and costs and benefits to children and professionals and the impact on individuals protected by the 2010 Equality Act. To augment the evidence presented in a 2015 systematic review by the National Society for the Prevention of Cruelty to Children, we searched Medline, Web of Science, Cochrane Library, IBSS, ASSIA, Sociological Abstracts, Social Service Abstracts, and Proquest Public Health databases to identify studies conducted in developed countries that were published in English between Jan 1, 2015, and June 1, 2017. Keywords used were child, young person, smack, slap, hit, spank, corporal punishment, and physical discipline. Two authors independently reviewed abstracts. Findings880 articles were identified, of which 33 were considered. 19 of them were of sufficient quality to provide impartial evidence about the impact of physical punishment on children and young people. The 2015 systematic review showed that a parent's right to physically punish their child was outdated, potentially harmful, and an ineffective parenting strategy. A 2016 meta-analysis found no evidence that parental spanking was associated with improved child behaviour but was associated with an increased risk of negative health outcomes (eg, aggression, antisocial behaviour, externalising and internalising behaviour problems, mental health problems, negative parent–child relationships, impaired cognitive ability, low self-esteem, and risk of physical abuse). There was no evidence that spanking was only associated with negative outcomes when it was combined with physical abuse nor that spanking was only associated with negative outcomes in studies appraised as being methodologically weak. InterpretationProtecting children and young people from physical punishment is an important public health issue that is supported by robust evidence. FundingNone.

Moderation effects of early adolescents’ emotional empathy on the relationship between attachment of parents and peers and internal and external problem behaviors

Moderation effects of early adolescents’ emotional empathy on the relationship between attachment of parents and peers and internal and external problem behaviors

The relationship between parental conflict and preschool children's behavior problems: A moderated mediation model of parenting stress and child emotionality

Based on process model and the organism-environment interaction model, the present study examined a possible pathway to better understand the relationships between parental conflict and their children's externalizing and internalizing behavior problems through parenting stress and child emotionality. Mothers (N = 2925) of preschool children in China completed questionnaires regarding parental conflict, children's behavior problems, parenting stress, and child emotionality. Results indicated that parenting stress partially mediated the association between parental conflict and both of children's externalizing and internalizing behavior problems. The mediating effects of parenting stress in the relationship between parental conflict and children's behavior problems were moderated by child emotionality. Specifically, the relationship between parental conflict and children's behavior problems via parenting stress was stronger for children with high (vs. low) negative emotionality. Limitations and implications of this study were discussed.

The Impact of Caregiving Disruptions of Previously Institutionalized Children on Multiple Outcomes in Late Childhood.

This study examined disruptions in caregiving, as well as the association of these disruptions, with cognitive, behavioral, and social outcomes at age 12 in a sample of 136 Romanian children who were abandoned to institutions as infants and who experienced a range of subsequent types of care. Children were found to experience significantly more caregiving disruptions (CGD) earlier in life than later in childhood. More frequent CGD predicted increases in externalizing and internalizing behavior problems at age 12. Results are discussed in terms of the association between CGD and the long-term development of children who have experienced institutional rearing.

Parental harsh discipline and adolescent problem behavior in China: Perceived normativeness as a moderator.

This study examined the relations between parental harsh discipline (psychological aggression and corporal punishment) and adolescents' externalizing and internalizing problem behaviors and the moderating effects of adolescents' perceived normativeness of harsh discipline in Chinese society. Using a sample of 1158 Chinese middle-school students, our findings revealed that parental harsh discipline was associated with high levels of adolescent externalizing and internalizing behaviors. Adolescents' perceived normativeness of psychological aggression buffered the association between parental psychological aggression and adolescents' internalizing problem behaviors, whereas their perceived normativeness of corporal punishment buffered the association between parental corporal punishment and adolescents' externalizing problem behaviors. The findings from the current study highlight the importance of considering how adolescents' perceptions may influence the effects of parental harsh discipline on adolescent adjustment.

Familial financial stress and child internalizing behaviors: The roles of caregivers' maltreating behaviors and social services.

Based on the family stress model and the stress-buffering model, the present study examines the relationship between caregivers' financial stress and child internalizing problem behaviors, the mediating role of caregiver maltreating behaviors, and whether social services for caregivers buffer this relationship. The current study is based on data from wave two of the National Survey of Child and Adolescent Well-Being dataset (N = 2670). Results indicated increased high familial financial stress was associated with child internalizing problems. Caregivers' psychological aggression, physical assault, child neglect, and sexual maltreatment emerged as mechanisms mediating this relationship. Tangible service and social network service were found to mitigate the deleterious effect of financial stress on child internalizing behaviors, but primarily for those whom financial stress was high. These findings highlight the role perceived financial stress has on potential maltreatment and child outcomes, rather than relying on objective measures of economic status. Implications for social services focused interventions for children and caregivers coping with high levels of perceived financial stress are discussed.

Functioning Among Typically Developing Siblings of Individuals with Autism Spectrum Disorder: A Meta-Analysis.

The literature on typically developing siblings of individuals with autism spectrum disorder (ASD-Sibs) provides inconsistent results, with some studies reporting ASD-Sibs are more likely to have negative outcomes than comparison groups, and others reporting no significant differences. Therefore, the purpose of this study was to meta-analytically aggregate study effect sizes to more accurately calculate the degree to which ASD-Sibs function similarly or differently compared to siblings of people who do not have ASD. Studies were eligible for inclusion if they had a sample of ASD-Sibs older than 5; reported on emotional, psychological, behavioral, or social functioning; and provided information necessary for calculating relevant effect sizes. Results from 69 independent samples indicated that ASD-Sibs have significantly more negative outcomes than comparison groups overall (g = - 0.26); specific areas of functioning in which ASD-Sibs fared worse include internalizing behavior problems, psychological functioning, beliefs, social functioning, and the sibling relationship, but no significant differences in adjustment, attention/hyperactivity, externalizing behavior problems, coping, or family functioning. Noteworthy sub-areas of functioning in which ASD-Sibs also fared worse included beliefs about disability (g = - 0.56), anxiety symptoms (g = - 0.25), and depression symptoms (g = - 0.36). In terms of comparison group, ASD-Sibs had significantly lower functioning than siblings of individuals with other intellectual and developmental disabilities (g = - 0.31), including Down syndrome (g = - 0.40) and siblings of individuals without any disabilities (g = - 0.31). Clinicians and service providers should work to ensure that ASD-Sibs are included in family interventions and support strategies, and researchers should further explore individual differences that may relate to enhanced or impaired functioning in ASD-Sibs.

유아의 내재화 문제행동과 유아의 성 및 부모 양육관련 변인의 관계에 대한 종단적 분석

The study aimed to examine the change pattern of child internalizing problem behaviors and to identify longitudinal associations with child sex and parent nurturing variables (nurturing stress and nurturing behavior). The data were 1,280 samples from the Panel Study on Korean Children (PSKC) and were analyzed through the multi-variate latent growth model. The results were as follows. First, the internalizing problem behaviors were decreased with time, while the higher the initial value of internalization problem behaviors, the lesser the change rate with time. Second, mother’s nurturing variables (nurturing stress and controlled/warm-hearted nurturing behavior) had impacts on the initial child internalizing problem behaviors, while they had little effects on the change of internalizing problem behaviors as children get older.

Exploring the Effects of Positive Psychological Strengths on Psychological Adjustment in Adolescents

The present study reported an exploration of the association between covitality constructs and psychological adjustment– subjective wellbeing, academic achievement, and internalizing and externalizing behavior problems– in adolescents. Participants of the study comprised of 547 adolescents, with 51.1%female and 48.9% male, ranging in age from 13 to 19 years (M = 15.57, SD = 1.13). Findings from the study indicated that higher levels of belief-in-others and engaged living were significant predictors of increased subjective wellbeing. Higher levels of belief-in-self, belief-in-others, and engaged living were also found the significant predictors of increased academic achievement. Thereafter, results from the predictive effect of covitality constructs on mental health problems revealed that higher levels of belief-in-self, belief-in-others, and engaged living were significant predictors of decreased internalizing behavior problems, whereas externalizing behavior problems were significantly predicted by belief-in-self and emotional competence in adolescents. What is more, the combined effect of each of the covitality constructs on adolescents’ psychological adjustment indicators was greater than the effect of this each positive psychological domain individually. Taken together, these outcomes should contribute to the design of prevention and intervention services in order to promote mental health and wellbeing.

The Relationship between Emotional Maltreatment, Internalizing Problem Behavior, Self-Esteem, Social Support of Adolescents

The Relationship between Emotional Maltreatment, Internalizing Problem Behavior, Self-Esteem, Social Support of Adolescents

Is Parent-Child Disagreement on Child Anxiety Explained by Differences in Measurement Properties? An Examination of Measurement Invariance Across Informants and Time.

There are numerous empirical studies demonstrating that agreement between parent-reports of youth and youth self-reports of internalizing behavior problems is modest at best. This has spurred much research on factors that influence the magnitude of associations between informants, including individual difference characteristics of the informants and contexts through which individuals interact with the child. There is also tremendous interest in understanding symptom trajectories longitudinally. However, each of these lines of work are predicated on the assumptions that the psychometric construct that is being assessed from each informant and at each measurement occasion is the same. This study examined measurement invariance between maternal and child reports and longitudinally across ages 9 and 12 on five dimensions of anxiety using the Screen for Child Anxiety and Related Disorders (SCARED; Birmaher et al., 1999). No cross-informant models for anxiety dimensions achieved acceptable fit and at least partial metric and scalar invariance. Moreover, few longitudinal models demonstrated acceptable fit and at least partial metric and scalar invariance. Thus, using the SCARED as an example, these results show that inter-informant agreement may be compromised by different item functioning, and highlight the need for testing invariance before using measures for longitudinal tracking of symptoms.

The Effects of Parents Emotion Regulation Styles and Controlling Parenting Behavior on Preschoolers Internalizing Problem Behaviors

The Effects of Parents Emotion Regulation Styles and Controlling Parenting Behavior on Preschoolers Internalizing Problem Behaviors

Physical activity and modified organized sport among preschool children: Associations with cognitive and psychosocial health

PurposeTo investigate the associations of physical activity intensity and modified organized sport with cognitive (i.e., executive functions) and psychosocial development in preschoolers. MethodsPreschool children (n = 247; 4.2 ± 0.6 years) had their physical activity intensity (light: LPA; moderate: MPA; vigorous: VPA; moderate-to-vigorous: MVPA) and total physical activity (TPA) objectively measured using accelerometery, and parents reported children's participation in sport. Direct assessment of children's executive functions (working memory, inhibition and shifting) and educator-reported psychosocial difficulties were also collected. Associations were examined using linear regression adjusting for covariates and preschool clustering. ResultsLPA was negatively associated with children's visual-spatial working memory (b = −0.04; 95% CI: −0.07, −0.01, p = 0.02) while a positive association with VPA approached significance (b = 0.04; 95% CI: −0.01, 0.09, p = 0.08) but was relatively weak. Higher VPA (b = −0.17; CI: −0.28, −0.06, p = 0.01) was associated with fewer internalizing behavior problems. However, more externalizing behavior problems was associated with MPA (b = 0.30; CI: 0.02, 0.58, p = 0.03), weakly associated with VPA (b = 0.31; CI: −0.05, 0.68, p = 0.09), and moderately associated with MVPA (b = 0.18; CI: 0.00, 0.36, p = 0.05). Participation in modified organized sport was associated with higher shifting performance (Mdiff = 2.17; CI: 0.91, 3.44, p < 0.01). ConclusionDecreasing LPA, increasing VPA and supporting participation in organized sport may be viable targets for cognitive and psychosocial development in preschool children. Longitudinal and experimental studies are needed to confirm these findings.

Cross-national aspects of cyberbullying victimization among 14\u201317-year-old adolescents across seven European countries

BackgroundThe increasing use of the Internet and social network sites (SNS) has created a new domain of socio-emotional development for adolescents. The aim of this cross-sectional study was to explore cybervictimization across seven European countries, in relation to socio-demographic, Internet use and psychosocial variables.MethodsA cross-sectional school-based study was conducted in the participating countries: Germany, Greece, Iceland the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test and Achenbach’s Youth Self-Report.ResultsThe highest rate of cyber victimization was found in Romania (37.3%) and the lowest in Spain (13.3%). Multiple logistic regression analyses gave differing results between countries. In Romania, Poland and Germany cyberbullying victimization was associated with SNS use, whereas Internet use was associated with increased odds of cybervictimization only in Romania. Cybervictimization was associated with greater internalizing behavior problems in all countries analysed, and with externalizing problems in all except Romania.ConclusionsCyberbullying victimization is an on-going problem, which is subject to country-specific socio-demographic factors and diverse patterns of current Internet use and its development. Preventive measures should emphasize the integration of Internet communication technology education in educational contexts, and focus on the consistent association between cybervictimization and internalizing and externalizing difficulties.

Stability of bullying and internalizing problems among adolescents with ASD, ID, or typical development

BackgroundIt is known that children with disabilities, especially adolescents with autism spectrum disorder (ASD), are at increased risk for victimization. However, little is known about the impact of victimization over time. AimsPrimary aims included identifying to what extent risk factors (i.e., internalizing behavior problems and conflict in friendship) related to bullying victimization over time. Methods and proceduresIn-depth interviews conducted separately with 15-year-olds with autism spectrum disorder (ASD), intellectual disability (ID), or typical development (TD) and their mothers investigated the experiences of victimization in a two-year follow up to an earlier study at adolescent age 13. Outcomes and resultsFindings at age 15 demonstrated that the highest rates of bullying continued to be endorsed by youth with ASD. However, youth with ID were found to experience and report the most severe bullying. Longitudinal examination revealed that internalizing behaviors at age 13 predicted victimization experiences at age 15. Conclusions and implicationsDuring middle adolescence, youth with ASD continue to experience more frequent victimization. Thus, shifting the focus of interventions that not only target the salient social deficits of ASD, but also address comorbid conditions such as internalizing symptoms, may further contribute to reduction of social isolation and peer difficulties.

Maternal Cortisol Concentrations During Pregnancy and Sex-Specific Associations With Neonatal Amygdala Connectivity and Emerging Internalizing Behaviors

BackgroundMaternal cortisol during pregnancy has the potential to influence rapidly developing fetal brain systems that are commonly altered in neurodevelopmental and psychiatric disorders. Research examining maternal cortisol concentrations across pregnancy and offspring neurodevelopment proximal to birth is needed to advance understanding in this area and lead to insight into the etiology of these disorders. MethodsParticipants were 70 adult women recruited during early pregnancy and their infants born after 34 weeks gestation. Maternal cortisol concentrations were assessed serially over 4 days in early, mid, and late gestation. Resting state functional connectivity magnetic resonance imaging of the neonatal amygdala was examined. Mothers reported on children’s internalizing behavior problems at 24 months of age. ResultsMaternal cortisol concentrations during pregnancy were significantly associated with neonatal amygdala connectivity in a sex-specific manner. Elevated maternal cortisol was associated with stronger amygdala connectivity to brain regions involved in sensory processing and integration, as well as the default mode network in girls, and with weaker connectivity to these brain regions in boys. Elevated maternal cortisol was associated with higher internalizing symptoms in girls only, and this association was mediated by stronger neonatal amygdala connectivity. ConclusionsNormative variation in maternal cortisol during pregnancy is associated with the coordinated functioning of the amygdala soon after birth in a sex-specific manner. The identified pathway from maternal cortisol to higher internalizing symptoms in girls via alterations in neonatal amygdala connectivity may be relevant for the etiology of sex differences in internalizing psychiatric disorders, which are more prevalent in women.