Low Warmth Research Articles

Longitudinal Mental Health Service and Medication Use for ADHD Among Puerto Rican Youth in Two Contexts

ObjectiveThe study describes prevalence and rates of services and medication use and associated factors over time among Puerto Rican youths with attention-deficit/hyperactivity disorder (ADHD). MethodLongitudinal data are obtained on Puerto Rican children ages 5 through 13 years in the south Bronx in New York (n = 1,138) and two metropolitan areas in Puerto Rico (n = 1,353). The Diagnostic Interview Schedule for Children-IV is the diagnostic tool. Five composite measures of risk factors: negative family influences, ineffective structuring, environmental risks, child risks, and maternal acceptance are constructed to relate services and medication use to risk variables. ResultsADHD prevalence is similar in Puerto Rico and the south Bronx. Overall mental health services, medication, and psychostimulant use is lower in Puerto Rico across three time points. Most participants never received treatment at any time point. More environmental risks, negative child traits, and low maternal warmth are associated with more services, even after adjusting for comorbidity. When risk variables are controlled, the effects of ADHD on services use decrease. Previous treatment is a strong predictor of subsequent treatment. ConclusionsRates of services and medication use are lower in Puerto Rico. Context seems to be more important than ethnicity in predicting mental health services and medication use among Puerto Rican children with ADHD. Other psychiatric diagnoses and general risk variables are important correlates of services and medication use. J. Am. Acad. Child Adolesc. Psychiatry, 2008;47(8):879-889.

Korean American Adolescent Depression and Parenting

Korean American adolescents tend to experience more mental health problems than adolescents in other ethnic groups. The goal of this study was to examine the association between Korean American parent-adolescent relationships and adolescents' depressive symptoms in 56 families. Thirty-nine percent of adolescents reported elevated depressive symptoms. Adolescents' perceived low maternal warmth and higher intergenerational acculturation conflicts with fathers were significant predictors for adolescent depressive symptoms. The findings can be used to develop a family intervention program, the aim of which would be to decrease adolescent depressive symptoms by promoting parental warmth and decreasing parent-adolescent acculturation conflicts.

Reciprocal influences between girls' conduct problems and depression, and parental punishment and warmth: a six year prospective analysis.

Although the reciprocal effects of parenting and child behavior have long been recognized, the emphasis of empirical study in the field of developmental psychopathology has been on parenting effects on children. For girls in particular, little is known about unique parenting effects on conduct problems in comparison to depression, or vice versa. In the current study, data from the large-scale (n = 2,451) Pittsburgh Girls Study were used to examine the reciprocal relations between parenting and child behavior over a six year period (child ages 7-12 years). Girls and their caregivers (85% of whom were biological mothers) were interviewed annually in their homes. Girls reported on symptoms of conduct disorder and depression, and caregivers reported on level of parent-child warmth and use of harsh punishment. The results of generalized estimating equation regression models demonstrated that both parenting behaviors were uniquely predictive of changes in girls' conduct problems and depressed mood. When the effects of race and poverty on these associations were controlled for, both parenting effects on girls' conduct problems remained significant, but only low parental warmth remained as a significant predictor of depressed mood. Girls' conduct problems, but not depressed mood, predicted changes in harsh punishment over time. The small effect of girls' depressed mood, on changes in parental warmth, was further weakened when socio-demographic factors were also included in the model.

Personality and Parental Rearing Practices as Predictors of Adolescent Emotional and Behavioral Problems: Gender Differences in Predictive Accuracy

Many models of psychological development are based on the assumption that parent’s actions are linked to, or the cause of, a child’s behavior. Information about childhood experiences, particularly parental rearing behaviour, is of importance in the clinical investigation of adjustment problems in adolescence. It has been well documented that adolescents run a heightened risk for emotional and behavioral problems when they feel rejected or overprotected by their parents and that parental rejection and overprotection has different effects for gender in developing emotional and behavioral problems. In general, the perceptions of early negative parental behavior are found to be connected to maladjustment and problem behaviors with internalizing as well as externalizing symptoms in adolescence. High perceived parental overinvolvment, rejection, and low emotional warmth correlates with low adjustment and low selfesteem, externalizing disorders, childhood depression, obsession-compulsion, and psychosomatic complaints, and parental control and absence of autonomy is connected with anxiety disorders. Adolescent delinquents perceived their parents as more rejecting, overprotecting, and less emotionally warm than normal adolescents. The perceptions of parental rejection and overprotection in the group of adolescent delinquents also correlated with attention and social problems and somatic complaints. Whether personality in combination with gender plays a role in the association between parental rejection and overprotection and emotional and behavioral problems has not yet received much attention. This study focuses on assessment of personality and parental rearing practices as predictors of adolescent emotional and behavioral problems and gender differences in predictive accuracy of emotional and behavioral problems. Data is used from longitudinal study on development of adjustment problems from childhood to adolescence. A total of 467 adolescent (251 girls and 216 boys), ages 16–17, completed questionnaires about parental rearing practices EMBU (The Egna Minnen Betraffande Uppfostran for Children, Arrindell et al., 1999). EMBU is a short 34-item questionnaire that intends to measure children and adolescents’ perception of three main aspects of parental rearing behaviour: Emotional Warmth, Rejection and Overprotection. Adolescents also completed questionnaires about their emotional and behavioral problems (YSR 11/18, Achenbach, 1991), and personality traits (NEO-FFI, Costa and McCrae, 1992). Girls scored higher on emotional problems (but not on behavioral problems) than boys. Parental behavior was more strongly associated with girls’ emotional and behavioral problems, in comparison to boys. Regression analysis revealed that parental rearing behavior is less significant predictors of emotional and behavioral problems in adolescence, than personality traits. Furthermore, parental rearing behavior and personality traits (namely, neuroticizm) were stronger predictors of emotional and behavioral problems for girls in comparison to boys. Overall, parental rearing practices and personality traits of adolescents are better predictors for emotional and behavioral problems of girls in comparison to boys.

Parent–Child Relations, Conduct Problems and Cigarette Use in Adolescence: Examining the Role of Genetic and Environmental Factors on Patterns of Behavior

This study investigated genetic and environmental influences on the associations between mother–child relationship quality (warmth and hostility) and adolescent conduct problems and cigarette use. Participants included 601 mothers and adolescent twin pairs (aged 12–17 years). Mothers and adolescents provided separate reports of mother-to-child warmth and hostility. A combined measure of mother and adolescent reported conduct problems was used while adolescents provided reports of their cigarette use. Analyses were conducted using bivariate genetic analyses of correlated factors models and regression analyses of monozygotic twin differences. Genetic influences were found for most ratings of the parent–child relationship, with evidence of gender and/or rater-specificity for some measures. The relationship between mother–child hostility with adolescent conduct problems and cigarette use was influenced by genetic and environmental effects. Evidence was found for shared environment effects on the relationship between mother–child warmth and conduct problems. Examining monozygotic twin differences provided further support for non-shared environmental influence on the relationship between mothers’ expressions of hostility and low warmth and adolescent adjustment. Findings are discussed in relation to the interplay between genetic and environmental effects underlying links between parent–child relations and adolescent behavior problems.

Callous-Unemotional Behaviors in Young Girls: Shared and Unique Effects Relative to Conduct Problems

Among girls, little is known about the shared and unique associations that callous-unemotional (CU) behaviors and conduct problems have with aspects of emotional and behavioral dysregulation and with parenting practices. This study examined these associations using a large community-based sample of young girls (N = 990). The findings revealed that hyperactivity–impulsivity and negative emotionality were positively and uniquely associated with conduct problems, but not with CU behaviors, after controlling for co-occurring conduct problems. Conduct problems were also positively associated with both generalized anxiety and panic/somatic anxiety. In contrast, CU behaviors were negatively related to generalized anxiety problems after controlling for co-occurring conduct problems. The results also indicated that conduct problems were more closely associated with harsh punishment and low parental warmth among girls with low versus high CU behaviors.

The Development of Callous-Unemotional Traits and Antisocial Behavior in Children: Are There Shared and/or Unique Predictors?

Callous and unemotional (CU) traits have been linked to severe antisocial behavior in youth, but studies examining the etiology of CU traits are lacking. Based on prior research, it was hypothesized that childhood anxiety and parenting practices would interact to predict changes in CU traits over time. Hypotheses were tested using a sample of 120 moderate to highly aggressive fifth graders followed over a 1-year period. Although CU traits displayed moderate temporal stability and predicted increases in antisocial behavior, evidence suggested that these features were not immutable. Children exposed to lower levels of physical punishment showed decreases in CU traits over time, whereas higher levels of child-reported parental warmth and involvement predicted decreases in both CU traits and antisocial behavior over time. Lower levels of anxiety were uniquely related to increased CU traits for children who described their primary caregiver as exhibiting low warmth and involvement.

Parenting and Adolescent Antisocial Behavior and Depression

Little is known about the interplay of genotypes and malleable risk factors in influencing adolescent psychiatric symptoms and disorders. Information on these processes is crucial in designing programs for the prevention of psychiatric disorders. To assess whether latent genetic factors and measured parent-child relationships interact (G x E) in predicting adolescent antisocial behavior and depression. We characterized risk of antisocial behavior and depression in adolescents by means of a genetically informed design. We used in-home questionnaire and observational measures of adolescent outcomes and environmental moderators (parenting), and a latent variable behavior genetic analytic model. A nationally distributed sample recruited from random-digit dialing and national market panels. A total of 720 families with at least 2 children, 9 through 18 years old, stratified by genetic relatedness (monozygotic and dizygotic twins, full biological siblings in nondivorced and stepfamilies, and half-siblings and biologically unrelated siblings in stepfamilies). Antisocial behavior and depressive symptoms. There was an interaction of genotype and both parental negativity and low warmth predicting overall antisocial behavior, as well as aggressive and nonaggressive forms of antisocial behavior, but not depression. Genetic influence was greater for adolescent antisocial behavior when parenting was more negative or less warm. Genotype-environment correlation was partialled out in the analysis and thus did not account for the results. This study demonstrates, on the basis of careful measurement and appropriate analytic methods, that a continuous measure of parenting in the normative range moderates the influence of genotype on antisocial behavior.

Signs, symptoms and risk factors: health visitors' perspectives of child neglect

AbstractFollowing a brief review of child neglect in England, this small scale, descriptive study ranked in descending order of importance, based on their expertise in the field of child protection, the perceptions of experienced health visitors with respect to 45 signs, symptoms and risk factors of child neglect derived from the literature. The research employed a prospective, survey design using anonymised, self‐completion, postal questionnaires and involved 124 health visitors working in East Anglia of whom 92 finally took part. The response rate was 74%. The study was conducted in 2002, over a period of one year, with respondents from care settings in Norfolk, Suffolk and Cambridgeshire, UK. On the basis of 4001 observations, findings demonstrated promising within‐cohort professional agreement regarding ways in which significant features of child neglect were similarly regarded by health visitors and reflected broadly the established wisdom in the literature. The top ten ranked child neglect characteristics included violence to the child, the child being excluded by the family, the child being left unattended or left to care for other children, violence within the home, a domestic atmosphere of high criticism and low warmth, evidence of human and animal excrement, an unsafe environment, the availability of little or no food, a history of child abuse and poor parenting and unmet medical needs. By contrast, poverty, poor hygiene, housing and state of clothing, financial pressures and unemployment were scored as least important. While the importance of establishing a professional consensus on neglect is considered crucial to improving the evidence base of all protecting neglected children, further investigation is needed on the extent to which perception data might be used in education and practice and its impact on the identification and management of child neglect. Copyright © 2007 John Wiley & Sons, Ltd.

Maternal cigarette smoking during pregnancy and child aggressive behavior.

This study's objective was to examine the association between maternal smoking during pregnancy and childhood aggressive behavior in African-American and Puerto Rican children, as well as the relationship between maternal unconventional behavior, low maternal affection, and offspring aggression. Participants consisted of African-American and Puerto Rican children (N = 203; mean age = 8.6, SD = 0.87) and their mothers living in an inner city community. An interview consisting of a structured questionnaire was administered to the mothers and their children. Scales with adequate psychometric properties were adapted from previous validated measures. They included maternal smoking during pregnancy, maternal education, unconventionality, and warmth. Controlling for demographic factors, maternal unconventional behavior, and low maternal warmth, maternal smoking during pregnancy was associated with having offspring who were aggressive. Maternal unconventionality and warmth were independently related to childhood aggression. Although causal limitations are noted, it may be that a decrease in smoking during pregnancy is associated with a reduction in aggression in the offspring.

Dehumanizing the Lowest of the Low

Traditionally, prejudice has been conceptualized as simple animosity. The stereotype content model (SCM) shows that some prejudice is worse. The SCM previously demonstrated separate stereotype dimensions of warmth (low-high) and competence (low-high), identifying four distinct out-group clusters. The SCM predicts that only extreme out-groups, groups that are both stereotypically hostile and stereotypically incompetent (low warmth, low competence), such as addicts and the homeless, will be dehumanized. Prior studies show that the medial prefrontal cortex (mPFC) is necessary for social cognition. Functional magnetic resonance imaging provided data for examining brain activations in 10 participants viewing 48 photographs of social groups and 12 participants viewing objects; each picture dependably represented one SCM quadrant. Analyses revealed mPFC activation to all social groups except extreme (low-low) out-groups, who especially activated insula and amygdala, a pattern consistent with disgust, the emotion predicted by the SCM. No objects, though rated with the same emotions, activated the mPFC. This neural evidence supports the prediction that extreme out-groups may be perceived as less than human, or dehumanized.

Sibling relationships and best friendships in young adulthood: Warmth, conflict, and well‐being

AbstractAlthough much work addresses the importance of siblings and friendships in separate investigations, few studies simultaneously examine both relationships. Young adults (N= 102, M age = 18.7) were surveyed about their friendships, their sibling relationships, and their psychological well‐being (assessed by self‐esteem and loneliness). Participants with harmonious (high warmth, low conflict) sibling relations and same‐gender friends had the highest well‐being. Participants with affect‐intense (high warmth, high conflict) sibling relationships had low well‐being. However, participants who had low‐involved (low warmth, low conflict) and affect‐intense same‐gender friendships did not differ in well‐being. When examining joint effects, having a harmonious same‐gender friendship compensated for having a low‐involved sibling relationship, but having harmonious sibling relations did not compensate for having low‐involved friendships. Overall, the results underscore the importance of positive and negative relationship properties and the joint effects of multiple relationships.

Early predictors of self-regulation in middle childhood

The present study examined the contribution of caregiving practices at ages 4-5 (Time 1) to children's capacity for self regulation at ages 8-9 (Time 2). The multi- ethnic sample comprised 549 children of National Longitudinal Survey of Youth (NLSY) participants. High levels of maternal warmth and low levels of physically punitive discipline at Time 1 were associated with a greater capacity for self-regulation at Time 2. These associations remained signifi cant once initial levels of self-regulation were taken into account, indicating that the development of self-regulation is open to caregiver infl uence during childhood. Neither child gender nor ethnicity moderated the effects of early parenting practices on later self-regulation; the interaction between low maternal warmth and high discipline was also non-signifi cant. Findings add to the literature on how early parenting practices shape children's capacity for effective self-regulation, and have implications for researchers and practitioners.

Communication and Frightening Behavior Among Couples with Past and Recent Histories of Physical Marital Aggression

The present study compares observed communication and couples' reports of husbands' frightening behaviors among couples with no history of husbands' physical marital aggression, a past history of such aggression, and recent history of such aggression. Ninety community couples reported on husbands' physical marital aggression during two visits to the lab, approximately 1.5 years apart. During the second visit, we videotaped couples' discussions of conflictual marital issues. Poor communication, as indexed by high hostility, low problem-description and low warmth, characterized couples with recent aggression, as compared to past aggression or no aggression. Husbands' frightening behavior characterized the couples with either recent or past aggression, compared to no aggression. In addition, for couples who had experienced severe aggression, the rates of husbands' frightening behavior were similar regardless of whether husbands persisted, reduced or desisted in the severe aggression. Discussion addresses possible reasons that reductions and desistance in husbands' aggression may be associated with more positive communication patterns but with continued reports of frightening behavior.

Understanding the Risks of Child Neglect: An Exploration of Poverty and Parenting Characteristics

A strong association between poverty and child neglect has been established, but the mechanisms that explain this relationship have not been clearly articulated. This research takes advantage of survey and child maltreatment administrative data about families with young children and assesses the influence of poverty and parenting characteristics on subsequent child neglect. The authors find that indicators of poverty, such as perceived material hardship and infrequent employment, and parenting characteristics, such as low parental warmth, use of physical discipline, and allowing a child to engage in frequent television viewing, are predictive of child neglect. Parenting characteristics do not appear to mediate the link between perceived hardship and neglect, although they suppress the link between employment and neglect. Results from this study provide information that is highly relevant to the approach and design of child maltreatment prevention and intervention strategies.

Pathways between profiles of family functioning, child security in the interparental subsystem, and child psychological problems

This study was designed to delineate pathways between systems profiles of family functioning, children's emotional insecurity in the interparental relationship, and their psychological adjustment in a sample of 221 children and their parents. Consistent with family systems theory, cluster analyses conducted with assessments of marital, coparental, and parent-child functioning indicated that families fit into one of four profiles: (a) cohesive families, characterized by warmth, affection, and flexible well-defined boundaries in family relationships; (b) disengaged families, reflected in high levels of adversity and low levels of support across family subsystems; (c) enmeshed families, evidenced by high levels of discord and weak maintenance of relationship boundaries in the family unit; and (d) adequate families, defined by elevated parental psychological control within a larger family context of low discord and high warmth. In comparison to children in cohesive families, children in enmeshed and disengaged families exhibited greater signs of insecurity in the interparental relationship concurrently and internalizing and externalizing symptoms both concurrently and 1 year later. Structural equation models revealed that a latent, multimethod measure of insecurity in the interparental relationship partially mediated associations between family enmeshment and disengagement and children's psychological symptoms 1 year later. Results are discussed in relation to how they inform and refine a family-wide model of the emotional security hypothesis.

Perceived parental rearing style in obsessive–compulsive disorder: relation to symptom dimensions

Obsessive–compulsive disorder (OCD) runs in families, but the specific contribution of genetic and environmental factors to its development is not well understood. The aim of this study was to assess whether there are differences in perceived parental child-rearing practices between OCD patients and healthy controls, and whether any relationship exists between parental characteristics, depressive symptoms and the expression of particular OCD symptom dimensions. A group of 40 OCD outpatients and 40 matched healthy controls received the EMBU (Own Memories of Parental Rearing Experiences in Childhood), a self-report measure of perceived parental child-rearing style. The Yale–Brown Obsessive–Compulsive Scale (Y–BOCS) and the Hamilton Depression Rating Scale (HDRS) were used to assess the severity of obsessive–compulsive and depressive symptoms. The Y–BOCS Symptom Checklist was used to assess the nature of obsessive–compulsive symptoms, considering the following five symptom dimensions: contamination/cleaning, aggressive/checking, symmetry/ordering, sexual/religious and hoarding. Logistic and multiple linear regression analyses were conducted to study the relationship between parental style of upbringing, depressive symptoms and OCD symptom dimensions. Severe OCD (Y–BOCS: 27.0±7.4) and mild to moderate depressive symptoms (HDRS: 14.0±5.4) were detected in our sample. Compared with healthy controls, OCD patients perceived higher levels of rejection from their fathers. No differences between the groups with respect to perceived levels of overprotection were detected. The seventy of depressive symptoms could not be predicted by scores on any perceived parental characteristics. Hoarding was the only OCD symptom dimension that could be partially predicted by parental traits, specifically low parental emotional warmth. Social/cultural variables such as parental child-rearing patterns, in interaction with biological and genetic factors, may contribute to the expression of the OCD phenotype.

Correlates of aggressive and delinquent conduct problems in adolescence

The primary purpose of the study was to test a hypothetical model for aggressive and delinquent conduct problems in adolescence. A total of 168 adolescents from 121 families were studied using several questionnaires and a semi-structured interview. The following factors were considered: obstetric complications, temperament (novelty-seeking), self-esteem, family influences (perceived parenting, alcohol abuse/dependence of parents, antisocial personality disorder of the father) and peer-group characteristics (peer rejection and membership in a deviant peer group). The evaluation methods applied included correlation analyses and testing of two hypothetical models using structural equation modeling. The correlation analyses revealed significant relationships between adolescent aggressive and delinquent behavioral problems and parental antisocial behavior; perceived parental rejection and low emotional warmth; adolescent novelty-seeking, self-esteem, peer rejection and peer deviance. The two empirical models, separately for aggressive and delinquent behavior problems, revealed direct relationships between paternal antisocial behavior, parental rejection, adolescent novelty seeking, peer deviance, peer rejection, and offspring aggression and delinquency. There were, however, two differences with respect to the relationships between peer rejection, peer deviance, aggression and delinquency. First, peer rejection was more strongly associated with aggressive behavior and only moderately linked to delinquency. Second, deviance in the peer-group was found to be closely related with delinquency but only moderately with aggression. Our findings suggest that several pathways for aggressive and delinquent conduct problems are comparable while others were not. Regarding the findings of the empirical models, we conclude that only intervention measures that include parents, peers and individual adolescents may help decrease the incidence of aggressive and delinquent conduct problems. Aggr. Behav. 31:24–39, 2005. © 2005 Wiley-Liss, Inc.

Recall of threat and submissiveness in childhood: development of a new scale and its relationship with depression, social comparison and shame

AbstractResearch on the link between recall of early parenting and psychopathology has focused on recall of parental behaviours such as neglect, rejection, low warmth and overprotection. This study investigates recall of the personal feelings of perceived threat and subordination in childhood. A short, new self‐report scale was developed, called the Early Life Experiences Scale (ELES) and given to 225 undergraduate students. Analysis revealed three factors: a factor for threat, a factor related to submissiveness and a factor related to feeling (un)valued. All participants completed measures of recall of parental behaviour and depression; 119 also completed a shame scale, and 106 completed a social comparison scale. Both the recall of parental behaviour measure and the ELES correlated significantly with depression, social comparison and shame. However, a standard multiple regression analysis found that only the submissive factor of the ELES predicted depression. Copyright © 2003 John Wiley & Sons, Ltd.

A model of (often mixed) stereotype content: Competence and warmth respectively follow from perceived status and competition.

Stereotype research emphasizes systematic processes over seemingly arbitrary contents, but content also may prove systematic. On the basis of stereotypes' intergroup functions, the stereotype content model hypothesizes that (a) 2 primary dimensions are competence and warmth, (b) frequent mixed clusters combine high warmth with low competence (paternalistic) or high competence with low warmth (envious), and (c) distinct emotions (pity, envy, admiration, contempt) differentiate the 4 competence-warmth combinations. Stereotypically, (d) status predicts high competence, and competition predicts low warmth. Nine varied samples rated gender, ethnicity, race, class, age, and disability out-groups. Contrary to antipathy models, 2 dimensions mattered, and many stereotypes were mixed, either pitying (low competence, high warmth subordinates) or envying (high competence, low warmth competitors). Stereotypically, status predicted competence, and competition predicted low warmth.