Types Of Behavior Problems Research Articles

Mental Disorders and Problem Behavior in a Community Sample of Adults with Intellectual Disability: Three-Month Prevalence and Comorbidity

The aim of this study was to investigate the prevalence of mental disorders in a Norwegian sample of adults with intellectual disability (ID) using the Psychopathology Checklists for Adults With Intellectual Disability (P-AID; Hove & Havik, 2008), a screening instrument adopting diagnostic criteria from the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Intellectual Disability/Mental Retardation (DC-LD; Royal College of Psychiatrists, 2001). The P-AID checklists, comprising 10 psychiatric diagnoses and 8 types of problem behaviors, were completed by staff at community-based homes for adults with ID in Western Norway. One in three adults with ID showed indices of a mental disorder. Problem behavior was the most prevalent single diagnosis next to anxiety and affective disorder, and there was a high frequency of comorbidity among the disorders. The findings extend previous reports on mental disorders and comorbidity and support the use of DC-LD in epidemiological research.

Behaviour problems and social competence deficits associated with symptoms of attention‐deficit/hyperactivity disorder: effects of age and gender

Previous research has shown that children with high levels of attention-deficit/hyperactivity disorder (ADHD) symptoms often have a wide variety of associated behaviour problems. However, relatively little is known regarding to what extent these associated behaviour problems are present to the same degree in younger as well as older children and in girls as well as in boys. This study used parent ratings to examine effects of age and gender on behaviour problems, social competence, negative impact on everyday life, and family burden among pre-school and school-aged children high in ADHD symptoms (n=60) and comparison children (n=499). With regard to age, the pre-school children did not differ from the school-aged children on any of the different types of problem behaviour or with regard to social competence. The interactions between age and group were not significant. The behaviour problems of older children did, however, have more negative impact on the child's daily life and induced higher levels of family burden compared with problems of younger children, especially among children with high levels of ADHD symptoms. Boys were more severely affected than girls with regard to ADHD symptom severity, most associated problem behaviours, as well as negative impact and family burden. Significant interactions of ADHD symptoms and gender were also found, which indicated that gender differences were primarily found among children with high levels of ADHD symptoms. Children with high levels of ADHD symptoms have many associated behaviour problems, even in pre-school years, and boys with high levels of ADHD symptoms are more severely affected compared with girls.

An investigation of classroom situational dimensions of emotional and behavioral adjustment and cognitive and social outcomes for Head Start children.

This study used a developmental-ecological approach to investigate the relationship across the school year between early problems in preschool classroom situations and a comprehensive set of readiness competencies for urban low-income children. Study 1 identified 3 reliable and unique underlying classroom situational dimensions where behavior problems occurred: structured learning, peer interaction, and teacher interaction situations. Boys and younger children evidenced more problematic behavior across all situations. Study 2 investigated the relationship between early problems in the situations and readiness outcomes. Early situational difficulties uniquely and differentially predicted lower peer social and classroom learning outcomes. In combination, both the type of behavior problem (what) and the situational problem (where) explained greater variance in the prediction of readiness outcomes, contributing to a more comprehensive understanding of developmental trajectories.

Prevention and Reduction of Behavioural Problems in School: An evaluation of the Respect program

Disobedient pupils, off‐task behaviour, and bullying are common problems in schools in many countries; they interfere with teaching, create an unsafe learning environment, and challenge the staff. Effective programs involving entire schools to prevent and reduce such problems have already been designed and implemented. However, most interventions target one type of problem behaviour, and their effects have only been evaluated in the short term. The Respect program1 is broad in the sense that it targets not just one but several types of behaviour in order to prevent and reduce problem behaviour. The program was implemented among all the staff and pupils at three primary schools and one secondary school in Norway. A cohort longitudinal design was used in evaluating the program. Pupils in the four schools reported a decrease in the four areas of problem behaviour. This decrease was sustained or continued after the intervention period for some types of behaviour, even though the results differed between grade levels. In terms of effect size, the results were small to moderate for most grade levels. Although this analysis was non‐experimental in nature, it does document sustainable change resulting from intervention in an entire school and suggests that this could be maintained in the long term.

Behaviour problems in children with language impairment

Language impairment is often associated with behaviour problems. However, detailed relations between different types of language impairment and specific behaviour problems in children have yet to be demonstrated. The present study attempted to do just this with an eye to the implications to identify foci for early intervention. The language abilities of 71 five-year-old children with language impairment were assessed via the administration of an extensive battery of language tests. The children's behaviour profile was assessed via administration of the Child Behaviour Checklist. Factor analyses confirmed the presence of four language factors: speech, syntax, semantics and phonology. Forty percent of the children displayed serious significant behaviour problems. The most frequently occurring behaviour problems were: withdrawn behaviour, somatic complaints, thought problems and aggressive behaviour. Behaviour problems were associated with three of the four language factors but not strongly associated with speech problems. Differential relations between specific types of language impairment and specific behaviour problems already exist at a young age. Phonological problems showed broad relations to problem behaviour; semantic language problems were especially related to internalizing behaviour problems. This finding suggests the need for specific therapies for both different types of language problems and different types of behaviour problems.

Editorial: Why a diversity of methods are required to understand childhood disorders

Editorial: Why a diversity of methods are required to understand childhood disorders

Psychometric properties of Psychopathology checklists for Adults with Intellectual Disability (P-AID) on a community sample of adults with intellectual disability

The DC-LD is a new classification system providing operationalized diagnostic criteria in recognition of lacking applicability of standard psychiatric criteria for adults with intellectual disability. This study attempts to evaluate internal consistency, inter-rater reliability and factor structure of the Psychopathology Checklists for Adults with Intellectual Disability (P-AID), a set of checklists developed from the DC-LD. The P-AID checklists comprising 10 psychiatric diagnoses and 8 types of problem behaviors were filled in by staff at community based homes for adults with intellectual disability in Western Norway. A total of 593 were returned (66%) of which 83 had two sets of checklists. Intellectual disability was administratively defined. Alpha ( α) values for the total P-AID checklists indicating high internal consistency. The inter-rater reliability measured by ICC showed values between 0.63 and 0.88 in 8 of 10 psychopathology Checklists. Factor analysis indicated four orthogonal units measured by the P-AID. Issues regarding sensitivity and specificity are discussed. This study is the first attempt to develop and evaluate Psychopathology Checklists based on the DC-LD. The results from this study indicate the P-AID can be used in identifying mental health needs at a detailed diagnostic level.

The co-occurrence between internalizing and externalizing behaviors

Although Internalized and Externalized problem behaviors are described as separate phenomena at the psychometric and clinical levels, they frequently co-occur. Only few studies, however, have investigated the causes of such covariation. In a sample of 398 twin pairs aged 8-17 drawn from the general population-based Italian Twin Registry, we applied bivariate genetic analyses to parent-rated CBCL/6-18 Internalization and Externalization scores. Covariation of Internalizing and Externalizing problem behaviors was best explained by genetic and common environmental factors, while the influence of unique environmental factors upon covariance appeared negligible. Odds ratio values showed that a borderline/clinical level of Externalization is a robust predictor of co-existing Internalizing problems in the same child, or within a sibship. Our findings help to approximate individual risks (e.g., in clinical practice, predicting the presence of Internalization in an externalizing child, and vice-versa), and to recognize that several shared environmental and genetic factors can simultaneously affect a child's proneness to suffer from both types of problem behaviors.

Educational Supports for Students with Disabilities and Significant Behavioural Challenges: Teacher Perceptions

This study examined teacher perceptions of educational supports for students with disabilities and significant behavioural problems. Specifically, the study sought to (a) identify the types of behavioural problems displayed by students identified as exhibiting significantly challenging behaviour; (b) ascertain the types of supports and resources available to teachers to support students with challenging behaviours; and (c) elicit recommendations from teachers for how best to provide support for students with disabilities and significant behavioural challenges. Findings from the study indicated that the teachers were routinely being exposed to students who exhibited relatively high levels of significantly challenging behaviour. Teachers reported that they did not feel sufficiently prepared or supported to work successfully with such students and expressed the need for comprehensive, regular, and ongoing professional development activities that were aligned with their needs and those of their students. Despite the challenges encountered, the teachers expressed a strong commitment to assisting students with significant behavioural problems to achieve positive outcomes.

The relation between 3-year-old children's skills and their hyperactivity, inattention, and aggression.

This study examines the relation between 3-year-old children's (N = 280) symptoms of inattention, hyperactivity, and aggression and their cognitive, motor, and preacademic skills. When the authors controlled for other types of attention and behavior problems, maternal ratings of hyperactivity and teacher ratings of inattention were uniquely and moderately associated with children's lower cognitive and preacademic skills. The few modest, simple associations between maternal ratings of aggression and children's skills were no longer significant when hyperactivity and inattention were controlled. This suggests that cognitive and preacademic problems among children with attention-deficit/hyperactivity disorder symptoms may begin to emerge as early as age 3. The results highlight the importance of examining the association between different types of behavior problems and young children's skills.

Biological, behavioral, and relational levels of resilience in the context of risk for early childhood behavior problems

Longitudinal growth patterns of internalizing and externalizing behavior problems were examined in a community sample of 441 children across the ages of 2 to 5 using hierarchical linear modeling. Contextual risk was measured using five indicators (socioeconomic status, marital status, number of siblings, parent stress, parent psychopathology), and three levels of child resilience (biological, behavioral, and relational) were also assessed. Results indicate that a general pattern of decline in both types of behavior problems was observed for the entire sample across time, although considerable individual variability in this pattern was observed. Children's externalizing and internalizing behavior at age 5 was predicted by the level of risk at age 2. All three child resilience factors were also predictive of externalizing and internalizing behaviors at age 5. In the prediction of the slope of problem behavior over time, risk status interacted with both temperamental fearlessness and a mutually responsive orientation with the mother to predict the decline in externalizing and internalizing problem behavior. Results underscore the complex interactions of risk and multiple levels of resilience that are implicated in the maintenance of problem behavior over time. They highlight the importance of considering whether expected resilience factors operate similarly across different levels of risk.

Changing Service Systems for High-Risk Youth Using State-Level Strategies

Changing Service Systems for High-Risk Youth Using State-Level Strategies

The evolution of problem and social competence behaviors during toddlerhood: A prospective population-based cohort survey.

Research in developmental psychopathology has long been preoccupied with rather broad categories of behavior, but we know little about the specific behaviors that comprise these categories. The objective of this study was to: (a) estimate the prevalence of problem and social competence behaviors in the general population of children at 17 months of age, and (b) describe the continuity and discontinuity in the degree to which children exhibit these behaviors between 17 and 29 months of age. The results show that frequent problem behaviors are not typical of children under two years of age. Further, the results suggest that it is possible to distinguish between different types of problem behaviors before two years of age. In addition, the results show that gender differences in some problem behaviors are already present before two years of age, and increase in magnitude during toddlerhood. Finally, the results show that interindividual differences in problem behaviors observed before two years of age are stable. The predictive accuracy of frequent problem behaviors in children at 17 months of age was limited, however, with often a majority of toddlers not behaving this way a year later. Overall, our results suggest that toddlerhood represents a critical period when behavioral and emotional problems of potentially clinical significance emerge. Pediatricians should routinely ask parents to report the frequency of their young children's problem behaviors during child health supervision visits so that children whose frequent problem behaviors persist over time can be identified and possibly referred for treatment.

Body Mass Index and Body Weight Perception as Risk Factors for Internalizing and Externalizing Problem Behavior Among Adolescents

Purpose To examine the relationship between body mass index (BMI), body weight perception (BWP), and indicators of internalizing and externalizing distress and social, attention and thought problems in a large representative sample of Dutch youth. Methods A total of 1826 pupils in the eighth grade of primary education and 5730 students in the first four years of secondary education gave their height and weight to obtain an estimate of their BMI. They reported their evaluation of their body weight and completed Achenbach’s Youth Self-Report (YSR) (1991), which assesses eight types of problem behavior. Data were analyzed in a multivariate framework with BMI and BWP as predictors and the YSR scores on different kinds of problem behavior as dependent variables, controlling for background characteristics. Results Both BMI and BWP are associated with internalizing and externalizing problem behavior, and social, attention and thought problems. Multivariate tests show that BWP is more closely linked to problem behavior than BMI. Adolescents who were either underweight or overweight but considered themselves in good shape had no more problems than the group with normal BMI and BWP ‘good’. The perception of being ‘too thin’ and particularly the perception of being ‘too heavy’ best predict problem behavior in both male and female adolescents. Overweight youngsters with an adequate perception of their weight have less somatic complaints than their normal-weight peers who perceive themselves as too heavy, but they show higher withdrawnness, social problems, and anxiety/depression. Conclusions Adolescent girls are more dissatisfied with their weight than boys; however, the relationship between weight perception and problem behavior is the same for both genders.

Adolescent personality, problem behaviour and the quality of the parent–adolescent relationship

The relationship between adolescent personality and problem behaviour has been well established. However, relatively little attention has been given to the role of the social environment in the association between adolescent personality and problem behaviour. We tested the mediating and moderating role of the quality of the parent–adolescent relationship in the associations between adolescents' personality traits and problem behaviour. The sample consisted of 140 adolescents (11 to 18 years of age) and both their parents. Results supported a mediating role of the father/mother–adolescent relationship in the associations between Agreeableness, Emotional Stability, and Conscientiousness and externalizing problem behaviour. The father/mother–adolescent relationships did not mediate the associations between personality traits and internalizing problem behaviour. We also found support for a moderating role of the father/mother–adolescent relationships in the association between Emotional Stability and both externalizing and internalizing problem behaviours. Other moderated effects were specific for parent, personality trait and type of problem behaviour. Copyright © 2006 John Wiley & Sons, Ltd.

Family Structure and Problem Behavior of Adolescents and Young Adults: A Growth-Curve Study

In the present longitudinal 3-wave study of 1274 adolescents and young adults, aged 12–24 at the 1st wave, it is examined whether youngsters from intact versus postdivorce families show long-term differences in internalizing and externalizing problems. Furthermore, possible differences in the development of this problem behavior between offspring from intact and postdivorce families are examined, i.e., possible differences in growth curves of internalizing and externalizing problems are investigated. Longitudinal multilevel analyses reveal long-term differences in internalizing and externalizing problems according to family structure. Adolescents and young adults growing up in postdivorce families display more internalizing and externalizing problem behavior than youngsters of intact families. The development of these 2 types of problem behavior does not differ by gender or family structure. That is, the shape of the growth curves of internalizing and externalizing problem behavior is similar for boys and girls and also for youngsters from intact and postdivorce families.

Informant, gender and age differences in ratings of adolescent problem behaviour

The aim of this study was to determine gender and age differences and agreement among the reports of adolescent problem behaviour by parents, teachers, and adolescents themselves. For 1,122 11- to 18-year-olds, reports by parents, teachers, and adolescents were obtained. Multivariate regressions were performed to investigate the effect of informant, gender, and age on problem behaviour. Adolescents reported higher levels of problems than parents and teachers for all types of behaviour. Parents reported higher levels of problem behaviour than teachers. Gender differences among informants were dependent on type of problem behaviour. With increasing age, scores of adolescents, parents, and teachers diverged for most types of problems, with larger differences for older adolescents than for younger adolescents. Norms for adolescents need age adjustments for reports by adolescents, parents, and teachers. To obtain a complete view on children's problem behaviours information from multiple informants and differences among them is needed.

Inattention/hyperactivity and aggression from early childhood to adolescence: Heterogeneity of trajectories and differential influence of family environment characteristics

Inattention/hyperactivity and aggressive behavior problems were measured in 335 children from school entry throughout adolescence, at 3-year intervals. Children were participants in a high-risk prospective study of substance use disorders and comorbid problems. A parallel process latent growth model found aggressive behavior decreasing throughout childhood and adolescence, whereas inattentive/hyperactive behavior levels were constant. Growth mixture modeling, in which developmental trajectories are statistically classified, found two classes for inattention/hyperactivity and two for aggressive behavior, resulting in a total of four trajectory classes. Different influences of the family environment predicted development of the two types of behavior problems when the other behavior problem was held constant. Lower emotional support and lower intellectual stimulation by the parents in early childhood predicted membership in the high problem class of inattention/hyperactivity when the trajectory of aggression was held constant. Conversely, conflict and lack of cohesiveness in the family environment predicted membership in a worse developmental trajectory of aggressive behavior when the inattention/hyperactivity trajectories were held constant. The implications of these findings for the development of inattention/hyperactivity and for the development of risk for the emergence of substance use disorders are discussed.

The relationship between alcohol consumption and problem behaviours: Gender differences among British adults

This study sets out to investigate the possible association between alcohol consumption and eight types of problem behaviour in the lives of a sample of 2027 British adults. It also examines gender differences in the prevalence of these problems. The problems considered were related to working, eating, shopping, use of the Internet, sexual activity, exercise, gambling and dieting. Last occasion's alcohol consumption was significantly associated with having experienced problems related to work, gambling, dieting and sexual activity. Total previous week's drinking was only associated with two of these problems—gambling and sexual activity. There were a number of distinct gender differences in the levels of specific problems reported. Females were significantly more likely than males to report having experienced problems related to eating and dieting. Conversely, males were more likely than females to report having had problems related to work, use of the Internet, sexual activity and gambling. These findings do indicate that adult drinking was associated with several forms of “‘problem behaviour”. Even so, they do not support the conclusion that all such behaviours are necessarily interconnected. The gender differences that emerged were not unexpected in view of prevailing social norms and stereotypes concerning the behaviour of the sexes.

Verbal and physical non-aggressive agitated behaviors in elderly persons with dementia: robustness of syndromes

More than a decade ago, different syndromes of agitation were identified in elderly nursing home residents, and it was found that these syndromes correlate with medical, cognitive, and psychosocial functioning. The present study was conducted to examine the robustness of two major syndromes, verbal agitation and physical non-aggressive agitation, as assessed via direct observations. Study participants were 175 elderly persons with dementia recruited from 11 nursing home facilities in Maryland. Observations of the participants' behavior were conducted using the agitated behaviors mapping instrument. The profiles that emerged for physically agitated residents and for verbally agitated residents were remarkably similar to those originally reported. Specifically, verbally agitated behaviors correlated with female gender, with cognitive decline, poor performance of activities of daily living, impaired social functioning, and signs of depressed affect. Physically non-aggressive agitated behaviors correlated with cognitive impairment and with fewer concurrent medical diagnoses. Examining correlates of different syndromes of agitated behaviors may provide researchers with valuable information that can be used for in-depth analysis of both the characterization and etiology of agitation, thus paving the way for the development of interventions that target particular types of problem behaviors.