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ABSTRACT: This study examined dimensions of callous behaviors in early childhood and the role of these behaviors in the development of conduct problems, as well as responsiveness to a family-centered preventative intervention. Caregiver reports of callous behaviors were examined using exploratory and confirmatory factor analysis. Problem behavior was examined using within- and cross-informant reports of these behaviors. Parenting was measured using observational methods within the context of a randomized control trial of the Family Check-Up with a sample of 731 ethnically diverse boys and girls (followed from ages 2 to 4) at high risk for later conduct problems. Results demonstrated that a measure of deceitful-callous (DC) behaviors had acceptable factor loadings and internal consistency at ages 3 and 4. DC behaviors at age 3 predicted problem behavior concurrently and longitudinally within and across informant. However, DC behaviors did not reduce the effectiveness of the family preventative intervention. These findings have implications for our understanding of behaviors that may precede later callous-unemotional traits and for our understanding of the development and prevention of early starting conduct problems.
Development and Psychopathology 05/2013; 25(2):347-63. · 4.40 Impact Factor
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ABSTRACT: A growing body of research has examined callous–unemotional (CU) traits among samples of antisocial youth. Debate surrounds the malleability of CU traits and their responsiveness to parenting and parent-focused interventions. This review examines evidence from studies that have investigated various re-lationships between parenting, CU traits, and antisocial behavior (AB). Studies were categorized according to five distinct research questions each addressing associations among parenting, CU traits, and AB in a different way. The results suggest that dimensions of parenting are prospectively related to changes in CU traits. Sub-groups of youth with both high levels of CU traits and AB also appear to have experienced negative parenting practices. However, negative parenting is not consistently related to AB in cross-sectional studies for youth with high levels of CU traits. At the same time, parenting-focused interventions appear effective in reducing the level of AB and CU traits in youth. The findings and implications for future studies are critically discussed as they pose challenges for current etiological theories of AB.
Clinical Psychology Review 04/2013; 33:593–608. · 7.07 Impact Factor
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ABSTRACT: This research investigated potential collateral benefits of the Family Check-Up (FCU) intervention, namely, primary caregivers' perceived social support and couple relationship satisfaction. A subsample of 435 low-income families with a 2-year-old child was recruited to participate in a randomized controlled trial assessing preventative effects of the FCU. Longitudinal growth models were used to evaluate intention-to-treat effects of the FCU on increases in primary caregivers' ratings of social support satisfaction with perceived social support and significant-other relationships, and indirect effects on primary caregivers through improvements in children's behavior problems. Support was found for a model in which reductions in child problem behavior from ages 2 to 4 predicted positive change in caregiver-rated social support and relationship satisfaction over a 3-year period. This indirect effects model is discussed with respect to implications for early childhood prevention research focused on improving family functioning. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
Journal of Family Psychology 03/2013; · 1.66 Impact Factor
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ABSTRACT: Family and youth violence are increasingly recognized as key public health issues in developing countries. Parenting interventions form an important evidence-based strategy for preventing violence, both against and by children, yet most rigorous trials of parenting interventions have been conducted in high-income countries, with far fewer in low- and middle-income countries (LMICs). This systematic review, conducted in line with Cochrane Handbook guidelines, investigated the effectiveness of parenting interventions for reducing harsh/abusive parenting, increasing positive parenting practices, and improving parent-child relationships in LMICs. Attitudes and knowledge were examined as secondary outcomes. A range of databases were systematically searched, and randomized trials included. High heterogeneity precluded meta-analysis, but characteristics of included studies were described according to type of delivery mode and outcome. Twelve studies with 1580 parents in nine countries reported results favoring intervention on a range of parenting measures. The validity of results for most studies is unclear due to substantial or unclear risks of bias. However, findings from the two largest, highest-quality trials suggest parenting interventions may be feasible and effective in improving parent-child interaction and parental knowledge in relation to child development in LMICs, and therefore may be instrumental in addressing prevention of child maltreatment in these settings. Given the well-established evidence base for parenting interventions in high-income countries, and increasingly good evidence for their applicability across cultures and countries, there is now an urgent need for more rigorously evaluated and reported studies, focusing on youth outcomes as well as parenting, adapted for contexts of considerable resource constraints.
Prevention Science 01/2013; · 2.63 Impact Factor
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ABSTRACT: The measurement of parenting behaviors is important to the field of psychology and the goal of remediating problematic parenting as a means of reducing child problem behaviors. The Parenting Young Children (PARYC) is a self-report measure designed to address parenting behaviors relevant for the caregivers of young children, and was assessed in sample of 579 high risk families. The measure assesses the frequency of several parenting behaviors, the perception of the parenting behaviors as problematic, and the degree to which the caregiver would like to make changes in specific parenting skills. An examination of the validity of the parenting behavior items revealed three parenting scales: (1) Supporting Positive Behavior (2) Setting Limits, and (3) Proactive Parenting. Confirmatory factor analysis results corroborate the findings of the exploratory factor analysis, supporting the measurement structure of these parenting scales. Tests of convergent validity indicate the PARYC scale is a suitable measure of parenting behaviors. In addition, the self-perception of parenting behaviors as problematic predicted concurrent levels of service utilization while controlling for simultaneous child behavior problems.
Journal of Child and Family Studies 06/2012; 21(3):498-511. · 1.12 Impact Factor
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ABSTRACT: This study examines the role of one component of emotion regulation, behavioral control, in the growth of children's early behavior problems by examining whether increases in parental positive behavior support brought about by a family-centered intervention were associated with greater child behavioral control, and whether greater behavioral control at age 3 mediated the association between improvements in aspects of positive behavior support from ages 2 to 3 and decreases in growth of behavior problems from ages 2 to 4. The sample included 713 at-risk children (50% female) and their primary caregivers (50% European American, 28% African American, 13% biracial, 9% other) who were randomly assigned to the intervention or control group. Children had a mean age of 29.91 months at the initial assessment. Data were collected through home visits at child ages 2 to 4, which involved questionnaires for primary caregivers and structured and unstructured play activities for children with primary and alternative caregivers and siblings. Results indicated that the intervention improved parental positive behavior support and reduced growth of child behavior problems. One dimension of positive behavior support, proactive parenting, was modestly associated with behavioral control at age 3, which in turn was significantly associated with growth in behavior problems from ages 2 to 4, with greater behavioral control related to lower levels of growth in behavior problems. Results provide support for the notion that proactive parenting is an important factor in the development of children's behavioral control and that behavioral control plays an important role in the growth of behavior problems.
Journal of Clinical Child & Adolescent Psychology 04/2012; 41(3):288-301. · 1.92 Impact Factor
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ABSTRACT: The relationship between parenting and the development of antisocial behavior in children is well established. However, evidence for associations between dimensions of parenting and callous-unemotional (CU) traits is mixed. As CU traits appear critical to understanding a subgroup of youth with antisocial behavior, more research addressing the link between early parenting and CU traits is needed.
The current study investigated longitudinal predictions between measures of harsh and positive parenting, and early CU behavior. Data from mother-child dyads (N = 731; 49% female) were collected from a multi-ethnic, high-risk sample with young children, and included self-reported and multi-method observed parenting. CU behavior was assessed using a previously validated measure of deceitful-callous behavior (Hyde et al., 2011).
Results suggest that dimensions of harsh parenting, but not positive parenting, contribute to the development of child deceitful-callous behavior. Nevertheless, deceitful-callous behavior showed strong stability over time and the effects of harsh parenting, especially observed harshness, were modest.
The current findings have implications for developmental psychopathology and early interventions for antisocial behavior. The results also raise a number of issues about measuring emerging CU behavior in very young children, including the interrelation between parent perceptions and reports of child behavior, parent reactions, and the subsequent development of severe antisocial behavior.
Journal of Child Psychology and Psychiatry 04/2012; 53(9):946-53. · 4.28 Impact Factor
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ABSTRACT: The current study investigated psychometric properties of the Family Affective Attitude Rating Scale (FAARS) for assessing parents' thoughts and feelings about their child, coded from a 5-min speech sample. Parental affective attitudes derive from previous experiences of parenting and child behavior, representations of the parent-child relationship and broader parental characteristics. Data were collected from mother-child dyads at ages 2 and 3 (N = 731; 49 % female) from a multi-ethnic and high-risk community sample. Multi-informant observations of parenting and questionnaire measures were used to test construct and discriminant validity. FAARS showed good internal consistency and high inter-rater agreement. Affective attitudes were related to mothers' perceptions of their daily hassles, their reports of conflict with their child, and observed measures of positive and harsh parenting. Negative affective attitudes uniquely predicted later child problem behavior, over and above maternal reports of and observed measures of parenting. Overall, results support the validity of FAARS coding in mothers of preschoolers, a previously untested group. FAARS is a novel measure, directly assessing maternal perceptions of the parent-child relationship, and indirectly providing an index of maternal affect, stress, and depressive symptoms. Its brevity and cost-effectiveness further enhance the potential use of the FAARS measure for clinical and research settings.
Journal of Abnormal Child Psychology 03/2012; 40(6):945-55. · 3.09 Impact Factor
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ABSTRACT: Research has established that AIDS-orphaned youth are at high risk of internalizing psychological distress. However, little is known about youth living with caregivers who are unwell with AIDS or youth simultaneously affected by AIDS-orphanhood and caregiver AIDS sickness.
1025 South African youth were interviewed in 2005 and followed up in 2009 (71% retention). Participants completed standardized measures of anxiety, depression, and posttraumatic stress. Comparison groups were youth who were AIDS-orphaned, other-orphaned, and nonorphaned, and those whose caregivers were sick with AIDS, sick with another disease, or healthy.
Longitudinal analyses showed that both AIDS-orphanhood and caregiver AIDS sickness predicted increased depression, anxiety, and posttraumatic stress symptoms over a 4-year period, independently of sociodemographic cofactors and of each other. Caregiver sickness or death by non-AIDS causes, and having a healthy or living caregiver, did not predict youth symptomatology. Youths simultaneously affected by caregiver AIDS sickness and AIDS-orphanhood showed cumulative negative effects.
Findings suggest that policy and interventions, currently focused on orphanhood, should include youth whose caregivers are unwell with AIDS.
Journal of Pediatric Psychology 02/2012; 37(8):857-67. · 2.91 Impact Factor
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ABSTRACT: The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD) in a large sample of South African youth.
The checklist was completed by 1025 (540 male; 485 female) South African youth (aged between 10 and 19 years). The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach's alpha and McDonald's omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD.
Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales) were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues' Dysphoria Model of PTSD symptoms) which provided a better fit to the observed data.
Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made.
PLoS ONE 01/2012; 7(10):e46905. · 4.09 Impact Factor
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ABSTRACT: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world.
A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children (M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M = 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression.
AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans.
Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children.
Journal of Child Psychology and Psychiatry 08/2011; 53(4):363-70. · 4.28 Impact Factor
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ABSTRACT: To examine whether bullying is a risk factor for psychological distress among children in poor, urban South Africa. To determine risk and protective factors for bullying victimization.
One thousand and fifty children were interviewed in deprived neighborhoods, including orphans, AIDS-affected children, streetchildren, and child-headed households. Using standardized scales, children reported on bullying victimization, psychological problems, and potential risk and protective factors at individual, peer, family, and community levels.
34% of children reported bullying victimization. Bullied children showed higher levels of anxiety, depression, suicidal ideation, and post-traumatic stress, as well as higher levels of clinical-level disorder. Risk factors for being bullied were being a victim of physical or sexual abuse or domestic violence at home, living in a high-violence community, and experiencing AIDS-related stigma (independent of sociodemographic cofactors and child psychological disorder). Protective factors were sibling support and support from friends, although findings suggest that friendship groups may also be sources of bullying for AIDS-affected children.
Bullying is an independent and important risk factor in child psychological distress in South Africa. Children victimized at home or in the community are more likely to be bullied, suggesting a cycle of violence.
Those working with children in Southern Africa should be alert to risk of bullying, especially among abused or AIDS-affected children. Interventions combating community violence and AIDS-related stigma may have additional positive impacts on bullying, and promotion of peer and sibling support may reduce bullying victimization among high-risk children.
Child abuse & neglect 09/2010; 34(10):793-803. · 2.34 Impact Factor
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ABSTRACT: We examined mediators and moderators of change in conduct problems, in a multiagency randomized trial of the Incredible Years parenting program. Preschoolers (n = 153) at risk for conduct problems were randomly assigned to intervention (n = 104) and wait-list (n = 49) groups. Boys and younger children, and those with more depressed mothers, tended to show greater improvement in conduct problems post-intervention. Other risk factors (i.e., teen or single parenthood, very low income, high initial levels of problem behavior) showed no predictive effects, implying intervention was at least as successful at helping the most disadvantaged families, compared to more advantaged. Mediator analyses found change in positive parenting skill predicted change in conduct problems.
Journal of Clinical Child & Adolescent Psychology 01/2010; 39(4):568-80. · 1.92 Impact Factor
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ABSTRACT: Studies show elevated levels of psychological distress among acquired immune deficiency syndrome (AIDS)-orphaned children. Caregiving factors are critical in child mental health, but little is known about their effects among AIDS-orphaned children. This study aimed to explore whether caregiving factors (e.g. caregiver illness, monitoring and abuse) mediated between orphanhood status and psycho-logical problems. A total of 1025 children and adolescents (aged 10–19 years), liv-ing in South African urban informal settlements, were interviewed using sociodemographic questionnaires and standardized psychological scales of depres-sion, anxiety, post-traumatic stress disorder, peer problems, delinquency and con-duct problems. AIDS-orphaned children (n = 425) were compared to control groups of other-orphans (n = 241) and non-orphans (n = 278). Results showed that child abuse, domestic violence, sibling dispersion and changes of caregiver were associated with psychological problems for all children, but did not mediate between orphanhood and psychological distress. AIDS-orphaned children reported more caregiver illness and excessive housework, and these two factors mediated the strong associations between psychological distress and AIDS-orphanhood. These findings suggest that interventions addressing caregiver ill-health and sup-porting young carers may have potential to ameliorate psychological distress among AIDS-orphaned children.
Vulnerable Children and Youth Studies 10/2009; 4(1):1-29.
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ABSTRACT: This study investigated moderators of change in an empirically supported family-centered intervention (the Family Check-Up) for problem behavior in early childhood. Participants were 731 2- to 3-year-olds (49% girls; 28% African American, 50% European American, 13% biracial) from low-income families and had been screened for risk of family stress and early-onset problem behavior. They were randomized to the Family Check-Up intervention or to a no-intervention control group. Latent growth models examined sociodemographic and parent psychological risk factors as potential moderators of change in problem behavior between ages 2, 3, and 4. Results revealed 2 moderators of intervention effectiveness. Caregivers with the lowest educational levels were more responsive to the family-centered intervention, and 2-parent families were more responsive to the intervention. Other risk factors showed no predictive effects. Overall, findings suggest that this brief family-centered intervention can be equally effective in reaching the most distressed and most disadvantaged families, compared to those who are more advantaged. However, results suggest that more attention may be needed to address the intervention needs of single parent families in reducing problem behavior in early childhood.
Journal of Consulting and Clinical Psychology 07/2009; 77(3):543-53. · 4.85 Impact Factor
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ABSTRACT: This study examined associations between AIDS-orphanhood status, poverty indicators, and psychological problems (depression, anxiety, post-traumatic stress, peer problems, delinquency, conduct problems) among children and adolescents in townships surrounding Cape Town, South Africa. One thousand and twenty-five children and adolescents completed standardized and culturally sensitive cross-sectional surveys. Children orphaned by AIDS had more psychological problems including depression, peer problems, post-traumatic stress, and conduct problems. Specific poverty indicators including food security, access to social welfare grants, employment in the household and access to school were associated with better psychological health. Poverty indicators mediated associations of AIDS-orphanhood with psychological problems. Food security showed the most consistent association with reduced psychological problems. Poverty alleviation measures have the potential to improve psychological health for AIDS-orphaned children in South African townships.
AIDS Care 06/2009; 21(6):732-41. · 1.60 Impact Factor
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ABSTRACT: In the current study, we examined latent growth in 731 young children's inhibitory control from ages 2 to 4, and whether demographic characteristics or parenting behaviors were related to initial levels and growth in inhibitory control. As part of an ongoing longitudinal evaluation of the Family Check-Up (FCU), children's inhibitory control was assessed yearly at ages 2, 3, and 4. Inhibitory control was initially low and increased linearly to age 4. High levels of harsh parenting and male gender were associated with low initial status in inhibitory control. High levels of supportive parenting were associated with faster growth. Extreme family poverty and African American ethnicity were also associated with slower growth. The results highlight parenting as a target for early interventions in contexts of high socioeconomic risk.
Review of Social Development 02/2009; 19(2):326-347. · 1.56 Impact Factor
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ABSTRACT: Maternal depression has been consistently linked to the development of child problem behavior, particularly in early childhood, but few studies have examined whether reductions in maternal depression serve as a mediator in relation to changes associated with a family-based intervention. The current study addressed this issue with a sample of 731 families receiving services from a national food supplement and nutrition program. Families with toddlers between ages 2 and 3 were screened and then randomized to a brief family intervention, the Family Check-Up, which included linked interventions that were tailored and adapted to the families needs. Follow-up intervention services were provided at age 3 and follow-up of child outcomes occurred at ages 3 and 4. Latent growth models revealed intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. The results are discussed with respect to targeting maternal depression in future intervention studies aimed at improving early child problem behavior.
Development and Psychopathology 02/2009; 21(2):417-39. · 4.40 Impact Factor
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ABSTRACT: The authors examined the longitudinal effects of the Family Check-Up (FCU) on parents' positive behavior support and children's school readiness competencies in early childhood. It was hypothesized that the FCU would promote language skills and inhibitory control in children at risk for behavior problems as an indirect outcome associated with targeted improvements in parents' positive behavior support. High-risk families in the Women, Infants, and Children Nutrition Program participated in a multisite preventive intervention study (N = 731) with 3 yearly assessments beginning at child age 2 years. Positive behavior support was measured using 4 indicators derived from at-home observations of parent-child interaction during semistructured tasks. Longitudinal structural equation models revealed that parents in families randomly assigned to the FCU showed improvements in positive behavior support from child age 2 to 3, which in turn promoted children's inhibitory control and language development from age 3 to 4, accounting for child gender, ethnicity, and parental education. Findings suggest that a brief, ecological preventive intervention supporting positive parenting practices can indirectly foster key facets of school readiness in children at risk.
Developmental Psychology 12/2008; 44(6):1737-52. · 3.21 Impact Factor
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ABSTRACT: This study examined relations among cumulative risk, nurturant and involved parenting, and behavior problems across early childhood.
Cumulative risk, parenting, and behavior problems were measured in a sample of low-income toddlers participating in a family-centered program to prevent conduct problems.
Path analysis was utilized to examine longitudinal relations among these constructs, with results supporting an indirect effect of cumulative risk on externalizing and internalizing problems through nurturant and involved parenting.
Results highlight the importance of cumulative risk during early childhood, and particularly the effect that the level of contextual risk can have on the parenting context during this developmental period.
Journal of Child Psychology and Psychiatry 08/2008; 49(11):1211-9. · 4.28 Impact Factor
