Article

Benefits of Child Behavior Interventions for Parent Well‐Being

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Objective To explore the direct and indirect associations among GenerationPMTO (i.e., the “Oregon model” of a parent management training program), child behavior problems, and parent outcomes. Background The behavioral parent training program GenerationPMTO is designed to improve child behavior outcomes. Although parent well‐being is not targeted, previous studies have found collateral benefits on parental well‐being for GenerationPMTO in preventive low‐risk samples and high‐risk samples. Method Bootstrapped structured equation models were used to analyze 2 randomized trials that evaluate parent well‐being (mental health, somatic health, and vitality) in 2 versions of GenerationPMTO: Brief Parent Training (BPT) for a preventive sample (N = 216) and GenerationPMTO, which was higher‐risk and a mix of a clinical and a preventive sample (N = 137). We examined direct and indirect effects of treatment condition for parent well‐being via change in children's behavior problems, change in parenting practices, and level of parenting self‐efficacy. Results Six months after treatment, results revealed positive effects on targeted child and parent outcomes in both samples, whereas only the BPT intervention had direct effects on parent well‐being. Conclusion Collateral benefits in the low‐risk BPT sample suggest that helping children and their families at earlier stages of negative development may increase the potential for immediate collateral benefits. Implications The results highlight the preventive potential of a brief behavioral parent training intervention based on the social interaction learning model.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... BPT focuses on instructing parents in more efficient techniques for managing behavior, with the goal of preventing improper conduct, encouraging positive social behavior, and fostering a good parent-child connection (Axelrod & Santagata, 2021). Studies have also demonstrated that BPT has beneficial impacts on the particular student it targets and also has direct implications on the well-being of parents, while also enhancing parentchild connections (Huang et al., 2009;Tømmerås et al., 2018). This intervention can be beneficial in addressing communication challenges experienced by families or schools with a child or student who has ADHD. ...
... These implementation sites developed and maintained infrastructures to provide optimal services for families within the model and to support and learn from each other. The GenerationPMTO program has been shown to be effective in randomized controlled studies in both Iceland and Norway (Amlund-Hagen et al., 2011;Ogden & Amlund-Hagen, 2008;Sigmarsd ottir et al., 2015;Tømmerås & Kjøbli, 2017;Tømmerås et al., 2018). ...
Article
Several European countries have offered refuge to families forced to flee their homes because of violence, war, and other disasters. Stressful factors associated with displacement and relocation place families at risk for disrupted effective child-rearing practices and associated growth in problems for parents and their children. The need to promote healthy adjustment and prevent and ameliorate problems for refugee families is vital. The present study describes SPARE (Strengthening Parenting Among Refugees in Europe), a trauma-informed adaptation of the evidence-based parenting program Generation Parent Management Training Oregon Model (GenerationPMTO). SPARE integrates core parenting components in GenerationPMTO with skills designed to address families’ trauma experiences. A collaborative team of GenerationPMTO experts in Iceland, Norway, Denmark, and the Netherlands have adapted this parent group intervention for Arabic-speaking (Middle Eastern) refugee families who have relocated in Europe. This report describes results from an acceptability and feasibility study based on the first two SPARE groups completed in Iceland and Norway. Overall, attendance was good, parents reported satisfaction with their experiences in the groups and said that the material addressed important family needs. Parents also indicated the need for more time to deepen their understanding, provide greater focus on age-specific needs, and in Norway in particular, more information about the child welfare system.
Article
Full-text available
GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges’ g from studies with pretest–posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies.
Article
The SARS CO-V-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.
Article
Full-text available
Three variants of a behavioral family intervention (BFI) program known as Triple P were compared using 305 preschoolers at high risk of developing conduct problems. Families were randomly assigned to enhanced BFI (EBFI), standard BFI (SBFI), self-directed BFI (SDBFI), or wait list (WL). At postintervention, the 2 practitioner-assisted conditions were associated with lower levels of parent-reported disruptive child behavior, lower levels of dysfunctional parenting, greater parental competence, and higher consumer satisfaction than the SDBFI and WL conditions. Overall, children in EBFI showed greater reliable improvement than children in SBFI, SDBFI, and WL. By 1-year follow-up, children in all 3 conditions achieved similar levels of clinically reliable change in observed disruptive behavior. However, the EBFI and SBFI conditions showed greater reliable improvement on parent-observed disruptive child behavior.
Article
Full-text available
Family resources have been associated with health care inequality in general and with social gradients in treatment outcomes for children with behavior problems. However, there is limited evidence concerning cumulative risk—the accumulation of social and economic disadvantages in a family—and whether cumulative risk moderates the outcomes of evidence-based parent training interventions. We used data from two randomized controlled trials evaluating high-intensity (n = 137) and low-intensity (n = 216) versions of Parent Management Training—Oregon (PMTO) with a 50:50 allocation between participants receiving PMTO interventions or regular care. A nine-item family cumulative risk index tapping socioeconomic resources and parental health was constructed to assess the family’s exposure to risk. Autoregressive structured equation models (SEM) were run to investigate whether cumulative risk moderated child behaviors at post-treatment and follow-up (6 months). Our results showed opposite social gradients for the treatment conditions: the children exposed to cumulative risk in a pooled sample of both PMTO groups displayed lower levels of behavior problems, whereas children with identical risk exposures who received regular care experienced more problems. Furthermore, our results indicated that the social gradients differed between PMTO interventions: children exposed to cumulative risk in the low-intensity (five sessions) Brief Parent Training fared equally well as their high-resource counterparts, whereas children exposed to cumulative risk in the high-intensity PMTO (12 sessions) experienced vastly better treatment effects. Providing evidence-based parent training seem to be an effective way to counteract health care inequality, and the more intensive PMTO treatment seemed to be a particularly effective way to help families with cumulative risk.
Article
Full-text available
There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically supported interventions in general and the core components of specific approaches in particular. The evidence base for behavioral parent training (BPT) and the standard of care for early-onset disruptive behavior disorders (oppositional defiant disorder and conduct disorder), which frequently co-occur with attention deficit hyperactivity disorder, are well established, yet an ahistorical, program-specific lens tells little regarding how leaders, University of Oregon Medical School, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; (Cunningham et al. in J Child Psychol Psychiatry 36:1141–1159, 1995; Cunningham et al. in COPE, the community parent education program: large group community-based workshops for parents of 3- to 18-year-olds, COPE Works, Hamilton, 2009), Defiant Children (DC; (Barkley in Defiant children: a clinician’s manual for assessment and parent training, Guilford Press, New York, 1987; Barkley in Defiant children: a clinician’s manual for assessment and parent training, Guilford Press, New York, 2013), Helping the Noncompliant Child (HNC; Forehand and McMahon in Helping the noncompliant child: a clinician’s guide to parent training, Guilford Press, New York, 1981; McMahon and Forehand in Helping the noncompliant child: family-based treatment for oppositional behavior, 2nd ed., Guilford Press, New York, 2003), Parent–child interaction therapy (PCIT; Eyberg and Robinson in J Clin Child Adolesc Psychol 11:130–137, 1982. doi:10.1080/15374418209533076; Eyberg in Child Fam Behav Ther 10:33–46, 1988; Eyberg and Funderburk in Parent–child interaction therapy protocol, PCIT International, Gainesville, 2011), and the Incredible Years (IY; (Webster-Stratton in Behav Ther 12:634–642, 1981. doi:10.1016/S0005-7894(81)80135-9; Webster-Stratton in J Pediatr Psychol 7:279–294, 1982. doi:10.1093/jpepsy/7.3.279; Webster-Stratton in The incredible years: parents and children series. Leader’s guide: preschool version of BASIC (ages 3–6 years, The Incredible Years, Seattle, 2008). Our goal is not to provide an exhaustive review of the evidence base for the Hanf-Model programs, rather our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed.
Article
Full-text available
. Despite the wide use of the Eyberg Child Behavior Inventory (ECBI), its construct validity is still an issue of debate. Whereas previous studies primarily have relied on confirmatory factor analyses (CFAs), the present study aimed to evaluate the Norwegian 22-item version of the ECBI intensity scale using exploratory structural equation modeling (ESEM), which offers more flexibility compared to traditional CFA. The study used data from three samples of parents with children with emerging or existing problem behaviors. Results showed that the ESEM model showed good fit and identified the three factors Oppositional defiant behavior, Conduct problem behavior, and Inattentive behavior. In addition, the ESEM approach revealed several small and significant (λ ≤ .21) cross-loadings. The results illustrated the strengths of ESEM over CFA and suggest that ESEM provide a useful statistical framework to evaluate the structure of ECBI items.
Article
Full-text available
This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children’s adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training-Oregon Model), and family attenuation and dissolution (Treatment Foster Care-Oregon Model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements.
Article
Full-text available
Previous research has suggested that the use of item parcels in structural equation modeling can lead to biased structural coefficient estimates and low power to detect model misspecification. The present article describes the population performance of items, parcels, and scales under a range of model misspecifications, examining structural path coefficient accuracy, power, and population fit indices. Results revealed that, under measurement model misspecification, any parceling scheme typically results in more accurate structural parameters, but less power to detect the misspecification. When the structural model is misspecified, parcels do not affect parameter accuracy, but they do substantially elevate power to detect the misspecification. Under particular, known measurement model misspecifications, a parceling scheme can be chosen to produce the most accurate estimates. The root mean square error of approximation and the standardized root mean square residual are more sensitive to measurement model misspecification in parceled models than the likelihood ratio test statistic. (PsycINFO Database Record
Article
Full-text available
This randomized intervention trial examined the effects of yearly Family Check-Ups (FCUs) and tailored parent management training on parent report of problem behavior from age 2 to 5 years and teacher report of oppositional behavior at age 7.5. A multiethnic risk sample of 731 families in 3 distinct geographical settings who were receiving assistance from the Women, Infants, and Children Nutritional Supplement (WIC) program were randomly assigned to a yearly FCU. Intention to treat (ITT) analyses were used to examine overall intervention effects, and complier average causal effect (CACE) modeling was used to examine the effects of annual intervention engagement in the FCU on parent reports of child problem behavior from age 2 to 5 and teacher reports of problem behavior at age 7.5. ITT intervention effects were found regarding parent report at ages 2 to 5 and teacher report at age 7.5, indicating less growth in problem behavior for children in the intervention group than for those in the control group. CACE modeling of intervention engagement revealed that the effect sizes on parent- and teacher-reported problem behavior increased as a function of the number of yearly FCUs caregivers participated in. Findings suggest that embedding yearly FCU services within the context of social, health, and educational services in early childhood can potentially prevent early-onset trajectories of antisocial behavior. The increases in effect size with successive FCU engagement underscores the importance of a motivational approach to parenting support among high-risk families.
Article
Full-text available
This article analyzes the use of single-item indicators in marketing research and their utilization in structural equation modeling. The study provides a literature review regarding the debate of the use of single-item measures in social sciences research and methodologically in structural equation modeling. The analysis of recent studies that use single-item indicators from top marketing journals provides information regarding the types of constructs fit for single-item measurement and their use in SEM. The article presents clarifications to the debate regarding the use of single-item indicators in marketing research, gives examples of types of constructs measurable through single-item indicators and provides recommendations that add knowledge to the empirical analysis and methodology domains of marketing research. structural equation modeling, SEM, single-item indicators, marketing research
Article
Full-text available
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).
Article
Full-text available
Objective: Group-based Parent Management Training, the Oregon model (PMTO, 12 sessions) was delivered by the regular staff of municipal child and family services. PMTO is based on social interaction learning theory and promotes positive parenting skills in parents of children with conduct problems. This study examined the effectiveness of the group-based training intervention in real world settings both immediately following and six months after termination of the intervention. Methods: One hundred thirty-seven children (3-12 years) and their parents participated in this study. The families were randomly assigned to group-based training or a comparison group. Data were collected from parents and teachers. Results: The caregiver assessments of parenting practices and child conduct problems and caregiver and teacher reported social competence revealed immediate and significant intervention effects. Short- and long-term beneficial effects were reported from parents, although no follow-up effects were evident on teacher reports. Conclusions: These effectiveness findings and the potential for increasing the number of families served to support the further dissemination and implementation of group-based parent training.
Article
Full-text available
A developmental cascade model linking competence and symptoms was tested in a study of a normative, urban school sample of 205 children (initially 8 to 12 years old). Internalizing and externalizing symptoms and academic competence were assessed by multiple methods at the study outset and after 7, 10, and 20 years. A series of nested cascade models was tested through structural equation modeling. The final model indicated 2 hypothesized cascade effects: Externalizing problems evident in childhood appeared to undermine academic competence by adolescence, which subsequently showed a negative effect on internalizing problems in young adulthood. A significant exploratory effect was consistent with internalizing symptoms containing or lowering the net risk for externalizing problems under some conditions. These 3 cascade effects did not differ by gender and were not attributable to effects of IQ, parenting quality, or socioeconomic differences. Implications are discussed for developmental models of cascades, progressions, and preventive interventions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
In the present report, the authors contend that many of the effects of contextual variables on the development of antisocial behavior in childhood and adolescence are mediated through family and peer process variables. The implication is that much of the effect of context on antisocial behavior will be through contextual associations with social interactions among family members or with exposure to, and interactions within, the deviant peer group. In the studies described in the first section of this chapter, the authors emphasize that the family and peer processes, which are proximal to childhood and adolescent onset of antisocial behavior, are embedded in a larger matrix of distal contextual variables. The studies presented in the second half of the chapter provide prospective evidence that the cycle continues into the next generation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Brief Parent Training (BPT) is a short-term intervention (3-5 sessions) delivered by regular staff in municipal child and family services. BPT is based on social interaction learning theory and Parent Management Training, the Oregon model (PMTO) and promotes parenting skills in families with children who either are at an early stage of problem behavior development or have developed conduct problems. This study examined the effectiveness of BPT compared to regular services in primary care settings at post assessment. Participants were 216 children (3-12 years) and their parents who were randomly assigned to BPT or the comparison group. Data were collected from parents and teachers. Significant intervention effects emerged for caregiver assessments of parenting practices, child conduct problems, and social competence. The results suggested that BPT had beneficial effects for families, although the generalization of the effects to school was limited.
Article
Full-text available
We examine the controversial practice of using parcels of items as manifest variables in structural equation modeling (SEM) procedures. After detailing arguments pro and con, we conclude that the unconsidered use of parcels is never warranted, while, at the same time, the considered use of parcels cannot be dismissed out of hand. In large part, the decision to parcel or not depends on one's philosophical stance regard- ing scientific inquiry (e.g., empiricist vs. pragmatist) and the substantive goal of a study (e.g., to understand the structure of a set of items or to examine the nature of a set of constructs). Prior to creating parcels, however, we recommend strongly that in- vestigators acquire a thorough understanding of the nature and dimensionality of the items to be parceled. With this knowledge in hand, various techniques for creating parcels can be utilized to minimize potential pitfalls and to optimize the measure- ment structure of constructs in SEM procedures. A number of parceling techniques are described, noting their strengths and weaknesses.
Article
Full-text available
Maternal depression is one of the most well-documented risk factors for child and adolescent depression, but little work has focused on how to reduce this risk. Although a few interventions have been developed and tested, implementing targeted prevention efforts with depressed mothers and their children is not common practice. The increased risk of depression for children of depressed mothers is so clear, however, professionals can no longer "sit on the sidelines" without initiating specific prevention efforts with this population. To do so requires a paradigm shift-moving from a focus on individual treatment to a prevention approach that engages the entire family as the unit of care. The purpose of this paper is to draw on existing literature to highlight potential "pathways to prevention" for children of depressed mothers. Recommendations for initiating these pathways based on family lifecycle stage, point of contact, and service setting are presented and discussed.
Article
Full-text available
Article
Full-text available
Four different sources for cascade effects were examined using 9-year process and outcome data from a randomized controlled trial of a preventive intervention using the Parent Management Training-Oregon Model (PMTO™). The social interaction learning model of child antisocial behavior serves as one basis for predicting change. A second source addresses the issue of comorbid relationships among clinical diagnoses. The third source, collateral changes, describes events in which changes in one family member correlate with changes in another. The fourth component is based on the long-term effects of reducing coercion and increasing positive interpersonal processes within the family. New findings from the 9-year follow-up show that mothers experienced benefits as measured by standard of living (i.e., income, occupation, education, and financial stress) and frequency of police arrests. It is assumed that PMTO reduces the level of coercion, which sets the stage for a massive increase in positive social interaction. In effect, PMTO alters the family environment and thereby opens doors to healthy new social environments.
Article
Full-text available
Effects of intervention with the Oregon model of Parent Management Training (PMTO) on marital relationship processes and marital satisfaction in recently married biological mother and stepfather couples were examined. Sixty-seven of the 110 participating families were randomly assigned to PMTO, and 43 families to a non-intervention condition. Intervention had reliable positive indirect effects on marital relationship processes 24 months after baseline which in turn were associated with higher marital satisfaction. These indirect effects were mediated by the impact of PMTO on parenting practices 6 months after baseline. Enhanced parenting practices resulting from PMTO prevented escalation of subsequent child behavior problems at school. Consistent with a family systems perspective and research on challenges to marital quality in stepfamilies, improved co-parenting practices were associated with enhanced marital relationship skills and marital satisfaction as well as with prevention of child behavior problems.
Article
Full-text available
Most research on the dose-effect model of change has combined data across patients who vary in their total dose of treatment and has implicitly assumed that the rate of change during therapy is constant across doses. In contrast, the good-enough level model predicts that rate of change will be related to total dose of therapy. In this study, the authors evaluated these competing predictions by examining the relationship between rate of change and total dose in 4,676 psychotherapy patients who received individual psychotherapy. Patients attended 6.46 sessions on average (SD = 4.14, range = 3-29, Mdn = 5). The results indicated that although patients improved during treatment, patients' rate of change varied as a function of total dose of treatment. Small doses of treatment were related to relatively fast rates of change, whereas large doses of treatment were related to slower rates of change. Total dose had a nonlinear relationship with the likelihood of clinically significant change. Given the variability in rates of change, it appears that time limits for treatment uniform to all patients would not adequately serve patients' needs.
Article
Full-text available
This meta-analysis involved 92 studies that compared children living in divorced single-parent families with children living in continuously intact families on measures of well-being. Children of divorce scored lower than children in intact families across a variety of outcomes, with the median effect size being .14 of a standard deviation. For some outcomes, methodologically sophisticated studies yielded weaker effect sizes than did other studies. In addition, for some outcomes, more recent studies yielded weaker effect sizes than did studies carried out during earlier decades. Some support was found for theoretical perspectives emphasizing parental absence and economic disadvantage, but the most consistent support was found for a family conflict perspective.
Book
Socioeconomic Status, Parenting, and Child Development presents cutting-edge thinking and research on linkages among socioeconomic status, parenting, and child development. The contributors represent an array of different disciplines, and approach the issues from a variety of perspectives. Accordingly, their “take�? on how SES matters in the lives of children varies. This volume is divided into two parts. Part I concerns the constructs and measurement of SES and Part II discusses the functions and effects of SES. Each part presents four substantive chapters on the topic followed by an interpretive and constructively critical commentary. The chapters--considered as a whole--attest to the value of systematically examining the components of SES and how each flows through an array of specific parenting practices and resources both within and outside the home environment to help shape the course of child development. The result is a more fully delineated picture of how SES impacts the lives of children in the 21st century--a picture that contains a road map for the next generation of studies of SES and its role in the rapidly evolving ecology of family life. © 2003 by Lawrence Erlbaum Associates, Inc. All rights reserved.
Book
This handbook describes the ways in which society shapes the mental health of its members and further shapes the lives of those who have been identified as mentally ill. With regards to the social origins of mental health, this handbook covers both the social conditions that lead to the behavior defined as mental illness and the way in which the concept of mental illness is socially constructed around those behaviors. This handbook also covers a third body of work that examines socially conditioned responses to mental illness on the part of individuals and institutions along with the ways in which these responses affect the lives of persons with mental illness. Sections include: I: Introduction: Alternative Understandings of Mental Health. II: Observing Mental Health in the Community. III: The Social Distribution of Mental Illness. IV: Social Antecedents of Mental Illness. V: Social Consequences of Mental Illness. V I: Institutional Contexts of Mental Illness. VII: Social Continuities. Each of these viewpoints survey the field in a critical manner, evaluating theoretical models in light of the best available empirical evidence. Distinctively sociological approaches are highlighted by means of explicit comparison to perspectives characterizing related disciplines such as psychology, psychiatry, and anthropology. This volume seeks to record where the field has been, to identify its current location and to plot its course for the future.
Book
This second edition of the Handbook of the Sociology of Mental Health features theory-driven reviews of recent research with a comprehensive approach to the investigation of the ways in which society shapes the mental health of its members and the lives of those who have been diagnosed as having a mental illness The award-winning Handbook is distinctive in its focus on how the organization and functioning of society influences the occurrence of mental disorder and its consequences. A core issue that runs throughout the text concerns the differential distribution of mental illness across various social strata, defined by status characteristics such as gender, race/ethnicity, socioeconomic status, and age. The contributions to this volume shed light on the social, cultural, and economic factors that explain why some social groups have an elevated risk of disorder. They also address the social repercussions of mental disorder for individuals, including stigmatization within the larger society, and for their families and social networks. The second edition of this seminal volume includes substantial updates to previous chapters, as well as seven new chapters on: -The Individual’s Experience of Mental Illness.--The Medicalization of Mental Illness.---Age, Aging, and Mental Health.- -Religion and Mental Health.- -Neighborhoods and Mental Health.- -Mental Health and the Law—and Public Beliefs about Mental Illness.
Article
The social sciences offer a variety of theories on how children develop, and various theories and disciplines apply their own vocabularies and conceptualise different aspects of the processes of socialization. This book looks at the theorizing of socialization in sociology, anthropology, psychology, in the life course approach, and as the interplay of genetics and environmental factors. It analyses the dominant perspectives and viewpoints within each discipline and field, and shows how the various theories and disciplines apply their own vocabularies and conceptualise different aspects of the processes of socialization. It argues that socialization does not represent a fixed trajectory into a static social order, and that different disciplines meet the challenges of complex developmental processes and changing environments in different ways. Socialization is a fundamental concept in sociology, but sociology has only to a limited degree sought to produce a coherent understanding of the processes of socialization, which has to encompass the interplay of societal, psychological and genetic factors. This book draws the threads together and, by doing so, offers a general framework for our understanding of the socialization process. At the centre of this process is the child as a subject, in an interplay with the patterns and significant others of the micro environment as well as with the macro-conditions of the modern knowledge based economies.
Article
Policymakers are interested in early-years interventions to ameliorate childhood risks. They hope for improved adult outcomes in the long run that bring a return on investment. The size of the return that can be expected partly depends on how strongly childhood risks forecast adult outcomes, but there is disagreement about whether childhood determines adulthood. We integrated multiple nationwide administrative databases and electronic medical records with the four-decade-long Dunedin birth cohort study to test child-to-adult prediction in a different way, using a population-segmentation approach. A segment comprising 22% of the cohort accounted for 36% of the cohort’s injury insurance claims; 40% of excess obese kilograms; 54% of cigarettes smoked; 57% of hospital nights; 66% of welfare benefits; 77% of fatherless child-rearing; 78% of prescription fills; and 81% of criminal convictions. Childhood risks, including poor brain health at three years of age, predicted this segment with large effect sizes. Early-years interventions that are effective for this population segment could yield very large returns on investment.
Article
Parent Management Training-Oregon Model (PMTO(®) ) is a set of theory-based parenting programs with status as evidence-based treatments. PMTO has been rigorously tested in efficacy and effectiveness trials in different contexts, cultures, and formats. Parents, the presumed agents of change, learn core parenting practices, specifically skill encouragement, limit setting, monitoring/supervision, interpersonal problem solving, and positive involvement. The intervention effectively prevents and ameliorates children's behavior problems by replacing coercive interactions with positive parenting practices. Delivery format includes sessions with individual families in agencies or families' homes, parent groups, and web-based and telehealth communication. Mediational models have tested parenting practices as mechanisms of change for children's behavior and found support for the theory underlying PMTO programs. Moderating effects include children's age, maternal depression, and social disadvantage. The Norwegian PMTO implementation is presented as an example of how PMTO has been tailored to reach diverse populations as delivered by multiple systems of care throughout the nation. An implementation and research center in Oslo provides infrastructure and promotes collaboration between practitioners and researchers to conduct rigorous intervention research. Although evidence-based and tested within a wide array of contexts and populations, PMTO must continue to adapt to an ever-changing world.
Chapter
This chapter introduces the major themes of this handbook. These themes address how society shapes the thoughts, feelings, and actions of its members in ways that are considered to be mental illness, and the consequences of having, or being thought to have, a mental illness. This subject matter encompasses the medical model and alternative perspectives, including the social construction of mental illness, the medicalization of deviant states and behaviors, and the experiences and understandings of persons with mental illnesses. The sociological search for the causes of mental illness frequently examines how social inequality leads to disproportionate exposure to social stress, as well as limits the resources that might otherwise ameliorate the adverse effects of stress exposure. This etiological perspective also addresses how major social institutions, such as family, work, and religion, shape the likelihood of developing a disorder. An additional emphasis concerns the social consequences of disorder, such as, stigma, encounters with the legal system, and effects on the family. Finally, the handbook considers how mental health problems are arrayed over time in trajectories that have cumulative consequences for people’s lives.
Article
The present study examined associations between the quality of teacher-child relationships and behavior problems among elementary school students using data from the NICHD Study of Early Child Care and Youth Development, a study of 1,364 children from birth through adolescence. There were two main findings. First, high-quality teacher-child relationships predicted low levels of externalizing behaviors. Second, high-quality relationships acted as protective factors, helping to prevent children with high levels of internalizing behaviors in early childhood from developing trajectories of long-term internalizing behavior problems. Teacher-child relationships may be proximal phenomena that can be targeted in interventions to help prevent behavior problems in middle childhood.
Article
Parents’ health and children’s health are closely intertwined—healthier parents have healthier children, and vice versa. Genetics accounts for some of this relationship, but much of it can be traced to environment and behavior, and the environmental and behavioral risk factors for poor health disproportionately affect families living in poverty. Unhealthy children are likely to become unhealthy adults, and poor health drags down both their educational attainment and their income. Because of the close connection between parents’ and children’s health, write Sherry Glied and Don Oellerich, we have every reason to believe that programs to improve parents’ health will improve their children’s health as well. Yet few programs aim to work this way, except for a narrow category of programs that target pregnant women, newborns, and very young children. Glied and Oellerich assess these programs, discuss why there are so few of them, and suggest ways to expand them. Their chief conclusion is that structural barriers in the U.S. health-care system stand in the way of such programs. Some of these barriers have to do with health insurance, access to care, and benefits, but the biggest one is the fact that physicians typically specialize in treating either children or adults, rather than families as a whole. The Affordable Care Act has begun to break down some of these barriers, the authors write, but much remains to be done.
Article
Programs that aim to improve the lives of children from disadvantaged backgrounds are facing a challenge. On the one hand, scholars and policy makers agree that we must invest in children to secure our country’s future and to promote educational and economic opportunity, suggesting that we should expand programs for children, especially during early childhood. On the other hand, there is a growing sense in some quarters that existing programs for children are not working as well as they could. A few widely cited models, such as Perry Preschool and the Abecedarian Project, have demonstrated that high-quality programs can make a big difference in children’s lives. The children who participated in these programs have shown long-term gains in educational attainment, employment, and earnings relative to their peers, and those who participated in Perry Preschool had lower rates of arrest. The evidence from larger-scale efforts, such as Head Start and some state prekindergarten programs, is less clear-cut. On the one hand, numerous assessments of Head Start, the nation’s largest preschool program, which enrolls about 900,000 mostly disadvantaged children, have found improvements in children’s test scores, as well as their rates of high school graduation, college attendance, and delinquency, especially among children from disadvantaged backgrounds. Similarly, assessments of state prekindergarten programs, which have a much shorter history than Head Start, have found that in elementary school, the participants—especially those from disadvantaged backgrounds—had better language skills and were less likely to repeat a grade or be suspended. On the other hand, a recent randomized trial of Head Start found that the test score gains children experienced at the end of the program typically faded by the end of kindergarten. And a well-executed evaluation of a preschool intervention in Tennessee found a similar fade-out by the end of first grade. It’s not unusual for gains in cognitive test scores to fade—the same phenomenon occurred in the Perry Preschool and Abecedarian projects. Still, the recent Head Start and Tennessee evaluations have caused some people to doubt the efficacy of early childhood education and of universal prekindergarten more broadly. Although it’s too early to assess the long-term benefits of the new prekindergarten programs, it’s hard to be optimistic that current programs can boost poor children’s development enough to overcome the huge divide in educational achievement and economic opportunity between children from poor families and children from economically secure families. The United States has experienced a dramatic increase in income inequality over the past four decades, which, not surprisingly, has been accompanied by a growing income gap in children’s test scores. So even if the 30billionorsothatthefederalandstategovernmentsspendonpreschoolprogramsandthe30 billion or so that the federal and state governments spend on preschool programs and the 640 billion the nation spends on public education are having large effects, they are not large enough to compensate for the growing gap in achievement between children from high- and low-income families. The school problems of poor children stem in large part from the home environment. Numerous studies show that parents and the home environment they provide exert a continuing influence on children as they grow up. Betty Hart and Todd Risley, in their well-known study from nearly two decades ago, found major differences in the home language environments provided by poor and more affluent parents. They estimate that the average child on welfare is exposed to 62,000 words per week at home, compared with 125,000 words per week for more privileged children. Similarly, based on the large sample of the Panel Study of Income Dynamics, Meredith Phillips shows very large differences, all of them favoring children from more affluent families, in time spent in conversation with adults, in primary caregivers’ verbal responsiveness, and in time spent in literary activities. The upshot is that children from poor families show up for kindergarten already far behind in school readiness, and they fall further behind during the school years. These important differences in poor children’s home environments, the parenting they receive, and the effectiveness of public schools in helping them overcome their disadvantages are certain to affect their economic opportunities as adults. Intergenerational...
Article
Most of the authors in this issue of Future of Children focus on a single strategy for helping both adults and children that could become a component of two-generation programs. Lindsay Chase-Lansdale and Jeanne Brooks-Gunn, on the other hand, look at actual programs with an explicit two-generation focus that have been tried in the past or are currently under way. These explicitly two-generation programs have sought to build human capital across generations by combining education or job training for adults with early childhood education for their children. Chase-Lansdale and Brooks-Gunn explain the theories behind these programs and review the evidence for their efficacy. A first wave of such programs in the 1980s and 1990s produced mostly disappointing results, but the evaluations they left behind pointed to promising new directions. More recently, a second wave of two-generation programs—the authors dub them “Two-Generation 2.0”—has sought to rectify the flaws of earlier efforts, largely by building strong connections between components for children and adults, by ensuring that children and adults receive services of equal duration and intensity, and by incorporating advances in both education and workforce development. These Two-Generation 2.0 programs are still in their infancy, and we have yet to see clear evidence that they can achieve their goals or be implemented cost-effectively at scale. Nonetheless, Chase-Lansdale and Brooks-Gunn write, the theoretical justification for these programs is strong, their early results are promising, and the time is ripe for innovation, experimentation, and further study.
Article
During the past decade, Norwegian authorities have initiated and funded a project to scale up the use of evidence-based programs for the prevention and treatment of conduct problems in children. The first step in this process was to increase treatment competence by implementing the Parent Management Training-Oregon Model (PMTO) in specialist services for children. The second step was to develop the program Early Initiatives for Children at Risk (Norwegian acronym, TIBIR), designed to identify children with possible conduct problems as early as possible and to offer tailored interventions as part of the ordinary primary services for children in individual municipalities. The theoretical rationale and practical considerations leading to the design of TIBIR are presented, together with the program modules and current research activities. Some of the challenges concerning the program's ability to reach various risk groups are discussed, as are the challenges encountered regarding quality assurance and fidelity maintenance. Finally, some future research questions are presented and discussed.
Article
Part V of the Monograph Best practices in quantitative methods for developmentalists (see records 2006-23007-001; 2006-23007-002; 2006-23007-003; 2006-23007-004; 2006-23007-005; 2006-23007-006; 2006-23007-008 and 2006-23007-009). Analysis of mediating and moderating variables is often fundamental to the study of human development. Few developmental researchers, however, take advantage of contemporary advances for the analysis of mediating variables and classic advice for the analysis of moderating variables, both of which have lately become more user-friendly--for example, through web-based tools. In this chapter, we review statistical techniques for the study of mediating and moderating variables with three goals in mind: (1) communicating the current consensus on best statistical practices, (2) providing a primer for those unfamiliar with these practices, and (3) directing readers toward resources that simplify their application. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A theory that purports to explain children's aggressive behavior must begin with an explanation of how it begins. It must also address both the stability in expression of aggression while also explaining the developmental changes in the forms taken by aggression. This chapter focuses on both issues. The general strategy is to think of infant and caregiver exchanges as reflecting complex contributions from the contextual matrix in which these interactions are embedded. Some processes may partially reflect long-standing biological processes (e.g., birth complications, genes), and others represent contextual intrusions, such as divorce, depression, and maternal stress. The key idea is that the impact of these contextual variables on child outcomes is mediated by the nature of the infant and caregiver exchanges. Finally, the antisocial individual carries the dual burden of recognizable deviancy plus obvious social incompetence. Understanding how coercion begins requires that we also study the beginning of social incompetence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
It was hypothesized that the effects of the contextual variables Socioeconomic Disadvantage (SED) and Maternal Antisocial Qualities (MAQ) on Antisocial Behavior Problems (ABP) in boys would be mediated through their disrupting effect on parenting practices. Socioeconomically disadvantaged motehrs had less effective discipline, and their sons were at greater risk for antisocial behavior problems. With older boys, mothers with antisocial qualities placed their sons at risk for antisocial behavior problems because of disrupted parenting practices. Socioeconomic disadvantage had no impact on parenting or antisocial behavior problem constructs.
Article
We propose a model of family conflict and coercion that links economic stress in family life to adolescent symptoms of internalizing and externalizing emotions and behaviors. The 180 boys and 198 girls in the study were living in intact families in the rural Midwest, an area characterized by economic decline and uncertainty. Theoretical constructs in the model were measured using both trained observer and family member reports. These adolescents and their parents were interviewed each year for 3 years during the seventh, eighth, and ninth grades. Our theoretical model proposes that economic pressure experienced by parents increases parental dysphoria and marital conflict as well as conflicts between parents and children over money. High levels of spousal irritability, coupled with coercive exchanges over money matters, were expected to be associated with greater hostility in general by parents toward their children. These hostile/coercive exchanges were expected to increase the likelihood of adolescent emotional and behavioral problems. Overall, results were consistent with the proposed model. Moreover, the hypothesized processes applied equally well to the behavior of mothers and fathers, as well as sons and daughters.
Article
Drs Alan Kazdin of the Yale Child Study Center, New Haven, Conn, and John Weisz of the University of California at Los Angeles have compiled a practical resource outlining evidence-based treatments for childhood disorders. Chapters written by expert psychotherapy researchers on a wide range of clinical problems, including anxiety disorders, depression, attention-deficit/hyperactivity disorder, oppositional and antisocial behaviors, eating disorders, and enuresis, detail the theoretical background underlying each intervention, the empirical evidence, and the specifics of treatment delivery. This book serves as an excellent resource for clinicians looking to bolster their clinical practice using empirically based techniques, as well as clinical researchers seeking an overview of issues involved in treatment-outcome research.
Article
This Technical Report was retired November 2021 Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.
Article
Research during the past decade shows that social class or socioeconomic status (SES) is related to satisfaction and stability in romantic unions, the quality of parent-child relationships, and a range of developmental outcomes for adults and children. This review focuses on evidence regarding potential mechanisms proposed to account for these associations. Research findings reported during the past decade demonstrate support for an interactionist model of the relationship between SES and family life, which incorporates assumptions from both the social causation and social selection perspectives. The review concludes with recommendations for future research on SES, family processes and individual development in terms of important theoretical and methodological issues yet to be addressed.
Article
A dynamic cascade model of development of serious adolescent violence was proposed and tested through prospective inquiry with 754 children (50% male; 43% African American) from 27 schools at 4 geographic sites followed annually from kindergarten through Grade 11 (ages 5-18). Self, parent, teacher, peer, observer, and administrative reports provided data. Partial least squares analyses revealed a cascade of prediction and mediation: An early social context of disadvantage predicts harsh-inconsistent parenting, which predicts social and cognitive deficits, which predicts conduct problem behavior, which predicts elementary school social and academic failure, which predicts parental withdrawal from supervision and monitoring, which predicts deviant peer associations, which ultimately predicts adolescent violence. Findings suggest targets for in-depth inquiry and preventive intervention.
Article
We propose a model of family conflict and coercion that links economic stress in family life to adolescent symptoms of internalizing and externalizing emotions and behaviors. The 180 boys and 198 girls in the study were living in intact families in the rural Midwest, an area characterized by economic decline and uncertainty. Theoretical constructs in the model were measured using both trained observer and family member reports. These adolescents and their parents were interviewed each year for 3 years during the seventh, eighth, and ninth grades. Our theoretical model proposes that economic pressure experienced by parents increases parental dysphoria and marital conflict as well as conflicts between parents and children over money. High levels of spousal irritability, coupled with coercive exchanges over money matters, were expected to be associated with greater hostility in general by parents toward their children. These hostile/coercive exchanges were expected to increase the likelihood of adolescent emotional and behavioral problems. Overall, results were consistent with the proposed model. Moreover, the hypothesized processes applied equally well to the behavior of mothers and fathers, as well as sons and daughters.