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Early risk indicators of internalizing problems in late childhood: A 9-year longitudinal study
Journal of Child Psychology and Psychiatry
Abstract
Longitudinal studies on risk indicators of internalizing problems in childhood are in short supply, but could be valuable to identify target groups for prevention.
Standardized assessments of 294 children's internalizing problems at the age of 2-3 years (parent report), 4-5 years (parent and teacher report) and 11 years (parent and teacher) were available in addition to risk indicators from the child, family and contextual domain.
Low socioeconomic status, family psychopathology at child age 2-3, parenting stress at child age 4-5 years, and parents' reports of child internalizing problems at age 4-5 years were the strongest predictors of internalizing problems at the age of 11. If these early risk factors were effectively ameliorated through preventive interventions, up to 57% of internalizing cases at age 11 years could be avoided.
Predictors from as early as 2-5 years of age are relevant for identifying children at risk of internalizing problems in late childhood. The methodological approach used in this study can help to identify children who are most in need of preventive interventions and help to assess the potential health gain and efficiency of such interventions.
... Zudem gibt es konsistente theoretische Überlegungen und empirische Belege dafür, dass ein Erziehungsverhalten geprägt durch Wärme positiv mit der Lebenszufriedenheit von Kindern und Jugendlichen zusammenhängt (Gherasim et al., 2017;Holte et al., 2014;Moran et al., 2018;Newland, 2015 (Edossa et al., 2017;Kopp, 1982, McClelland et al., 2010, Trommsdorff, 2009 (Duckworth & Seligman, 2005;Moffitt et al., 2011;Moffitt et al., 2013;Teixeira et al., 2015). Dagegen wurden eingeschränkte Selbstregulationskompetenzen mit der Entwicklung von psychopathologischen Symptomen, wie internalisierenden Problemen, Angstsymptomen und Depressionen in Verbindung gebracht (Ashford et al., 2008). ...
... Regulation skills develop and improve considerably from infancy to school age, but individual differences are moderately stable over time (Eisenberg et al., 2010). Limited regulation skills or maladaptive methods of regulating emotions have found to be associated with the development of psychopathology, such as internalizing problems, symptoms of anxiety, and depression (Ashford et al., 2008). In contrast, optimal emotion regulation was linked to characteristics of healthy functioning, such as selfesteem and life satisfaction (Teixeira et al., 2015). ...
... These findings reinforce the importance of empirically validated early intervention programs. Without intervention, difficulties in emotion regulation tend to remain stable over time and might be associated with psychopathological symptoms (Ashford et al., 2008). ...
... Detailed descriptions of the included studies are available in additional file 8. Of the 34 studies, 14 were set in the United States [35,36,39,43,45,47,[49][50][51][56][57][58][59]64], seven in Canada [38,46,[52][53][54][55]63], five in Australia [34,41,44,48,62], three in the UK [40,42,61], three in The Netherlands [33,37,65], one in Denmark [60] and one in which the countries included in the analysis were not explicitly stated [66]. ...
... Table 3 provides a summary of the main study characteristics and describes the exposures by domain of child development, outcomes and how they were measured. The main domain of child development studied in included papers was socio-emotional development with 24 studies [33][34][35][37][38][39]42,[44][45][46][47][48]50,53,54,[56][57][58][59][60]62,[64][65][66]. Exposures included behaviours such as internalizing and externalizing behaviours, social competence, emotion knowledge, emotional wellbeing, emotional reactivity and peer relations. ...
... Eighteen studies analysed associations between a socio-emotional exposure of child development and later mental health [33,35,38,39,42,[44][45][46][47]50,53,56,57,59,60,[64][65][66]. All associations highlighted that positive socio-emotional development is good for subsequent mental health, apart from five studies where no associations were found for some exposures and outcomes studied [39,42,50,60,65]. ...
The relationship between child development and adolescent health, and how this may be modified by socio-economic conditions, is poorly understood. This limits cross-sector interventions to address adolescent health inequality. This review summarises evidence on the associations between child development at school starting age and subsequent health in adolescence and identifies factors affecting associations. We undertook a participatory systematic review, searching electronic databases (MEDLINE, PsycINFO, ASSIA and ERIC) for articles published between November 1990 and November 2020. Observational, intervention and review studies reporting a measure of child development and subsequent health outcomes, specifically weight and mental health, were included. Studies were individually and collectively assessed for quality using a comparative rating system of stronger, weaker, inconsistent or limited evidence. Associations between child development and adolescent health outcomes were assessed and reported by four domains of child development (socio-emotional, cognitive, language and communication, and physical development). A conceptual diagram, produced with stakeholders at the outset of the study, acted as a framework for narrative synthesis of factors that modify or mediate associations. Thirty-four studies were included. Analysis indicated stronger evidence of associations between measures of socio-emotional development and subsequent mental health and weight outcomes; in particular, positive associations between early externalising behaviours and later internalising and externalising, and negative associations between emotional wellbeing and later internalising and unhealthy weight. For all other domains of child development, although associations with subsequent health were positive, the evidence was either weaker, inconsistent or limited. There was limited evidence on factors that altered associations. Positive socio-emotional development at school starting age appears particularly important for subsequent mental health and weight in adolescence. More collaborative research across health and education is needed on other domains of development and on the mechanisms that link development and later health, and on how any relationship is modified by socio-economic context.
... A number of antecedent risk factors for emotional problems have been identified. At the family level, these include: low socioeconomic status (SES) (Morgan et al. 2009;Ashford, Smit, Van Lier, Cuijpers and Koot 2008), single-parent families (Kalff, Kroes, Vles, Bosma, Feron, Hendriksen et al. 2001), parental discipline (Bayer, Ukoumunne, Mathers, Wake, Abdi and Hiscock 2012;Leve, Kim and Pears 2005), over-involved/protective or low warmth/unengaged parenting (Bayer et al. 2006), and parents' own mental health (Bayer et al. 2006;Leve et al. 2005). At the maternal level, stress (Ashford et al. 2008;Bayer et al. 2012), less education and lower employment occupation status (Anselmi, Piccinini, Barros and Lopes 2004;Kalff et al. 2001), along with younger maternal age (Kalff et al. 2001;Moffitt 2002), have been identified as increasing offspring risk for emotional problems. ...
... At the family level, these include: low socioeconomic status (SES) (Morgan et al. 2009;Ashford, Smit, Van Lier, Cuijpers and Koot 2008), single-parent families (Kalff, Kroes, Vles, Bosma, Feron, Hendriksen et al. 2001), parental discipline (Bayer, Ukoumunne, Mathers, Wake, Abdi and Hiscock 2012;Leve, Kim and Pears 2005), over-involved/protective or low warmth/unengaged parenting (Bayer et al. 2006), and parents' own mental health (Bayer et al. 2006;Leve et al. 2005). At the maternal level, stress (Ashford et al. 2008;Bayer et al. 2012), less education and lower employment occupation status (Anselmi, Piccinini, Barros and Lopes 2004;Kalff et al. 2001), along with younger maternal age (Kalff et al. 2001;Moffitt 2002), have been identified as increasing offspring risk for emotional problems. At the child level, preterm birth and low birth weight have been found to predict emotional problems, albeit with small effect sizes (Aarnoudse-Moens, Weisglas-Kuperus, van Goudoever and Oosterlaan 2009; Arpi and Ferrari 2013). ...
... Whilst a substantial existing literature aims to understand these antecedent risk factors (e.g., Ashford et al. 2008;Morgan et al. 2009), very few studies simultaneously consider health, social, and contextual factors, providing an incomplete understanding. Further, there are few studies that examine potential consistencies and differences in etiology across countries and cultures, with most studies conducted in single samples, or using North American and European cohorts. ...
Emotional problems in early childhood increase the risk of mental health problems into adolescence and adulthood, but the cross-cultural etiological risk factors are unclear. We examined predictors of emotional problems in preschoolers, using a national cohort of children in Chile and in Scotland. Participants included 1648 children and their families enrolled in the Chilean Encuesta Longitudinal de la Primera Infancia (ELPI) cohort and 3786 children and their families enrolled in the Growing Up in Scotland (GUS) cohort. Data were collected between 2005 and 2012. Information on emotional problems along with social and health determinants were collected via maternal reports. Emotional problems in the clinical range were identified in 10.4% of children from the ELPI cohort and in 3.6% of children from the GUS cohort. The difference between cohorts was statistically significant. Logistic regression revealed that maternal unemployment predicted emotional problems across cohorts. Lower maternal education and living in rural areas predicted higher risk of emotional problems for the ELPI cohort only, whereas having a younger mother, daily parent-child shared activities such as a lower frequency of sharing letters/shapes, and a higher exposure to television predicted higher risk for emotional problems for the GUS cohort. Maternal unemployment as a risk factor across cohorts indicates the importance of shared cross-cultural factors. However, sample specific differences highlight the importance and need for greater attention towards cultural specificities in policy and intervention development for child mental health.
... In terms of child temperament, negative affect (e.g., Uhl et al., 2019), sensory processing sensitivity (e.g., Liss et al., 2005), behavioral inhibition (Hastings et al., 2015), shyness (Findlay et al., 2009), and effortful control (Morris et al., 2002) are found to be linked to childhood internalizing problems. Moreover, child's difficulties in language (Helland et al., 2018), emotion recognition (Castro et al., 2018), peer relations , and social skills (Salavera et al., 2019); child's emotion regulation skills (Compas et al., 2017;Wang et al., 2018); family socioeconomic status (Ashford et al., 2008;Mills et al., 2011), family cohesion (Rabinowithz et al., 2016), and interparental conflict (Yap & Jorm, 2015); maternal mental health problems (Ashford et al., 2008;Lyons-Ruth et al., 1997;Wang et al., 2018) can be listed among the factors which are related to child internalizing problems. ...
... In terms of child temperament, negative affect (e.g., Uhl et al., 2019), sensory processing sensitivity (e.g., Liss et al., 2005), behavioral inhibition (Hastings et al., 2015), shyness (Findlay et al., 2009), and effortful control (Morris et al., 2002) are found to be linked to childhood internalizing problems. Moreover, child's difficulties in language (Helland et al., 2018), emotion recognition (Castro et al., 2018), peer relations , and social skills (Salavera et al., 2019); child's emotion regulation skills (Compas et al., 2017;Wang et al., 2018); family socioeconomic status (Ashford et al., 2008;Mills et al., 2011), family cohesion (Rabinowithz et al., 2016), and interparental conflict (Yap & Jorm, 2015); maternal mental health problems (Ashford et al., 2008;Lyons-Ruth et al., 1997;Wang et al., 2018) can be listed among the factors which are related to child internalizing problems. ...
... En este escenario, la centralidad de los roles de cuidado de padres y madres hace pertinente considerarlos como sujetos importantes a ser estudiados, ya que son parte transcendental del tejido social, afectando en última instancia en la mayoría de las adquisiciones de desarrollo relevantes a lo largo de la vida (Ashford, Smit, Van Lier, Cuijpers, & Koot, 2008;Bögels, Lehtonen, & Restifo, 2010;Bowlby, 1979;Ferreira et al., 2018;Kaluf & Maurás, 1998;Weijers, van Steensel, & Bögels, 2018). Un elemento que requiere ser considerado es el bienestar personal de estas figuras entendido desde la psicología, donde es posible distinguir dos corrientes dominantes: la vinculada con el bienestar subjetivo o hedónico (experiencias vividas y la evaluación del cumplimiento de esas experiencias) y la corriente vinculada con el bienestar eudaimónico (relacionada con el desarrollo del potencial humano y el significado de la vida) (Diener & Ryan, 2009). ...
... Los resultados aquí sintetizados ponen de manifiesto la importancia de poner énfasis en la generación y fortalecimiento de políticas públicas que tengan como fin reducir las pobrezas en el mundo y apoyar a las familias y personas en esta situación, en especial, en aquellos hogares con niños/as, ya que como se señaló, la pobreza se asocia a diferentes aspectos que limitan el bienestar de padres y madres, aumentando el estrés, la angustia y la posibilidad de presentar síntomas depresivos, ante lo cual, algunos estudios han determinado que además de las estrategias de crianza, estos factores afectan el desarrollo psicológico de los hijos/as (Ashford et al., 2008;Bögels et al., 2010;Brown et al., 2015;de Cock et al., 2017;de Cock et al., 2016;Dette-Hagenmeyer & Reichle, 2014;Goodman et al., 2011;Mason, Briggs, & Silver, 2011;Meaney, 2010;Ramchandani et al., 2008;Weijers et al., 2018). En este contexto, un buen predictor de los problemas psicológicos en niños/as pudiese ser el ingreso familiar, la educación, el estado ocupacional y la clase social de los padres y madres (Ayoub et al., 2009). ...
The objective of this review was to synthesize the main results and identify the gaps
identified in the research published in the last 5 years, on the relationship between
multidimensional poverty and personal well-being in fathers and mothers. Information was
extracted from journals indexed in the Web of Science (WOS), Scopus and Scientific
Electronic Library Online (SciELO) databases, those studies published between the years
2015-2019 were considered. The results are summarized in the low educational level,
unemployment or the low quality of jobs, low incomes and financial difficulties, instability of
access to housing, food insecurity, intimate partner violence, and insecurity of
neighborhoods, the limitation of providing extracurricular activities to children and the
responsibilities and demands of parenting, affect the well-being of fathers and mothers.
Social support is a protective factor.
... Socio-demographic variables, gender, age, family structure, parental mental health and family functioning have been found to be factors associated with an increased risk of psychopathology in children and adolescents (Emerson, 2003). It has been found that, during adolescence, the socio-economic status of parents (Amone-P' Olak et al., 2009;Ashford et al., 2008;Goodman, 2001;Kaltiala-Heino et al., 2001;Sund et al. , 2003) and cognitive deficit (Chadwick et al., 2005;Einfeld et al., 2006;Emerson, 2003;Koskentausta et al., 2004), two important predictors of behavioral problems (Huisman, Araya, Lawlor, Ormel, Verhulst, &Oldehinkel, 2010). Children and adolescents from families with lower socio-economic status have a more pronounced mental health problem (Ashford et al., 2008;Bradley &Corwyn, 2002;Goodman, 2001;Huisman et al., 2010;Kaltiala-Heino et al., 2001;Sund et al., 2003).Psychopathology and behavioral disorders in youth with ID have been found to tend to grow in adolescence and adulthood (Einfeldet al., 2006). ...
... It has been found that, during adolescence, the socio-economic status of parents (Amone-P' Olak et al., 2009;Ashford et al., 2008;Goodman, 2001;Kaltiala-Heino et al., 2001;Sund et al. , 2003) and cognitive deficit (Chadwick et al., 2005;Einfeld et al., 2006;Emerson, 2003;Koskentausta et al., 2004), two important predictors of behavioral problems (Huisman, Araya, Lawlor, Ormel, Verhulst, &Oldehinkel, 2010). Children and adolescents from families with lower socio-economic status have a more pronounced mental health problem (Ashford et al., 2008;Bradley &Corwyn, 2002;Goodman, 2001;Huisman et al., 2010;Kaltiala-Heino et al., 2001;Sund et al., 2003).Psychopathology and behavioral disorders in youth with ID have been found to tend to grow in adolescence and adulthood (Einfeldet al., 2006). ...
... In addition to the aforementioned background, this expectation is also well grounded in the FAMILY SES AND PRESCHOOLERS' ANXIOUS SYMPTOMS IN PANDEMIC 6 extensively-demonstrated evidence supporting the links between family SES and child adaptation in various domains (Conger et al., 2010;Masarik & Conger, 2017). In particular, there also exist widely-identified associations between family SES and young children's internalizing psychopathology, albeit predominantly in the Western samples (Ashford et al., 2008;Bor et al., 1997;Duncan et al., 1994;Gershoff et al., 2007;Mistry et al., 2004;Papachristou & Flouri, 2020;Park et al., 2011;Potijk et al., 2015;Strohschein, 2005). ...
... Also considering the widely-identified association between family SES and young children's internalizing psychopathology in Western samples (e.g., Ashford et al., 2008;Bor et al., 1997;Duncan, Brooks-Gunn, & Klebanov, 1994;Gershoff et al., 2007;Mistry et al., 2004;Papachristou & Flouri, 2020;Park, Fertig, & Allison, 2011;Potijk et al., 2015;Strohschein, 2005), more efforts are clearly needed to examine such effects in Chinese samples of preschoolers. As such, the current study seeks to narrow this gap by linking family SES to Chinese preschoolers' anxious symptoms, which is one prominent type of internalizing problems that has an early age of onset (Beesdo-Baum & Knappe, 2012;Egger & Angold, 200;Rapee et al., 2009) and can significantly predict long-term maladaptation if without effective interventions (Bittner et al., 2007;Roza et al., 2003). ...
Using data from 16,161 families with target child of 3-6 years old in Hubei, China during COVID-19 pandemic, this study examined the association between family socioeconomic status (SES) and preschoolers’ anxious symptoms (PAS). Parental investment and parenting style were tested as mediators for this association. Home quarantine length was tested as a moderator for this direct association and for the associations between family SES and parenting processes, whereas regional pandemic risk was tested as a moderator for the entire model. Results support the utility of Family Stress and Family Investment Models in a Chinese context by identifying unique roles of parental investment and parenting style in mediating the link between family SES and PAS. Quarantine length moderated the link between family SES and authoritarian parenting: Strength of this negative association was stronger for families with longer quarantine than for those with shorter quarantine. Further, family SES was negatively associated with PAS through its negative association with authoritarian parenting, regardless of the quarantine length. Model comparison analyses between high-risk region versus low/medium-risk region groups indicated that the pandemic risk for living regions did not alter any pathway in the model. Such findings inform the designs of targeted interventions to help families cope with pandemic-related challenges. Promoting parental investment and adaptive patenting style represents an avenue to diminish consequences of family economic hardship for young children's mental health, regardless of macrolevel pandemic risk. Interventions should attend to home quarantine duration, as it contextualizes the links among family SES, parenting, and child well-being.
... Internalizing problems in youth are common and have likely increased over the last decade, as documented in reviews and epidemiological studies [1][2][3]. They tend to emerge in childhood and are relatively stable throughout life [4,5]. Hence, a better understanding of what contributes to the development of such problems in childhood is crucial. ...
... Hence, a better understanding of what contributes to the development of such problems in childhood is crucial. Among environmental factors, a variety of early stressors related to the parent-child relationship and to parental behaviours, beliefs and attitudes, including insecure parent-child attachment relationships, parental over-involvement, endorsement of harsh parenting practices, over-reactive parenting, authoritarian parenting, and permissive parenting have been reported as predictors of internalizing problems in children [4,6,7]. However, a growing number of studies provide evidence that child characteristics such as temperament traits also contribute to the aetiology of internalizing disorders through both additive and moderating effects [8][9][10]. ...
Some children are more affected than others by their upbringing due to their increased sensitivity to the environment. More sensitive children are at heightened risk for the development of internalizing problems, particularly when experiencing unsupportive parenting. However, little is known about how the interplay between children’s sensitivity and parenting leads to higher levels of depressive symptoms. In the current study, we investigated the interaction between early parenting and children’s sensitivity on levels of depressive symptomatology in middle childhood, exploring the role of rumination as a possible mediator in a community sample. Participants included 196 USA resident families, from a middle class and mostly European–American background, and their healthy children, followed up from age 3 until 9 and 12 years. Environmental sensitivity was assessed observationally when children were 3 years old. Parenting style was based on parent-report at the age of 3 years. When children were nine, they completed questionnaires on rumination and depressive symptoms (repeated at 12 years). Analyses were run applying a Bayesian approach. Children’s sensitivity interacted with permissive parenting in predicting rumination at age 9. Rumination, in turn, was associated with depressive symptoms at age 9 and, to a lesser extent, at age 12. No relevant interactions emerged for authoritative and authoritarian parenting. Sensitive children may be at heightened risk for internalizing problems when exposed to a permissive parenting style. Permissive parenting was associated with increased ruminative coping strategies in sensitive children which, in turn, predicted higher levels of depression. Hence, rumination emerged as an important cognitive risk factor for the development of depressive symptoms in sensitive children.
... Regulation skills develop and improve considerably from infancy to school age, but individual differences are moderately stable over time (Eisenberg et al., 2010). Limited regulation skills or maladaptive methods of regulating emotions have been found to be associated with the development of psychopathologies, such as internalizing problems, symptoms of anxiety, and depression (Ashford et al., 2008). In contrast, optimal emotion regulation was linked to characteristics of healthy functioning, such as selfesteem and life satisfaction (Teixeira et al., 2015). ...
... These findings reinforce the importance of empirically validated early intervention programs. Without intervention, difficulties in emotion regulation tend to remain stable over time and might be associated with psychopathological symptoms (Ashford et al., 2008). ...
Previous research mostly focused on early parenting stress or postpartum symptoms of mental illness whereas the topic of a successful transition to motherhood and its long-term effects on parenting and child well-being remained more or less neglected. The present longitudinal study investigated whether a successful transition to motherhood influences emotionally warm parenting behavior, children's emotion regulation, and subjective life satisfaction. A successful transition to motherhood is feeling satisfied, self-efficient, and energetic in the maternal role during the first year after birth. Survey data from a large, nationally representative panel study with four measurement points across 11 years were analyzed using structural equation modeling (SEM). T1 corresponds to child's first year of life, at T2 children were around 3, at T3 the children were around 8, and at T4 children were around 12 years old. The study sample comprised 322 mother-child dyads. Mothers completed questionnaires to assess their early transition to motherhood (T1), children's emotion regulation (T1 and T2), and maternal warmth (T3). At age 12 (T4), children self-reported their life satisfaction. Results confirmed that a successful transition to motherhood had positive, long-term effects on maternal warmth and children's emotion regulation. Moreover, adapting optimally to motherhood had an indirect positive effect on children's subjective life satisfaction at age 12. Life satisfaction was in turn positively affected by maternal warmth and children's emotion regulation. The results highlight the importance of a successful transition to motherhood for parenting, children's emotion regulation, and life satisfaction. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Results supported previous research that early environmental risk predicts early externalizing behaviours (Trentacosta et al., 2008;Ashford et al., 2008). Specifically, children with a greater index of CR had more externalizing symptoms than those with a low index of CR, which is consistent with early CR models showing that as the number of risk factors increase, the higher prevalence of developmental and clinical problems (Rutter, 1979). ...
... This model has been demonstrated across multiple studies examining the role of CR on children's behavioural outcomes, with robust findings showing that children evidence more behaviour problems as they experience more risk factors (Appleyard et al., 2005;Atzaba-Poria et al., 2004;Atkinson et al., 2015). However, we found no association between CR and children's internalizing symptoms, but this is supported by other work showing that CR more robustly predicts internalizing behaviours later in development than in early childhood (Ashford et al., 2008). Previous studies have found an association between CR and internalizing symptoms (Appleyard et al., 2005), but these findings are predominantly with children over the age of seven. ...
This study examined children's stress system reactivity via the autonomic nervous system (ANS) and hypothalamic pituitary adrenal axis (HPAA) during an acute stressor as moderators of predicted relations between cumulative risk (CR) and mental health symptoms in a sociodemographically diverse sample of young children (n = 58). We employed a reliable stressor paradigm to allow assessment of individual differences in respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), indexing ANS reactivity, and salivary cortisol, indexing HPAA reactivity. Children's behaviours were assessed using the Child Behaviour Checklist (CBCL). Cumulative risk was indexed by eight parent-reported sociodemographic and psychosocial risk factors. There was a significant main effect of CR on externalizing but not internalizing behaviours. Significant moderations emerged showing that among children with high CR, less RSA withdrawal during the acute stressor and less cortisol recovery following the stressor were associated with to greater externalizing behaviours. Among children with low CR, RSA and cortisol recovery were unrelated to internalizing or externalizing symptoms. Cortisol and PEP reactivity were not significant moderators. Results highlight the relevance of stress system function for understanding differential susceptibility to the early emergence of externalizing symptoms, linked to cumulative risk exposure.
... 9 In light of such research, parenting stress may be considered a proxy for the global tone of the parent-child relationship although it most directly queries parents' perceptions. 10 Among other negative correlates 11,12 (e.g., disease severity in children with medical conditions, harsh discipline practices), increased parenting stress itself has been associated with higher numbers of offspring internalizing 11,13 and externalizing 11 problems during the preschool years. In fact, recent longitudinal findings show that the course of parenting stress over time relates to the course of child behavior problems. ...
... Moreover, although associations between parenting stress and child behavioral outcomes are well documented, among children with behavior problems, only 20% of the variance can be attributed to parenting stress. 13 As such, it is possible that child factors may serve to intensify or buffer the association between parenting stress and children's outcomes, perhaps especially under conditions of high parenting stress. This notion is also in agreement with prevailing theories on the development of childhood behavioral problems that underscore the interplay between child risk factors and the caregiving environment. ...
Objective:
Maternal anxiety is a well-known risk factor for early childhood behavior problems. In this study, we explore (1) whether parenting stress mediates this relation and also (2) whether child factors, namely self-regulation, modify the influence of maternal well-being on child externalizing and internalizing problems at 4 years of age.
Method:
Mothers taking part in the Growing Up in Singapore Towards Healthy Outcomes cohort completed the Spielberger State-Trait Anxiety Inventory when their children were 24 months of age. At 42 months of age, children performed a self-regulation task (n = 391), and mothers completed the Parenting Stress Index. When children were 48 months old, both parents completed the Child Behavior Checklist.
Results:
As predicted, parenting stress mediated the relation between maternal trait anxiety and child externalizing and internalizing problems. This mediating effect was further moderated by child self-regulation. The indirect effect of maternal trait anxiety through parenting stress on child externalizing problems was stronger among children with low self-regulation.
Conclusion:
Parenting stress is an additional pathway connecting maternal trait anxiety and children's externalizing and internalizing behavior problems. The risk for child externalizing problems conveyed by elevated maternal trait anxiety and parenting stress may be buffered by better self-regulation in 4-year-olds. These results suggest that interventions that include decreasing parenting stress and enhancing child self-regulation may be important to limiting the transgenerational impact of maternal trait anxiety.
... Externalizing behavior difficulties in children are frequently linked to poor psychological well-being of their mothers (Leve et al., 2005). Childhood behavioral disorders, like externalizing behavior, are of great concern since they tend to remain throughout childhood and adolescence (Ashford et al., 2008). ...
Most of the behaviors of children depend on their parents’ psychological well-being. This study investigated the relationship of maternal psychological well-being with externalizing behaviors of children. A Personal Information Form (PIF), an adapted self-reported Bangla version of the Strengths and Difficulties Questionnaire (SDQ), and an adapted General Health Questionnaire (GHQ-28) were administered on 800 (400 children, 400 mothers) participants to collect data. The children were selected from ten Bangla medium high schools in Dhaka city and their age ranges from 11 to 13 years. The schools and the children were selected using a multistage random sampling technique. The Correlation co-efficient indicated that externalizing behavior in children and mother psychological well-being were significantly positively correlated. Results also showed that somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression of mothers were significantly correlated with externalizing behavior of children. Multiple regression analysis results showed that mothers' anxiety and insomnia alone accounted for 46.9% of the variation and was the most powerful predictor of externalizing behavior. The other significant predictors were severe depression, somatic symptoms, and social dysfunction. All the predictors explained jointly 56.1% of variance in externalizing behavior of children. The implications of the findings have been discussed in the light of theory and scientific evidence from the previous studies. Jagannath University Journal of Science, Volume 11, Number 1, Jun. 2024, pp. 1−12
... The second aim of this study is to evaluate the impact, efficiency, and possible health gain of addressing risk factors associated with psychiatric problems in adolescents and young adults with ID. This epidemiological approach recently introduced in the area of adult depression [34,35] and applied in the field of childhood internalising problems [36], was expected to throw some light on potential preventive intervention targets related to these psychiatric problems. ...
... While numerous studies in Western countries have explored child psychopathology using both clinical and community samples [22][23][24][25][26], there is paucity of such research in Kenya and other African contexts. In this addition, a significant relationship (p < 0.05) was found between psychopathology in children as reported by both parents (CBCL) and psychopathology in parents as self-reported (ASR). ...
Several studies have reported on the association between parental and childhood psychopathologies. Despite this, little is known about the psychopathologies between parents and children in a non-clinical population. We present such a study, the first in a Kenyan setting in an attempt to fill this gap. The objective of this study was to determine the association between self-rating psychopathology in children, parent-rating psychopathology in their children and self-rating psychopathology in parents in a non-clinical population of children attending schools in Kenya. We identified 113 participants, comprising children and their parents in 10 randomly sampled primary schools in South East Kenya. The children completed the Youth Self-Report (YSR) scale and parents completed the Child Behavior Check List (CBCL) on their children and the Adult Self-Reports (ASR) on themselves. These instruments are part of the Achenbach System of Empirically Based Assessment (ASEBA), developed in the USA for a comprehensive approach to assessing adaptation and maladaptive behavior in children and adolescents. There was back and forth translation of the instruments from English to Swahili and the local dialect, Kamba. Every revision of the English translation was sent to the instrument author who sent back comments until the revised version was in sync with the version developed by the author. We used the ASEBA in-built algorithm for scoring to determine cut-off points for problematic and non-problematic behavior. Correlations, linear regression and independent sample t-test were used to explore these associations. The mean age of the children was 12.7. While there was no significant association between child problems as measured by YSR (self-reported) and parent problems as measured by ASR and CBCL in the overall correlations, there was a significant association when examining specific groups (clinical range vs. non-clinical). Moreover, significant association existed between total problems on YSR and ASR internalizing problems (t=-2.3,p = 0.023), with clinical range having a higher mean than the normal range. In addition, a significant relationship (p < 0.05) was found between psychopathology in children as reported by both parents (CBCL) and psychopathology in parents as self-reported (ASR).
Mothers were more likely to report lower syndrome scores of their children as compared to fathers. Our findings indicate discrepancies between children self-rating and parent ratings, suggesting that one cannot manage psychopathology in children without reference to psychopathology in their parents. We suggest broad-based psycho-education to include children and parents to enhance shared awareness of psychopathology and uptake of treatment.
... 8 There may still be important but less severe outcomes, such as increased externalizing and internalizing behaviors in children with PDE. 9,10 Few studies in human beings have directly examined the effects of PDE on key brain functions, such as emotion processing. Although intact emotion processing in children has shown to confer resilience to trauma and to promote effective conflict resolution abilities, 11,12 emotion processing difficulty is associated with later onset of psychiatric disorders including anxiety, depression, and eating disorders, as well as subclinical functional impairments. ...
Objective
This paper investigated the effects of prenatal drug exposure (PDE), childhood trauma (CT), and their interactions on the neurobiological markers for emotion processing.
Method
Here, in a non-clinical sample of pre-adolescents (9-10 years of age) from the Adolescent Brain Cognitive Development (ABCD) Study (N = 6,146), we investigate the impact of PDE to commonly used substances (ie, alcohol, cigarettes, and marijuana), CT, and their interaction on emotion processing. From the Emotional N-back functional magnetic resonance imaging task data, we selected 26 regions of interests, previously implicated in emotion processing, and conducted separate linear mixed models (108 total) and accounted for available environmental risk factors.
Results
PDE was associated with reductions in response bias related to the processing of fearful compared to happy faces in widespread cortical regions (including the superior frontal and fusiform gyri and the inferior parietal lobule). Reduced response bias in the superior frontal gyrus emerged as PDE driven and was present regardless of CT status, but correlated with several items on the Child Behavior Checklist only in those children with both PDE and CT. The lower response bias of the left inferior parietal lobule, on the other hand, was observed only in children with both PDE and CT, and correlated with internalizing and externalizing behaviors.
Conclusion
The study’s results support the diathesis–stress model, and suggest that PDE may confer vulnerability to the effects of later CT through altered neurodevelopment. Children experiencing these “double-hit” conditions may represent at-risk individuals who could benefit from early interventions to mitigate the onset of psychopathology. Because of limitations in the way that PDE was reported in the ABCD Study, including lack of severity measures and retrospective reporting, results are not sufficient for making recommendations or dictating policy for pregnant persons. Nevertheless, this study is a necessary first step in examining the interactive effects of prenatal and early-life exposures, as well as many aspects of the sociodemographic and psychological environment.
... Internalizing behavior difficulties in children are frequently linked to poor psychological well-being of their mothers (Edwards and Hans, 2015). Early behavioral disorders, like internalizing behaviors, are of great concern since they tend to remain throughout childhood and adolescence (Ashford et al., 2008). ...
Nowadays, mothers' psychological well-being and behavioral outcomes in children have become a major topic of interest globally in the social and clinical arena. Though fathers play an important role in parenting, mothers are the key persons responsible for caring for their children. Thus, the present study investigated the relationship between maternal psychological well-being and their children's internalizing behaviors. This study also aimed to build up some models related to predictor and outcome variables based on the current research findings. A cross-sectional survey research design was employed to conduct the study on 800 participants (400 children and 400 mothers). The children were selected from ten Bangla medium high schools in Dhaka, and the age ranges of the children ranged from 11 to 13 years. The schools and the children were selected following a multistage random sampling technique. The self-reported Bangla version of the Strengths and Difficulties Questionnaire (SDQ), the Bangla version of the General Health Questionnaire (GHQ-28), and a Personal Information Form (PIF) were administered to the participants to collect data. The correlation analysis showed a significant positive correlation between maternal psychological well-being and children's internalizing behavior. Results also revealed that somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression in mothers were significantly correlated with the internalizing behavior of children. Findings from multiple regression analysis indicated that the most powerful predictor of internalizing behavior was mothers' anxiety and insomnia, which independently explained 35% of the variance. The other significant predictors were social dysfunction, severe depression, and somatic symptoms. All four predictors jointly explained 40.6% of the variance in children's internalizing behavior. The implications of the findings have been discussed in light of theory and research evidence from earlier research.
... A child's temperament such as anger, and irritability also predicts internalizing and externalizing behaviors (Ezpeleta et al., 2012). For caregivers, parenting stress, family psychopathology (Ashford et al., 2008), maternal education level (Liu et al., 2014), parental depression and substance abuse (Connell & Goodman, 2002), and maternal age (Velders et al., 2011) were found to increase the risk of their children's behavior problems. Furthermore, studies showed that children who experience economic hardship had higher levels of internalizing and externalizing symptoms (Ciciolla et al., 2014;Costello et al., 2005;Dearing et al., 2006;Kaiser et al., 2017;Paterson et al., 2013;Zilanawala & Pilkauskas, 2012). ...
... For the construct of educational aspiration, no one informant holds all the truth about the construct, and parent-child agreement or disagreement may be related to critical facets of the children's internalizing problems (Zilcha-Mano et al., 2021). Because internalizing problems that persist through adulthood are often rooted in childhood (Ashford et al., 2008;Mazza et al., 2009), it is necessary to explore the relations between (in)congruence of educational aspirations and adolescents' internalizing problems. ...
... The offspring of depressed parents face an elevated risk not only for depression , but also internalising and externalising disorders generally (Ashford et al., 2008). They are also more likely to experience early-onset depression (Collishaw et al., 2016;Hosman et al., 2009;Weissman et al., 1997), which is associated with higher risk of somatic diseases (Scott et al., 2011), other psychiatric disorders and suicide (Rao & Chen, 2009). ...
Background
Parental depression increases children's risk of mental illness and may simultaneously impair the detection of children's symptoms. Here we investigate the nature of parent‐child agreement of children's psychopathology in children of parents with current (cMD) versus remitted (rMD) major depression.
Methods
Baseline data from 100 parent‐child dyads including healthy children aged 8–17 (M = 11.89, SD = 2.83) and their parents with a history of depression were analysed. The presence of sub‐clinical psychopathology (yes/no) in children was assessed using semi‐structured diagnostic interviews with child and parent (K‐DIPS). Self‐ (YSR) and parent‐report (CBCL) questionnaires were used to measure the severity of symptoms. Parent‐child agreement was calculated using Chi‐square tests and Cohen's kappa respectively. We compared whether agreement differed between children of parents with cMD (n = 52) versus rMD (n = 48).
Results
In the interviews parents more frequently reported sub‐clinical child psychopathology than the children themselves (χ² 1,100 = 4.63, p < 0.001, d = 0.59). This pattern characterised parents with cMD (χ² 1,52 = 7.99, p = 0.005; κ = 0.582) but not rMD (χ² 1,48 = 000, p = 0.686; κ = −0.010), a difference which was statistically significant (z = 3.14, p < 0.001, d = 0.66).
Conclusion
Since agreement between parents and children about the severity of children's symptoms was particularly poor in families where parents were currently depressed, parental mental illness should be taken into account when assessing youth psychopathology.
... Descriptive statistics were conducted to characterize the final sample. As child sex and parental years of education have been shown to impact the expression of internalizing behaviours in children [54,55] t-tests were conducted to determine whether there were significant differences in primary variables based on child sex, and correlation analyses to determine if parental education (a proxy for socioeconomic status) was significantly associated with the primary variables. If associations between our dependent variables and these demographic variables were present, this would suggest the benefit of including these demographics as covariates. ...
Parenting stress occurs when demands of the parenting role are perceived as overwhelming and has been proposed as a mechanism through which postpartum mood disturbances may impact child psychopathology. In a prospective longitudinal birth cohort of 111 birthing parent–child dyads, this study examined whether the relationship between birthing parents’ mood symptoms in infancy (3 months postpartum) and their child’s internalizing behaviour in early childhood (3 and 6 years old) is mediated by parenting stress at 6 months postpartum. The relationship between higher postpartum mood symptoms at 3 months and increased internalizing behaviour at 3 years of age was mediated by increased reports of parenting stress at 6 months (b = .12, 95% CI = .02, .25). This association was not evident at 6 years. Parenting stress in early infancy may provide a treatment target to reduce the impact of perinatal depression on early child behavior.
... Adolescents are vulnerable to depression and anxiety onset [44]. The identification of mechanisms governing risk and protection for depression and anxiety is an important first step in the prevention of psychopathology in adults. ...
Although previous studies have identified negative relationships between cognitive ability and emotional problems (EP), mechanism explaining these relationships remained unclear. This study evaluated two explanatory models using bivariate moderation model-fitting analysis in a twin design. The resilience model suggests that high cognitive ability decreases the risk of EP in adverse settings, and the scarring model suggests that EP symptoms lead to persistent cognitive deficits following onset. The Standard Progressive Matrices Plus (SPM) and EP scale were administered to a sample of 3,202 twins (mean age = 14.62 ± 1.74 years) attending public schools in Nigeria. The results of bivariate moderation model-fitting analyses only supported the resilience model. Moderation effects were not significant in the scarring model when genetic and environmental influences were incorporated. The best-fitting bivariate moderation model assuming the resilience model yielded a genetic correlation of − 0.57 (95% CI = − 0.40, − 0.84) with no significant environmental correlations. Moreover, the SPM moderated the environmental, not genetic, influences on EP, such that environmental influences were strong when protective factors were absent (low SPM) and weak when these were present (high SPM). These results indicate the need to develop targeted prevention and intervention strategies for EP in adolescents displaying low cognitive ability in deprived settings.
... In non-adoptive families, parenting stress has been found to be related to children's emotional and behavioral outcomes (for a systematic review and meta-analysis, see . For example, results suggest that parenting stress is significantly associated with children's internalizing (Anthony et al., 2005;Ashford et al., 2008;Liu & Wang, 2015;Rodriguez, 2011;Samuelson et al., 2017;Stadelmann et al., 2015;Stone et al., 2016;Tsotsi et al., 2019) and externalizing behaviors (Anthony et al., 2005;Buodo et al., 2013;Liu & Wang, 2015;Samuelson et al., 2017;Stone et al., 2016), as well as with deficits in social competence (Anthony et al., 2005). Although research in this area has typically been cross-sectional or unidirectional, some longitudinal studies have investigated transactional processes between parenting stress and child outcomes. ...
Despite decades of research on adopted children’s development, little research has examined the mutual relationship between children’s and parents’ post-adoption behavior. The current study used data from a longitudinal study to examine transactional processes between children’s psychosocial adjustment, parenting styles, and parenting stress in a sample of 67 adoptive families. Children’s early behavioral problems predicted later positive parenting, inconsistent parenting, and parenting stress. The findings underline the importance of pre-adoption training for adoptive parents, realistic information on adoptees’ adjustment problems, and continuous post-adoption support.
... A relatively recent study indicates that having children at home is positively associated with a preference for PA in nature [5]. Similarly, many studies have shown associations between parental stress related to reports of child behavioral and emotional problems, adjustment difficulties, and internalizing or externalizing problems [48], which can be reduced by exposure to nature by both parties [10]. Sleddens et al. [49] pointed out that the relationship of influence on PA of parents and children is bidirectional, despite the fact that the vast majority of the literature only explores the influence of parents on their children. ...
Physical activity in nature has several benefits as it is important for good health, offering physical, social, psychological or even ecological benefits. Nevertheless, in order to maintain adherence to this practice, high levels of satisfaction with the practice are necessary. The objective of this study is to explore whether children’s characteristics influence parental satisfaction with physical activity in nature, analyzing possible differences according to the gender and age of their children. Two hundred and eighty parents responded to two sociodemographic questions in addition to the Physical Activity Enjoyment Scale (PACES), which consists of 16 items. The normality of the data was determined using the Kolmogorov-Smirnov test. Subsequently, nonparametric tests were used to analyze the variables of gender and age in the items, dimensions and total scores of the questionnaire. Statistical differences were found in some of the positive items, which varied according to the age of the children. However, no significant differences were found in the items with respect to the children’s gender or when examining the dimensions or total score of the questionnaire based on both variables. Likewise, age did not show significant correlations with the dimensions and the total score of the questionnaire. Consequently, this study indicates that a child’s age may influence parents’ positive perceptions of the enjoyment of physical activity in nature. Similarly, the gender of the child does not seem to influence these perceptions.
... There is evidence that parental psychological disorders increase the risk of disturbance in child development [1,2] and that parental stress predicts children's mental and behavioral problems [3]. In particular, maternal stress can be an important factor associated with lower psychological adjustment in children [4,5], while maternal anxiety was identified as the most frequent and important predictor of children's mental health status [6]. ...
There is evidence that parental psychological disorders in stressful situations increase the risk of disturbance in child development. This has been investigated in disasters but not in pandemics, which are sensibly different from other types of traumatic events. We investigated the relationship between mothers’ anxiety and their children’s (self-reported) stress and the boundary conditions of this association during the first full COVID-19 lockdown in Italy. During the COVID-19 pandemic, mothers might have increased their protective attitudes to secure and support their children; we tested whether the relationship between mothers’ anxiety and children’s stress was weaker (buffer effect) or stronger (over-protection effect) when perceived parental support was high. We measured mothers’ anxiety, children’s perceived parental support, and children’s stress in a sample of 414 8- to 11-year-old primary school children (229 females, Mage = 9.44) and 395 mothers (Mage = 42.84). Results supported the over-protection scenario and provided the first evidence for the “helicopter-parent effect” during the COVID-19 pandemic: mothers’ anxiety was positively associated with children’s stress only when perceived support was high. Our finding highlights the importance of educating parents (for example, via emotional training) to prevent the worst consequences of adverse events in children and promote their mental health.
... Internalizing behaviors (anxiety, depression, social withdrawal, and somatic complaints such as nausea) and externalizing behaviors (aggression, defiance, and hyperactivity;Achenbach, 1991;Campbell 1995) among young children are associated with poorer academic performance (Bulotsky-Shearer & Fantuzzo, 2011; Collie disruptive student behaviors are commonly the second most frequently cited reasons for teacher attrition (e.g., Wynn et al., 2007;Ingersoll & Smith, 2003). One of the strongest predictors of persistent behavior problems across childhood is rates of behavior problems at kindergarten entry (e.g., Ashford et al., 2008;Morgan et al., 2009). Thus, investigating the factors that increase the risk of children developing behavior problems in early life is of vital importance. ...
Early onset of internalizing and externalizing behavior problems is associated with persistent and more severe academic, social, and mental health challenges later in life. Understanding the factors that increase children’s risk of developing these behavior problems prior to the start of formal school is important for preventing their emergence and mitigating their effects. Using data from the Early Childhood Longitudinal Study Kindergarten Class of 2010–2011 (ECLS-K 2011), this study investigated how individual student demographic characteristics (i.e., gender, race/ethnicity, family SES) predict internalizing and externalizing behaviors at the start of kindergarten and whether geographic locale (i.e., city, suburb, town, rural) might moderate these relationships. Path analyses revealed that internalizing and externalizing behaviors were stable across the kindergarten year and that students’ levels of externalizing behaviors in the fall positively predicted internalizing behaviors in the spring. Results also showed that, at kindergarten entry, boys showed higher rates of externalizing and internalizing behaviors compared to girls, Black children showed higher rates of externalizing behaviors, but lower rates of internalizing behaviors compared to White children, and SES negatively predicted both forms of behavior problems. Moderation analyses revealed that risks of entering kindergarten with elevated rates of behavior problems varied across locales for boys, Black children, and children from low SES families. Implications for policy and practice are also discussed.
... Verhulst and Koot (1992) suggested that approximately 40% to 60% of children with high levels of problematic behaviors at age 3 or 4 continue to experience these problems through age 10. Early childhood behavior problems are considered a critical public health concern because they not only affect the present well-being of children (Ben-Arieh et al., 2014), but also persist throughout later developmental stages and predict other negative developmental problems (Ashford et al., 2008;Vaillancourt et al., 2013). ...
Background
A sizable number of previous research investigated the influences of untreated behavior problems in children's early age, as well as how different environmental factors affect child behavior problems (King et al., 2004; Vaillancourt et al., 2013). However, few studies focused on the influences of different types of neighborhood factors on early childhood internalizing and externalizing symptoms via adverse childhood experiences.
Objective
This study aims to capture the specific pathways from neighborhood structural factors and process factors to early childhood internalizing and externalizing symptoms.
Participants and setting
The restricted version of the Fragile Family Child Wellbeing Study (FFCWS) dataset at ages 3 and 5 were used, and 2722 children were included in the final model.
Methods
The Structural Equation Model was used to estimate the pathways from neighborhood structural and process factors to early childhood internalizing (INT) and externalizing (EXT) symptoms. Neighborhood structural factors were measured at the census tract level. Neighborhood collective efficacy, child maltreatment experiences, and early childhood internalizing, and externalizing symptoms were reported by the focal child's mother.
Results
Neighborhood process factors and structural factors showed both direct and indirect effects on early childhood EXT and INT differently. Emotional assault and neglect worked as mediators in this relationship.
Conclusions
Findings emphasize the importance for researchers and practitioners to involve neighborhood context when assisting children with early childhood behavior problems. Implications for research and interventions are further discussed.
... Dies gilt für internalisierende Verhaltensprobleme vermutlich in ähnlicher Weise, zumindest deuten erste Studien über kürzere Zeiträume darauf hin (z. B. Ashford, Smit, van Lier, Cuijpers & Koot, 2008;Stone, Mares, Otten, Engels & Janssens, 2016), auch die Ergebnisse der vorliegenden Studie weisen in diese Richtung und eine kürzlich veröffentlichte Analyse im Rahmen der "Longitudinal Study of Australian Children" zeigt diese Stabilität für internalisierende Probleme auch über einen Zeitraum von 10 Jahren (O'Connor et al., 2021). Bezüglich der negativen kindlichen Beziehungsgestaltung sagten die Werte zur Baselinemessung im Vergleich zu den anderen untersuchten abhängigen Variablen die Varianz der Werte ein Jahr später weniger stark vorher. ...
Zusammenfassung. Theoretischer Hintergrund: Kinder in Pflegeverhältnissen (KiP) sind häufig schon früh im Leben verschiedenen Risikofaktoren ausgesetzt, die ihre weitere Entwicklung prägen können. Fragestellung: Ziel ist die Analyse der Stärke der Zusammenhänge unterschiedlicher Risikofaktoren mit der psychopathologischen Entwicklung von KiP. Methode: Es wurden zunächst eine Reihe von Risikofaktoren erhoben, ein Jahr später das Ausmaß an internalisierenden und externalisierenden Verhaltensproblemen, sowie die kindliche Beziehungsgestaltung bei Kindern in Familien mit und ohne Pflegeaufgaben untersucht. Ergebnisse: Diese sozial-emotionalen Entwicklungsdimensionen wiesen über den untersuchten Zeitraum hinweg eine hohe korrelative Stabilität auf. Keiner der untersuchten Risikofaktoren trug signifikant zur weiteren Varianzaufklärung bei, KiP wiesen zu allen Messzeitpunkten höhere Belastungswerte auf. Schlussfolgerung: Die Stabilität und erhöhten Ausprägungen der Verhaltensprobleme sind gerade für Familien mit Pflegeaufgaben eine Herausforderung.
... Family based risk factors include parenting interactions that are insensitive, lack warmth, or are controlling, as well as parental interactions that are over involved or over protective. Other factors include overly harsh discipline, parental mental health difficulties or stress, parental substance abuse, family violence, limited parental education, and parental conflict or separation/divorce (Dwyer et al., 2003;McCarty et al., 2005;Bayer et al., 2006Bayer et al., , 2011Pike et al., 2006;Van Zeijl et al., 2006;Ashford et al., 2008;Miner and Clarke-Stewart, 2008;Edwards et al., 2010;Wlodarczyk et al., 2017). ...
The period of infancy and early childhood is a critical time for interventions to prevent future mental health problems. The first signs of mental health difficulties can be manifest in infancy, emphasizing the importance of understanding and identifying both protective and risk factors in pregnancy and the early postnatal period. Parents are at a higher risk of developing mental health problems during the perinatal period. An understanding of the evidence around prevention and intervention for parental anxiety and depression is vital to the process of prevention of early mental health disorders in infants and young children. Here we review the existing prevention and treatment interventions in the early years focusing on the period from conception to 3 years – the majority targeting parents in order to improve their mental health, and that of their infants. Elements of successful programs for parents include psychoeducation and practical skills training, as well as work on the co-parenting relationship, developing secure attachment, and enhancing parental reflective functioning. While both targeted and universal programs have produced strong effect sizes, universal programs have the added benefit of reaching people who may otherwise not have sought treatment. In synthesizing this information, our goal is to inform the development of integrated models for prevention and novel early intervention programs as early in life as possible.
... Anxiety and depression co-occur or occur sequentially among children, sometimes from the same or similar factors (Garber and Weersing, 2010). These conditions, common among children, are often unnoticeable, and could be a precursor for a full-blown mental health problem in the future (Al-biltagi and Sarhan, 2016;Ashford et al., 2008;Costello et al., 2003;. In Ghana, these conditions are less recognized by parents, even though about 1.31% and 1% prevalence of depression and anxiety, respectively, have been reported among Ghanaian children (Kusi-Mensah et al., 2019). ...
... From a developmental perspective, parental strain is known to be detrimental to child development. A large set of empirical studies has demonstrated negative effects of parental strain on children's physical, social-emotional, and cognitive development [e.g., 27,28]. For example, one study found longitudinal reciprocal effects between parenting stress and child externalizing behavior for children aged 4 to 10 years [29]. ...
As COVID-19 sweeps across the globe, scientists have identified children and families as possibly particularily vulnerable populations. The present study employed a developmental framework with two measurement points (the first at the peak of the lockdown restrictions (N = 2,921), the second after restrictions had been majorly loosened (N = 890)) to provide unique insights into the relations between parental strain, child well-being, and child problem behavior. Cross-lagged panel analyses revealed longitudinal effects of child well-being and problem behavior at T1 on parental strain at T2 with parent-child relationship quality as a moderator. True intraindividual change models showed that decreases in parental strain between measurement points predicted increases in child well-being and decreases in child problem behavior. Thus, the present research points to parental stress coping and child emotional adjustment as promising avenues for professionals and policy makers in their efforts to ensure child and family well-being throughout the pandemic.
... Donovan and Spence (2000) present the case for the importance of developing preventative strategies for childhood anxiety disorders, in light of evidence that patterns of anxiety become more difficult to change the longer the duration of the anxiety. Ashford, Smit, van Lier, Cuijpers, and Koot (2008) concluded from a nine-year longitudinal study investigating the risk factors associated with childhood internalising problems (including anxiety and depression) that up to 57% of cases of internalising problems in late childhood (age eleven) could be ameliorated effectively through preventative interventions addressing risk factors identified between two to five years of age. ...
Childhood anxiety disorders are the most prevalent type of mental health problem in children and they can have long-term detrimental impacts. It is therefore important to understand the risk factors involved in their development in order for effective prevention programmes to be developed. Observational and experimental research have implicated specific parenting behaviours, temperamental, and genetic factors in the development of childhood anxiety disorders.
The first chapter examines the temperamental factors implicated in the development of childhood anxiety disorders. Behavioural Inhibition (BI) is a temperamental style that can be identified from infancy, which is characterised by persistent demonstrations of fear, wariness, and reticence in unfamiliar situations. A systematic literature review and meta-analysis is presented, examining the association between BI and presentations of childhood anxiety. 55 studies reporting a quantitative outcome for the association between BI and childhood anxiety were included in the meta-analysis. The 55 studies, from 43 independent samples, presented 135 effect sizes for the association between BI and childhood anxiety. A positive significant association was found between BI and childhood anxiety. Meta-regressions examined factors moderating the association; stronger effect sizes were found when: anxiety was measured continuously, BI was measured by parent-report, and anxiety was measured by parent-report. Recommendations are made for further research to examine the interaction between temperamental and parenting factors in the development of childhood anxiety.
The second chapter presents an empirical study investigating the impact of two specific parenting behaviours on infant affect and behaviour. Research has shown that parental expression of anxiety can increase their child’s anxiety, whereas demonstrating encouraging behaviour is associated with less anxiety in the child. The study examined whether it is possible to modify these parenting behaviours using video tuition to model the target parenting behaviours, and then examined if this had an impact on infants’ affect and behaviour. Twenty-two mother-infant dyads completed two experimental social-referencing tasks in which they met with a stranger. In one, mothers expressed anxiety when interacting with a stranger, and in the other they expressed encouragement. Infant affect and behaviour during subsequent interaction with the strangers was recorded. Measures of maternal mood/anxiety and infant temperament were gathered to examine if these moderated any effects found. The video tuition was successful in modifying mothers' behaviours. Infant temperament had the strongest effect on infants’ affect and behaviour, irrespective of the experimental condition. The study has demonstrated the utility of video tuition for modifying behaviours implicated in the development of childhood anxiety. Recommendations are made to replicate the study in a clinical sample and for further exploration of temperamental factors.
Keywords: childhood; infancy; anxiety; behavioural inhibition; temperament; parenting
... Associations of presence of clinical signs with psychological impairment was the novel thing in our data. We have shown the univariate risks of psychological impairment in those with presence of multiple clinical signs in (Table 4) determinant of internalizing problems in 11 y old adolescents [30]. Few studies on obesity and psychiatric health of obese adolescents have indicated that obese adolescents also often have psychological issues, such as impaired self-awareness, low self-esteem, inferiority, anxiety and depression and autonomic function, along with a lack of social adaptability [31]. ...
Aim: Adolescence is the stage of life in which a child transitions into an adult. It is characterized not only by accelerated growth, sexual maturation but there are complex psycho-social interactions during this period which play a major role in subsequent mental health.
... The few studies that have explored this link confirmed the cross-sectional findings. Specifically, Mäntymaa et al. [29] found that higher parenting stress at age 2 was significantly associated with more child internalizing problems at age 5. Goldberg et al. [30] also found a similar pattern where parenting stress at age 1, 2, and 3 was positively associated with child internalizing problems at age 4. Lastly, parental stress when the child was age 4-5 was significantly associated with more symptoms of child internalizing problems at age 11 [31]. Only two studies were identified examining the transactional model between parenting stress and children's internalizing problems. ...
Although the association between parenting stress and child behavioral outcomes is well established (Deater-Deckard, Clin Psychol 5:314–332, 1998), longitudinal research examining the direction of these effects is limited. This study examined transactional associations between parenting stress and child externalizing and internalizing behaviors among 1209 low-income female caregivers (Mage = 34.51) with children in early childhood or early adolescence (i.e., either 2- to 5-years-olds or 9- to 15-year-olds at Time 1) across a 6 year time span using three time points. Parent-driven associations between parenting stress and child internalizing problems for the early childhood group were found. In the early adolescent group, transactional and child-driven associations were found between parenting stress and child externalizing problems, but only child-driven associations for internalizing problems. Thus, transactional associations were only supported for the early adolescent group. These findings suggest developmental differences in how parenting stress and child behavioral problems are linked among low-income families. Clinical implications are discussed.
... The familial environment and the parent-child relationship are hypothesised to have important influences on child emotional development [24][25][26][27]. Parent characteristics such as low self-esteem and depressive symptoms, dysfunctional family environments and socioeconomic disadvantage are important risk factors for the development of child internalising disorders [25,28,29]. Specific negative parenting practices have been found to be associated with mood and anxiety symptoms [26,27,[30][31][32][33][34][35][36][37][38]. ...
Background
Internalising problems, such as depression and anxiety, are common and represent an important economical and societal burden. The effectiveness of parenting interventions in reducing the risk of internalising problems in children and adolescents has not yet been summarised. The aims of this review are to assess the effectiveness of parenting interventions in the primary, secondary and tertiary prevention of internalising problems in children and adolescents and to determine which intervention components and which intervention aspects are most effective for reducing the risk of internalising problems in children and adolescents.
Methods
Electronic searches in OVID SP versions of MEDLINE, EMBASE and PsycINFO; Cochrane Central Register of Controlled Trials; EBSCO version of ERIC and ClinicalTrials.gov have been performed to identify randomised controlled trials or quasi-randomised controlled trials of parenting interventions. At least two independent researchers will assess studies for inclusion and extract data from each paper. The risk of bias assessment will be conducted independently by two reviewers using the Cochrane Collaboration’s Risk of Bias Assessment Tool. Statistical heterogeneity is anticipated given potential variation in participant characteristics, intervention type and mode of delivery, and outcome measures. Random effects models, assuming a common between-study variability, will be used to account for statistical heterogeneity. Results will be analysed using a network meta-analysis (NMA). If appropriate, we will also conduct a component-level NMA, where the ‘active ingredients’ of interventions are modelled using a network meta-regression approach.
Discussion
Preventing and reducing internalising problems could have major beneficial effects at the economic and societal level. Informing policy makers on the effectiveness of parenting interventions and on which intervention’s component is driving the effect is important for the development of treatment strategies.
Systematic review registration
International Prospective Register for Systematic Reviews (PROSPERO) number CRD42020172251
... 4). Predictive associations between emotion regulation and child behavior problems are especially significant considering that a substantial amount of research has confirmed that early internalizing and externalizing behaviors are predictive of later internalizing and externalizing behaviors (Ashford, Smit, van Lier, Cuijpers, & Koot, 2008;Mantymaa et al., 2011). ...
Spina bifida (SB) is a congenital birth defect causing a wide variance of physical and intellectual disabilities. The first objective of this study was to examine SES and parental perceived support as predictors of HRQoL among youth with SB. It was hypothesized that lower SES would predict lower youth HRQoL, and higher parental perceived support would predict higher youth HRQOL. The second objective of this study was to examine parental perceived support as a moderator of the association between SES and youth HRQoL. Parental perceived support was hypothesized to serve as a buffer of the negative impact that low SES has on HRQoL. Results indicated significant effects of SES on school, physical, and total HRQoL subscales when covariates were not included. In addition, parental perceptions of social support from family members were significantly associated with Emotional HRQoL in youth with SB. There was a significant interaction between SES and parental perceived support from friends predicting youth Social HRQoL. However, post-hoc simple slope analyses were not significant. This study works to expand the understanding of the roles of SES and parental perceived social support on the HRQoL in children with SB, a population susceptible to poor quality of life due to the physical and cognitive challenges commonly associated with this condition.
... The familial environment and the parent-child relationship are hypothesised to have important influences on child emotional development (30)(31)(32)(33). Parent characteristics such as low self-esteem and depressive symptoms, dysfunctional family environments and socioeconomic disadvantage are important risk factors for the development of child internalising disorders (31,34,35). Specific negative parenting practices have been found to be associated with mood and anxiety symptoms (32,33,44,(36)(37)(38)(39)(40)(41)(42)(43). ...
Background: Internalising problems, such as depression and anxiety, are common and represent an important economical and societal burden. The effectiveness of parenting interventions in reducing risk of internalising problems in children and adolescents has not yet been summarised. The aims of this review are to:
1. assess the effectiveness of parenting interventions in the primary, secondary and tertiary prevention of internalising problems in children and adolescents;
2. determine which intervention components and which intervention aspects are most effective for reducing risk of internalising problems in children and adolescents.
Methods: Electronic searches in OVID SP versions of Medline, EMBASE and PsycINFO; Cochrane Central Register of Controlled Trials; EBSCO version of ERIC and clinicaltrials.gov have been performed to identify randomised controlled trials or quasi-randomised controlled trials of parenting interventions. At least two independent researchers will assess studies for inclusion and extract data from each paper. The risk of bias assessment will be conducted independently by two reviewers using the Cochrane Collaboration’s Risk of Bias Assessment Tool. Statistical heterogeneity is anticipated given potential variation in participant characteristics, intervention type and mode of delivery, and outcome measures. Random effects models, assuming a common between-study variability, will be used to account for statistical heterogeneity. Results will be analysed using a network meta-analysis (NMA). If appropriate, we will also conduct a component-level NMA, where the ‘active ingredients’ of interventions are modelled using a network meta-regression approach.
Discussion: Preventing and reducing internalising problems could have major beneficial effects at the economic and societal level. Informing policy makers on the effectiveness of parenting interventions and on which intervention’s component is driving the effect is important for the development of treatment strategies.
Systematic review registration: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42020172251
... In addition, although many studies have repeatedly highlighted that parental favoritism is a potential risk factors for children's internalizing and externalizing problems (e.g., Richmond et al. 2005), little is known about the relationship between parent-child discrepancies in parental favoritism and children's internalizing and externalizing problems. Studies have indicated that internalizing and externalizing problems that persist through adulthood are often rooted in childhood (Ashford et al. 2008;Mazza et al. 2009). For example, internalizing problems in childhood have been linked to pervasive and adverse developmental outcomes, such as depression and anxiety disorders, academic underachievement, and problems with employment (Aronen and Soininen 2000;Woodward and Fergusson 2001), externalizing problems in childhood increase the risk for aggression and substance use later in life (Maggs et al. 2008). ...
Previous studies have found discrepancies between parent and child reports of parental favoritism. Some studies have also found that these discrepancies have unique effects on children's psychosocial adjustment. Nonetheless, much is still unknown about discrepancies between parent-reports and child-reports of parental favoritism and how they are associated with children's development. The current study examines discrepancies in multi-informant reports on parental favoritism in relation to children's internalizing and externalizing problems. The sample consisted of 556 mother-child dyads and 554 father-child dyads (46% boys, Mage = 12.52 years, SDage = 1.18). Polynomial regression analyses and response surface analyses were used to disentangle the effects of parent-child discrepancies in perceived parental favoritism. The results indicate that children reported higher parental favoritism than their parents. And the highest internalizing and externalizing problems occurred when both the mother and the child reported high maternal favoritism, and when both the father and the child report high paternal favoritism. Therefore, these findings partly support the assumptions based on the operations triad model. The findings also highlight the importance of the discrepancy between child- and parent-reports on parental favoritism in the development of children's internalizing and externalizing problems.
... By demonstrating significantly more symptoms of depression and general psychopathology among the HR group with a large effect size, the data replicate earlier findings that children of depressed parents are at increased risk, not only for developing depression [5,77], but also internalising and externalising disorders more generally [78,79]. Participants who met diagnostic criteria for a psychiatric disorder following a clinical interview were excluded from the study. ...
Children of depressed parents are at heightened risk for developing depression, yet relatively little is known about the speciic mechanisms responsible. Since preventive interventions for this risk group show small efects which diminish overtime, it is crucial to uncover the key risk factors for depression. This study compared various potential mechanisms in children of depressed (high-risk; n = 74) versus non-depressed (low-risk; n = 37) parents and explored mediators of parental depression and risk in ofspring. A German sample of N = 111 boys and girls aged 8 to 17 years were compared regarding children’s (i) symptoms of depression and general psychopathology, (ii) emotion regulation strategies, (iii) attributional style, (iv) perceived parenting style and (v) life events. Children in the high-risk group showed signiicantly more symptoms of depres- sion and general psychopathology, less adaptive emotion regulation strategies, fewer positive life events and fewer positive parenting strategies in comparison with the low-risk group. Group diferences in positive and negative attributional style were small and not statistically signiicant in a MANOVA test. Maladaptive emotion regulation strategies and negative life events were identiied as partial mediators of the association between parental depression and children’s risk of depression. The study highlights the elevated risk of depression in children of depressed parents and provides empirical support for existing models of the mechanisms underlying transmission. Interestingly, the high-risk group was characterised by a lack of protective rather than increased vulnerability factors. These results are crucial for developing more efective preventive interventions for this high-risk population.
Introduction:
This study addresses the scarcity of research on the characteristics of young children's internalizing problems in Low and Middle-Income Countries (LMICs) through a systematic review of pre-pandemic literature. It aims to provide essential insights into understanding, preventing, and intervening in internalizing problems among young children. Additionally, it lays the groundwork for future studies to explore the effects of the pandemic on mental health in young children, including potential changes in the prevalence and nature of internalizing problems.
Methods:
The systematic review included thirty-one studies from LMIC studies published in English, Spanish, or Portuguese before March 2020 focusing on predictors, mediators, and characterizations of internalizing symptoms in preschoolers. The studies were classified by region to identify commonalities, interests, and differences.
Results:
The review revealed a significant disparity in research representation across regions, with the Americas being the most extensively studied and regions like the Eastern Mediterranean and Southeast Asia lacking adequate research. Validation of behavioral problem scales in LMICs was limited, posing challenges to accurate measurement. However, findings highlighted common risk factors such as maternal characteristics and environmental influences.
Conclusions:
Despite limitations, this review emphasizes the urgent need for comprehensive research on internalizing problems in preschoolers, particularly in LMICs. Broadening linguistic inclusion criteria and prioritizing validation efforts for behavioral problem scales are crucial steps towards addressing research gaps. Furthermore, highlighting common risk factors and patterns across regions underscores the importance of collaborative efforts to inform effective interventions and support child mental health globally.
Background:
Inhibitory control develops in early childhood, and atypical development may be a measurable marker of risk for the later development of psychosis. Additionally, inhibitory control may be a target for intervention.
Methods:
Behavioral performance on a developmentally appropriate Go/No-Go task including a frustration manipulation completed by children ages 3-5 years (early childhood; n = 107) was examined in relation to psychotic-like experiences (PLEs; 'tween'; ages 9-12), internalizing symptoms, and externalizing symptoms self-reported at long-term follow-up (pre-adolescence; ages 8-11). ERP N200 amplitude for a subset of these children (n = 34) with electrophysiological data during the task was examined as an index of inhibitory control.
Results:
Children with lower accuracy on No-Go trials compared to Go trials in early childhood (F(1,101) = 3.976, p = 0.049), evidenced higher PLEs at the transition to adolescence 4-9 years later, reflecting a specific deficit in inhibitory control. No association was observed with internalizing or externalizing symptoms. Decreased accuracy during the frustration manipulation predicted higher internalizing, F(2,202) = 5.618, p = 0.004, and externalizing symptoms, F(2,202) = 4.663, p = 0.010. Smaller N200 amplitudes were observed on No-Go trials for those with higher PLEs, F(1,101) = 6.075, p = 0.020; no relationship was observed for internalizing or externalizing symptoms.
Conclusions:
Long-term follow-up demonstrates for the first time a specific deficit in inhibitory control behaviorally and electrophysiology, for individuals who later report more PLEs. Decreases in task performance under frustration induction indicated risk for internalizing and externalizing symptoms. These findings suggest that pathophysiological mechanisms for psychosis are relevant and discriminable in early childhood, and further, suggest an identifiable and potentially modifiable target for early intervention.
Although internalizing problems are the most common forms of psychological distress among adolescents and young adults, they have precursors in multiple risk domains established during childhood. This study examined cascading risk pathways leading to depression and anxiety symptoms in emerging adulthood by integrating broad contextual (i.e., multiple contextual risks), parental (i.e., negative parenting), and child (i.e., internalizing behaviors) characteristics in early and middle childhood. We also compared common and differential pathways to depression and anxiety symptoms depending on the conceptualization of symptom outcomes (traditional symptom dimension vs. bifactor dimensional model). Participants were 235 children (109 girls) and their families. Data were collected at 3, 6, 10, and 19 years of child age, using multiple informants and contexts. Results from a symptom dimension approach indicated mediation pathways from early childhood risk factors to depression and anxiety symptoms in emerging adulthood, suggesting common and distinct risk processes between the two disorders. Results from a bifactor modeling approach indicated several indirect pathways leading to a general internalizing latent factor, but not to symptom-specific (i.e., depression, anxiety) latent factors. Our findings highlighted comparative analytic approaches to examining transactional processes associated with later internalizing symptoms and shed light on issues of early identification and prevention.
I examined whether maternal and/or paternal parenting stress predicted children's aggression and anxiety/depression, and whether this parenting stress interacted with children's self-regulation in the prediction of their aggression and anxiety/depression. Data were obtained from the 7th wave of longitudinal data of the Panel Study on Korean Children. Results of hierarchical multiple regression analysis demonstrate that both maternal and paternal parenting stress significantly and positively predicted children's aggression and anxiety/depression. In addition, the effects of maternal parenting stress on children's aggression and anxiety/depression were stronger for children with low (vs. high) self-regulation. My results show that the configuration of maternal parenting stress and children's selfregulation should be considered in the design of teachers' and parents' early supportive interventions for effective prevention of children's aggression and anxiety/depression.
Children experiencing internalizing problems (depression, anxiety, somatization) can have difficulty transitioning to preschool. Some research has shown that children who experience increased internalizing problems form negative relationships with their teachers. Other research has found that children who share more positive relationships with their teachers show fewer internalizing problems over time. The current study tests three conceptual models of the directional associations between children’s internalizing problems and teacher–child relationship quality across the preschool year: relationship-driven, child-driven, and transactional models. Participants included 443 ethnically diverse, low-income preschool children (47.9% girls, Mage = 4.08 years, SD = .34 years) who were assessed in the fall and spring of preschool. Children’s internalizing problems were rated by teachers using the Behavior Assessment System for Children II. The teacher–child relationship was rated by teachers using the Student–Teacher Relationship Scale and observers using the Individualized Classroom Assessment Scoring System. Results supported the child-driven model; internalizing problems in the fall of preschool predicted more teacher–child dependency and a less positive teacher–child relationship by spring of preschool. Findings suggest that children who enter preschool as more sad or anxious are perceived to interact less positively with teachers across the preschool year.
A well-organized free time at children and youth can prevent or ease the occurence of serious behavioural disoders and ensure a quality use of free time. The aim of the research is to examine if a well-organized free time has impact on the occurence of internalised and externalised disorders. The research starts with the assumption that students whose free time is organized have less intensity of exposure of some types of internalised and externalised behavioural disorders. The sample consists of 230 primary and secondary school finishing class students, both sex, aged 14-19 years old. The research was conducted at the area of the city of Tuzla. The Scale of self assessment of the youth was used in the research. The results show that students who do not spend a well-organized free time expose the following types of internalised and externalised disorders: anxiety, somatic issues without a clear medical cause, violation of rules at home and school.
Background:
Despite being necessary to delay the spread of COVID-19, home confinement could have affected the emotional well-being of children and adolescents. Knowing which variables are involved in anxiety and depressive symptoms could help to prevent young people's psychological problems related to lockdown as early as possible. This cross-sectional study aims to examine anxiety and depressive symptomatology in Italian, Spanish, and Portuguese children and adolescents in order to determine which variables are related to poorer well-being during the pandemic.
Method:
The parents of 515 children, aged 3-18 years old, completed an online survey. Children's anxiety symptoms were assessed using the Spence Children's Anxiety Scale-Parent Version, and depressive symptoms were measured with the Short Mood and Feelings Questionnaire-Parent Version.
Results:
We found differences in anxiety and depression between countries, with higher anxiety scores in Spanish children, and higher depression scores in Spanish and Italian children compared to the Portuguese. Anxiety and depressive symptoms were more likely in children whose parents reported higher levels of stress.
Conclusions:
These findings are discussed in the light of detecting and supporting affected children as early as possible.
Background: Internalising problems, such as depression and anxiety, are common and represent an important economical and societal burden. The effectiveness of parenting interventions in reducing risk of internalising problems in children and adolescents has not yet been summarised. The aims of this review are to assess the effectiveness of parenting interventions in the primary, secondary and tertiary prevention of internalising problems in children and adolescents and to determine which intervention components and which intervention aspects are most effective for reducing risk of internalising problems in children and adolescents.
Methods: Electronic searches in OVID SP versions of Medline, EMBASE and PsycINFO; Cochrane Central Register of Controlled Trials; EBSCO version of ERIC and clinicaltrials.gov have been performed to identify randomised controlled trials or quasi-randomised controlled trials of parenting interventions. At least two independent researchers will assess studies for inclusion and extract data from each paper. The risk of bias assessment will be conducted independently by two reviewers using the Cochrane Collaboration’s Risk of Bias Assessment Tool. Statistical heterogeneity is anticipated given potential variation in participant characteristics, intervention type and mode of delivery, and outcome measures. Random effects models, assuming a common between-study variability, will be used to account for statistical heterogeneity. Results will be analysed using a network meta-analysis (NMA). If appropriate, we will also conduct a component-level NMA, where the ‘active ingredients’ of interventions are modelled using a network meta-regression approach.
Discussion: Preventing and reducing internalising problems could have major beneficial effects at the economic and societal level. Informing policy makers on the effectiveness of parenting interventions and on which intervention’s component is driving the effect is important for the development of treatment strategies.
Systematic review registration: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42020172251
Background: Internalising problems, such as depression and anxiety, are common and represent an important economical and societal burden. The effectiveness of parenting interventions in reducing risk of internalising problems in children and adolescents has not yet been summarised. The aims of this review are to assess the effectiveness of parenting interventions in the primary, secondary and tertiary prevention of internalising problems in children and adolescents and to determine which intervention components and which intervention aspects are most effective for reducing risk of internalising problems in children and adolescents.
Methods: Electronic searches in OVID SP versions of Medline, EMBASE and PsycINFO; Cochrane Central Register of Controlled Trials; EBSCO version of ERIC and clinicaltrials.gov have been performed to identify randomised controlled trials or quasi-randomised controlled trials of parenting interventions. At least two independent researchers will assess studies for inclusion and extract data from each paper. The risk of bias assessment will be conducted independently by two reviewers using the Cochrane Collaboration’s Risk of Bias Assessment Tool. Statistical heterogeneity is anticipated given potential variation in participant characteristics, intervention type and mode of delivery, and outcome measures. Random effects models, assuming a common between-study variability, will be used to account for statistical heterogeneity. Results will be analysed using a network meta-analysis (NMA). If appropriate, we will also conduct a component-level NMA, where the ‘active ingredients’ of interventions are modelled using a network meta-regression approach.
Discussion: Preventing and reducing internalising problems could have major beneficial effects at the economic and societal level. Informing policy makers on the effectiveness of parenting interventions and on which intervention’s component is driving the effect is important for the development of treatment strategies.
Systematic review registration: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42020172251
The purpose of this study was to examine the hypothesis that child sex moderates the association between prenatal cocaine exposure (PCE) and autonomic functioning as well as to examine the role that caregiving environmental risk played in sex differences in autonomic functioning among exposed children. Measures of the parasympathetic nervous system (indexed by respiratory sinus arrhythmia [RSA]) and the sympathetic nervous system (indexed by skin conductance level [SCL]) were obtained from 146 (75 cocaine-exposed, 38 male; and 71 nonexposed, 36 male) children during baseline and a task designed to elicit negative affect (NA). We also examined the role of caregiving environmental risk as a moderator of the association between PCE and autonomic functioning separately for boys and girls. PCE boys had a significantly higher baseline RSA and lower baseline SCL than PCE girls or nonexposed children. Environmental risk also moderated the association between PCE and baseline RSA for boys, but not girls, such that boys with PCE and high environmental risk had the highest baseline RSA. These findings indicate that exposed boys had significantly lower levels of sympathetic activation while at rest. However, for autonomic reactivity, the exposed girls had a larger change in both RSA and SCL relative to nonexposed girls while exposed boys had significantly smaller increases in SCL during environmental challenge. Finally, girls with both PCE and high environmental risk had the highest levels of parasympathetic reactivity during challenge. These results underscore the importance of examining sex differences and considering comorbid environmental risk factors when examining developmental outcomes in cocaine-exposed children and highlight the complexity involved with understanding individual differences in cocaine-exposed populations.
The specificity of various child characteristics and environmental correlates of childhood internalizing and externalizing problems was examined using both cross-sectional and longitudinal analyses (from ages 2–3 and 4–5 years) in a general population sample of 10–11-year-olds. Specificity was defined according to a between-subjects and a within-subjects method, using parent and teacher reports of psychopathology. Temperamental withdrawal, parental internalizing psychopathology, and early single parenthood (for girls) were identified as correlates that are specific for internalizing problems, whereas temperamental high general activity level was identified as externalizing-specific. Further, parenting stress, poor school results (only for boys), and stressful life events (only for girls) were found to be common correlates of psychopathology. Research implications regarding the findings and the use of a within-subjects method are discussed.
Mental health data were gathered at ages 11, 13, 15, 18, and 21 in an epidemiological sample using standardized diagnostic assessments. Prevalence of Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised; American Psychiatric Association, 1987) mental disorders increased longitudinally from late childhood (18%) through mid- (22%) to late-adolescence (41%) and young adulthood (40%). Nearly half of age-21 cases had comorbid diagnoses; and comorbidity was associated with severity of impairment. The incidence of cases with adult onset was only 10.6%: 73.8% of adults diagnosed at age 21 had a developmental history of mental disorder. Relative to new cases, those with developmental histories were more severely impaired and more likely to have comorbid diagnoses. The high prevalence rate and significant impairment associated with a diagnosis of mental disorder suggests that treatment resources need to target the young adult sector of the population. The low new-case incidence in young adulthood, however, suggests that primary prevention and etiological research efforts need to target children and adolescents.
This article reviews the various literatures on the adjustment of children of depressed parents, difficulties in parenting and parent–child interaction in these families, and contextual factors that may play a role in child adjustment and parent depression. First, issues arising from the recurrent, episodic, heterogeneous nature of depression are discussed. Second, studies on the adjustment of children with a depressed parent are summarized. Early studies that used depressed parents as controls for schizophrenic parents found equivalent risk for child disturbance. Subsequent studies using better-defined samples of depressed parents found that these children were at risk for a full range of adjustment problems and at specific risk for clinical depression. Third, the parenting difficulties of depressed parents are described and explanatory models of child adjustment problems are outlined. Contextual factors, particularly marital distress, remain viable alternative explanations for both child and parenting problems. Fourth, important gaps in the literature are identified, and a consistent, if unintentional, “mother-bashing” quality in the existing literature is noted. Given the limitations in knowledge, large-scale, long-term, longitudinal studies would be premature at this time.
A 5-year longitudinal study investigated the interrelationships among children's experiences of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 years. Depressed children consistently showed helpless behaviors in social and achievement settings.
Young children develop social and emotional competence through interactions with others in the two major contexts in which they spend time: home and preschool. This study examined whether parenting stress in the home context is related to the children's behaviour while in preschool. Previous research has suggested that parenting stress negatively influences parenting behaviour, which in turn has been shown to impact children's development. This study examined the direct relationship between parenting stress and children's behaviour in two types of preschool programmes: private day care centres and Head Start. Parenting stress was significantly related to teacher ratings of social competence, internalizing behaviours, and externalizing behaviours, and the effects of parenting behaviour do not appear to mediate this relationship. Parenting stress was most strongly related to children's social competence. Parents' reports of expectations for their child's behaviour appear to weakly moderate the relationship between externalizing behaviour and parenting stress. This study suggests that examination of a parent's level of stress, in addition to parenting practices, may be important in research and interventions with preschool children's behaviour and social competence. Copyright © 2005 John Wiley & Sons, Ltd.
Background
There have been only a few previous population-based studies of symptoms of depression in young children. There are no previous population-based studies which examine the factors which might be causally associated with depression in very young children.
Methods
Data are from a cohort study of pregnant women who gave birth to a live singleton baby in a large public hospital in Brisbane, Australia. The Mater-University of Queensland Study of Pregnancy (MUSP) involves a 5-year follow-up, with mothers completing a short form of the Child Behaviour Checklist (CBCL) describing the mental health of their child. Five groups of variables (socio-demographic, pre- and perinatal, maternal mental health, maternal lifestyle and maternal attitude to the child) were used to predict CBCL depression scores at the 5-year follow-up.
Results
There are many factors associated with maternal reports of symptoms of depression in 5-year-old children. These include marital partner changes, mothers health problems in pregnancy, child health over the first 6 months of life, maternal anxiety and marital satisfaction early in the childs development and the mothers attitude towards caregiving. A multiple risk factor model indicates higher rates of depression for children experiencing multiple exposures to risk. While a number of exposures are associated with increased risk, many of those children perceived to be depressed appear to lack any measured exposures.
Conclusion
Many children as young as 5 years of age are observed to experience multiple symptoms of depression. The majority of children exposed to high levels of risk do not appear to become depressed; they appear to be resilient. The majority of children who experience multiple symptoms of depression appear to lack any known exposures to risk.
Based on the results of previous research, multiple factors in several domains (individual attributes of the adolescent, family attributes, and extrafamilial factors) were identified as possible risk and protective factors for development of problem behavior during adolescence. The first aim of this study was to examine the relative importance of these factors for the development of externalizing and internalizing problems. In addition to examining the role of particular risk and protective factors, we also tested the hypothesis that risk and protection have a cumulative effect. The results show that the individual attributes of the adolescent play an important role, both as a risk and as a protection, for the development of internalizing problems, but they appear to be of less importance for the development of externalizing problems. The family attributes (support, monitoring, and attachment) seem to be important for both types of problem behavior. Finally, the relationship with peers (especially the association with deviant peers) has both a risk and a protective effect for the development of problem behavior. When index of the number of risk and protective factor is used, it appears that the amount of risk has a stronger relation to variation in problem behavior than protection. Finally, in this sample, no evidence was found for the moderating effect of the protective factors.
The cross-cultural validity of the Child Behavior Checklist for Ages 2-3 (CBCL/2-3) was tested in three Dutch samples of children referred to mental health services, from the general population, and from a twin study. Six scales were derived from factor analyses and labeled Oppositional, Aggressive, and Overactive, which constituted a broadband Externalizing grouping; Withdrawn/Depressed and Anxious, which constituted a broadband Internalizing grouping; and Sleep Problems. Internal consistencies of the scales, their test-retest reliabilities, interparent agreement, discriminative power, predictive relations with problem ratings 2 years later, and relations to other instruments designed to measure general development and behavior problems were adequate, and highly comparable to psychometric properties in American samples. It was concluded that across languages and cultures behavioral/emotional problems of young preschoolers may be adequately assessed with the CBCL/2-3.
The specificity of various child characteristics and environmental correlates of childhood internalizing and externalizing problems was examined using both cross-sectional and longitudinal analyses (from ages 2-3 and 4-5 years) in a general population sample of 10-11-year-olds. Specificity was defined according to a between-subjects and a within-subjects method, using parent and teacher reports of psychopathology. Temperamental withdrawal, parental internalizing psychopathology, and early single parenthood (for girls) were identified as correlates that are specific for internalizing problems, whereas temperamental high general activity level was identified as externalizing-specific. Further, parenting stress, poor school results (only for boys), and stressful life events (only for girls) were found to be common correlates of psychopathology. Research implications regarding the findings and the use of a within-subjects method are discussed.
To examine a wide range of parent- and teacher-reported behaviors in relation to child-reported depression and anxiety in preadolescence.
Subjects were participants in a longitudinal study of 420 preschool children from the general population that started in 1989. At second follow-up 8 years later (ages 10-11 years), usable parent information was obtained for 358 children. For this study, 274 children for whom complete child, parent, and teacher reports were obtained at age 10 to 11 years were included. Measures included the Dimensions of Depression Profile for Children, the State-Trait Anxiety Inventory for Children, the Child Behavior Checklist/4-18, and the Teacher's Report Form.
Of 120 parent-reported problem items, only 11 and 9 were associated with child-reported depression and anxiety, respectively. For teachers, 33 and 20 items (of 120) were significantly associated with child-reported depression and anxiety, respectively, including items referring to withdrawal, anxiety, depression, social problems, and academic problems.
Teachers are more likely than parents to notice internalizing problems and related problems such as social and academic problems in children reporting depression or anxiety.
This longitudinal community study assessed the prevalence and development of psychiatric disorders from age 9 through 16 years and examined homotypic and heterotypic continuity.
A representative population sample of 1420 children aged 9 to 13 years at intake were assessed annually for DSM-IV disorders until age 16 years.
Although 3-month prevalence of any disorder averaged 13.3% (95% confidence interval [CI], 11.7%-15.0%), during the study period 36.7% of participants (31% of girls and 42% of boys) had at least 1 psychiatric disorder. Some disorders (social anxiety, panic, depression, and substance abuse) increased in prevalence, whereas others, including separation anxiety disorder and attention-deficit/hyperactivity disorder (ADHD), decreased. Lagged analyses showed that children with a history of psychiatric disorder were 3 times more likely than those with no previous disorder to have a diagnosis at any subsequent wave (odds ratio, 3.7; 95% CI, 2.9-4.9; P<.001). Risk from a previous diagnosis was high among both girls and boys, but it was significantly higher among girls. Continuity of the same disorder (homotypic) was significant for all disorders except specific phobias. Continuity from one diagnosis to another (heterotypic) was significant from depression to anxiety and anxiety to depression, from ADHD to oppositional defiant disorder, and from anxiety and conduct disorder to substance abuse. Almost all the heterotypic continuity was seen in girls.
The risk of having at least 1 psychiatric disorder by age 16 years is much higher than point estimates would suggest. Concurrent comorbidity and homotypic and heterotypic continuity are more marked in girls than in boys.
There have been only a few previous population-based studies of symptoms of depression in young children. There are no previous population-based studies which examine the factors which might be casually associated with depression in very young children.
Data are from a cohort study of pregnant women who gave birth to a live singleton baby in a large public hospital in Brisbane, Australia. The Mater-University of Queensland Study of Pregnancy (MUSP) involves a 5-year follow-up, with mothers completing a short form of Child Behaviour Checklist (CBCL) describing the mental health of their child. Five groups of variables (socio-demographic, pre- and perinatal, maternal mental health, maternal lifestyle and maternal attitude to the child) were used to predict CBCL depression scores at the 5-year follow-up.
There are many factors associated with maternal reports of symptoms of depression in 5-year-old children. These include marital partner changes, mother's health problems in pregnancy, child health over the first six months of life, maternal anxiety and marital satisfaction early in the child's development and the mother's attitude towards caregiving. A multiple risk factor model indicates higher rates of depression for children experiencing multiple exposures to risk. While a number of exposures are associated with increased risk, many of those children perceived to be depressed appear to lack any measured exposures.
Many children as young as 5 years of age are observed to experience multiple symptoms of depression. The majority of children exposed to high levels of risk do not appear to become depressed; they appear to be resilient. The majority of children who experience multiple symptoms of depression appear to lack any known exposures to risk.
Childhood temperament and family environment have been shown to predict internalizing and externalizing behavior; however, less is known about how temperament and family environment interact to predict changes in problem behavior. We conducted latent growth curve modeling on a sample assessed at ages 5, 7, 10, 14, and 17 (N = 337). Externalizing behavior decreased over time for both sexes, and internalizing behavior increased over time for girls only. Two childhood variables (fear/shyness and maternal depression) predicted boys' and girls' age-17 internalizing behavior, harsh discipline uniquely predicted boys' age-17 internalizing behavior, and maternal depression and lower family income uniquely predicted increases in girls' internalizing behavior. For externalizing behavior, an array of temperament, family environment, and Temperament x Family Environment variables predicted age-17 behavior for both sexes. Sex differences were present in the prediction of externalizing slopes, with maternal depression predicting increases in boys' externalizing behavior only when impulsivity was low, and harsh discipline predicting increases in girls' externalizing behavior only when impulsivity was high or when fear/shyness was low.
We investigated the links between familial loading, preadolescent temperament, and internalizing and externalizing problems in adolescence, hereby distinguishing effects on maladjustment in general versus dimension-specific effects on either internalizing or externalizing problems.
In a population-based sample of 2230 preadolescents (10-11 years) familial loading (parental lifetime psychopathology) and offspring temperament were assessed at baseline by parent report, and offspring psychopathology at 2.5-years follow-up by self-report, teacher report and parent report. We used purified measures of temperament and psychopathology and partialled out shared variance between internalizing and externalizing problems.
Familial loading of internalizing psychopathology predicted offspring internalizing but not externalizing problems, whereas familial loading of externalizing psychopathology predicted offspring externalizing but not internalizing problems. Both familial loadings were associated with Frustration, low Effortful Control, and Fear. Frustration acted as a general risk factor predicting severity of maladjustment; low Effortful Control and Fear acted as dimension-specific risk factors that predicted a particular type of psychopathology; whereas Shyness, High-Intensity Pleasure, and Affiliation acted as direction markers that steered the conditional probability of internalizing versus externalizing problems, in the event of maladjustment. Temperament traits mediated one-third of the association between familial loading and psychopathology. Findings were robust across different composite measures of psychopathology, and applied to girls as well as boys.
With regard to familial loading and temperament, it is important to distinguish general risk factors (Frustration) from dimension-specific risk factors (familial loadings, Effortful Control, Fear), and direction markers that act as pathoplastic factors (Shyness, High-Intensity Pleasure, Affiliation) from both types of risk factors. About one-third of familial loading effects on psychopathology in early adolescence are mediated by temperament.
Two mechanisms of the hypothesized social causation of psychopathology--differential incidence and cumulative prevalence--were tested over 9 years in a nationally representative sample of 1,075 children and youths, ages 8-17 at Time 1 (1986). Analyses using parental responses on behavior checklists at 4 time points showed significant increases in clinical elevations for those of the lowest socioeconomic status (SES) on anxious/depressed, somatic complaints, thought problems, delinquent, and aggressive syndromes. This SES-linked differential incidence supports the social causation hypothesis that factors associated with SES contribute to variations in levels of psychological problems. SES-linked differential cumulative prevalence was found for withdrawn and somatic complaints; this finding indicates that low-SES cases do not improve as much as do middle- and high-SES cases, which results in greater accumulation of low-SES cases.
In 2 longitudinal studies of negative life events and depressive symptoms in adolescents (N = 708) and in children (N = 508), latent trait-state-error structural equation models tested both the stress generation hypothesis and the stress exposure hypothesis. Results strongly suggested that self-reports of depressive symptoms reflect the influence of a perfectly stable trait factor as well as a less stable state factor. Support emerged for both the stress generation model and the stress exposure model. When the state depression factor was modeled as predicting stress, support for the stress generation model appeared to increase with age. When the trait depression factor was modeled as the predictor of stress, support for the stress generation model did not vary with the child's age. In both models, support for the stress exposure remained relatively constant across age.
A three-wave longitudinal study design with two 6-month intervals was used to examine the stability and change in Internalizing, Externalizing, and Total Problem behavior among children and adolescents referred to outpatient mental health services. Our results indicated high stabilities for parent ratings of child psychopathology across a 1-year interval. Additionally, we found decreases in the level of problem behavior. Interindividual differences in change were found for Total Problems and Externalizing behavior but not for Internalizing. While both the child's temperament and intelligence level and family relations were related to the initial level of parent-rated problem behavior, only intermediary stressful life events had an influence on the rate of change of child psychopathology.
The current investigation examined the role of cumulative risk, family routines, maternal monitoring, mother-child relationship quality, and youth socioemotional competence in adjustment outcomes of 521 10- to 14-year-old low-income Latino early adolescents. Results showed that, as the number of risk factors increased, levels of externalizing and internalizing problems also increased. Furthermore, findings indicated that socio-emotional competence was predictive of fewer externalizing and internalizing problems for females independent of the level of cumulative risk. Maintenance of family routines protected females exposed to elevated levels of cumulative risk from heightened levels of externalizing problems. Despite exposure to multiple risk factors, boys high in socio-emotional competence and those boys reporting a good quality mother-son relationship were protected from elevated levels of adjustment problems. Results underscore the importance of examining within-group variability among young Latino adolescents.
Using data from Wave 1 (n = 5,070) and Wave 2 (n = 4,404) of the National Longitudinal Study of Adolescent Health, we examined the relationship between cumulative risk exposure and youth problem behavior. Cross-sectional analyses revealed a positive, linear association between cumulative risk and problem behaviors. The association between cumulative risk and externalizing problems was stronger for White youth than for Black youth. The association between cumulative risk and internalizing problems was stronger for girls than for boys, and stronger for White youth than for Black and Hispanic youth. Cumulative risk predicted change over time in internalizing problems. Findings support the theoretical notion that adolescents experience diminished psychological comfort when risk factors are present across several social domains.
Despite increasing interest in the effects of parenting stress on children and families, many questions remain regarding the nature of parenting stress and the mechanism through which stress exerts its influence across time. In this study, cumulative parenting stress was assessed across the preschool period in a sample of 125 typically developing children and their mothers. Indices of parenting stress included both major life events stress-assessed annually from age 3 to 5, and parenting daily hassles assessed every 6 months across the same period. Naturalistic home observations were conducted when children were age 5, during which measures of parent and child interactive behaviour as well as dyadic pleasure and dyadic conflict were obtained. Mothers also completed the CBCL to assess children's behaviour problems. Results indicated that parenting daily hassles and major life stress are relatively stable across the preschool period. Both cumulative stress indices also proved to be important predictors of parent and child behaviour and dyadic interaction, although the predictions were somewhat differential. Despite meaningful relations between the stress factors and child well being, no evidence was found to support the premise that parent behaviour mediates the association between parenting stress and child outcomes. Results are discussed within a developmental framework to understand the stability and complexity of cumulative stress associations to early parent–child relationships. Copyright © 2005 John Wiley & Sons, Ltd.
Parasite communities are arranged into hierarchical levels of organization, covering various spatial and temporal scales. These range from all parasites within an individual host to all parasites exploiting a host species across its geographic range. This arrangement provides an opportunity for the study of patterns and structuring processes operating at different scales. Across the parasite faunas of various host species, several species-area relationships have been published, emphasizing the key role of factors such as host size or host geographical range in determining parasite species richness. When corrections are made for unequal sampling effort or phylogenetic influences, however, the strength of these relationships is greatly reduced, casting a doubt over their validity. Component parasite communities, or the parasites found in a host population, are subsets of the parasite fauna of the host species. They often form saturated communities, such that their richness is not always a reflection of t
A 5-year longitudinal study investigated the interrelationships among children's experiences of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 years. Depressed children consistently showed helpless behaviors in social and achievement settings.
Young adolescents in the clinical range on internalizing, externalizing, and both internalizing and externalizing behavior problems, as well as youth in the normal range on both types of problems, were identified separately using adolescents' self-reports and mothers' reports of behavior problems. In comparisons of groups identified on the basis of either type of informant, differences among the four groups were found in adolescents' self-perceptions of competence and in their fathers' psychological symptoms. Specifically, normals reported a more positive sense of their social acceptance and their behavioral conduct than all clinical groups, and fathers of adolescents in the clinical range on both internalizing and externalizing problems tended to report more psychological symptoms than the fathers of the normal group. Differences were found in mothers' psychological symptoms only when mothers' reports of adolescents' behavior problems were used to identify the groups. No consistent differences among the groups were found on adolescents' causal attributions for success and failure.
This article reviews the various literatures on the adjustment of children of depressed parents, difficulties in parenting and parent-child interaction in these families, and contextual factors that may play a role in child adjustment and parent depression. First, issues arising from the recurrent, episodic, heterogeneous nature of depression are discussed. Second, studies on the adjustment of children with a depressed parent are summarized. Early studies that used depressed parents as controls for schizophrenic parents found equivalent risk for child disturbance. Subsequent studies using better-defined samples of depressed parents found that these children were at risk for a full range of adjustment problems and at specific risk for clinical depression. Third, the parenting difficulties of depressed parents are described and explanatory models of child adjustment problems are outlined. Contextual factors, particularly marital distress, remain viable alternative explanations for both child and parenting problems. Fourth, important gaps in the literature are identified, and a consistent, if unintentional, "mother-bashing" quality in the existing literature is noted. Given the limitations in knowledge, large-scale, long-term, longitudinal studies would be premature at this time.