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Behavioral assessment is an area receiving ever increasing attention. In the present manuscript an attempt is made to expand the ways in which one problem area frequently addressed by behavior therapists, phobias, is assessed and evaluated. A number of overt behaviors and self reports of fear by a very young girl are described in a naturalistic setting and the implications of these data are presented.
OBJECTIVE: To test to what extent demographic variables and parent-reported problems and competencies in early adolescence predict incidence of mental health service use across a 5-year period in the general population. METHOD: Data on parent-reported problem behavior (Child Behavior Checklist [CBCL]), gathered on 2,496 Dutch young adolescents, aged 10 to 12 years in 1989-1990, were linked to psychiatric case register data over the years 1990-1994. Cox proportional hazards models were used to predict the incidence of using mental health services from problem behavior, competencies, and demographic covariates. RESULTS: Almost all CBCL problem scales predicted the incidence of mental health service use significantly. The effect was constant over time for most scales, but it decreased over time for others. CBCL Activities, gender, and one-parent family were significant predictors after accounting for the problem levels. All effects were similar for boys and girls. CONCLUSIONS: In many cases, there is a remarkable delay between the awareness of the adolescent's problems and seeking and/or receiving professional help. Longitudinal studies that use continuous information on service use yield a more comprehensive picture of the utilization of mental health services than studies that aggregate the information over the follow-up period.
This study was concerned with the effects of child controllability on adult assertiveness, as moderated by adult control perceptions. 4 boys (aged 7--9), trained to be responsive or unresponsive, interacted in adult-child dyads on a toy construction task with 32 women. As predicted, adult locus of control moderated the effects of child behavior. Child unresponsiveness produced an effect on adult behavior only among adults with low control perceptions ("externals"). With unresponsive children, external adults had relatively less assertive voice intonation during their statements of verbal approval and disapproval than during neutral statements (typically consisting of task directions). This pattern replicated previous observation of the communication of mothers with their own unresponsive children. For all other adult-child groupings, voice assertion was higher during affective messages than during neutral messages.
The family is the most central and enduring influence on children. Families, regardless of their composition, are themselves subject to a variety of social forces that influence how well they are able to meet children's needs. Pediatricians who understand the functions families serve and the factors that constrain them will be better able to assist parents in promoting their children's health and well-being.
PURPOSE: The purpose of this study was to evaluate the effectiveness of 2 behavior rating scales (1 describing child behavior and the other describing parent behavior) in predicting child behavior during dental treatment. METHODS: Participants consisted of 52 children, ages 3 to 12 years, and their parents. Parents completed the Eyberg Child Behavior Inventory and the Parent-Child Relationship Inventory while children received restorative dental treatment. Disruptive behavior was observed and coded. Dentists also provided subjective Frankl ratings of child behavior. RESULTS: Correlational analyses confirmed that age was the single best and only independent predictor of disruptive behavior in children during a restorative dental visit. However, a backward multiple regression demonstrated that the Support Scale and Limit Setting Scale of the Parent-Child Relationship Inventory were significant predictors of child disruptive behavior, but only when both scales were in the regression analysis. The Frankl ratings also significantly predicted observed disruptive behavior, supporting the construct validity of both the objective and subjective measures of problem behavior. CONCLUSIONS: Child age and parent reports of the parent-child relationship predicted child disruptiveness in the dental clinic, while parent reports of child behavior alone did not.
Risk and promotive effects were investigated as predictors of persistent serious delinquency in male participants of the Pittsburgh Youth Study (R. Loeber, D. P. Farrington, M. Stouthamer-Loeber, & W. B. van Kammen, 1998), living in different neighborhoods. Participants were studied over ages 13-19 years for the oldest sample and 7-13 years for the youngest sample. Risk and promotive effects were studied in 6 domains: child behavior, child attitudes, school and leisure activities, peer behaviors, family functioning, and demographics. Regression models improved when promotive effects were included with risk effects in predicting persistent serious delinquency. Disadvantaged neighborhoods, compared with better neighborhoods, had a higher prevalence of risk effects and a lower prevalence of promotive effects. However, predictive relations between risk and promotive effects and persistent serious delinquency were linear and similar across neighborhood socioeconomic status.
BACKGROUND: The purpose of this study was to examine psychological predictors of postoperative sleep in children undergoing outpatient surgery. METHODS: We used hierarchical multivariate regression to examine the impact of demographic and personality variables such as parental worry/anxiety [NEO-personality inventory, revised (NEO-PI-R) Neuroticism], parental coping style (Miller Behavioral Style Scale), children's aggressive behavior [child behavior checklist (CBCL) externalizing], and children's temperament (emotionality, activity, sociability, and impulsivity) on postoperative sleep in 52 consecutive, healthy, children undergoing outpatient surgery. Sleep was assessed using actigraphy, a valid, reliable and objective measure of sleep quality. All perioperative protocols were strictly controlled and standardized. RESULTS: We found that 22% of the children experienced difficulty with postoperative sleep as defined by actigraphy. A hierarchical multiple regression model that was constructed to identify predictors of postoperative sleep efficiency in children accounted for 82% of the variance (R = 0.906, F = 19.42, P = 0.0001). Significant predictors in this model included preoperative sleep patterns (60%), postoperative pain (8.2%), parental anxiety/worry (NEO-PI-R Neuroticism scale; 9%), and children's aggressive behavior (CBCL externalizing; 5%). CONCLUSIONS: We conclude that psychological factors such as parental anxiety/worry and children's aggressive behavior are predictive of children's postoperative sleep above and beyond the influence of preoperative sleep patterns and postoperative pain.
The Child Behavior Checklist for Ages 2-3 (Adelbach et al., J. Abnorm. Child Psychol. 15;629-650; 1987) was completed by mothers of 229 pairs of twins (mean age = 33 months). Using the two broad-band groupings of Internalizing and Externalizing described by Achenbach et al. (1987), various models to estimate genetic and environmental parameters were fitted using LISREL 7. Model-fitting results showed that the genetic components to the observed phenotypical variation were small and not necessary in the model. Influences from the shared environment, however, could not be dropped from the model without a deterioration in fit. Parameter estimates were not significantly different in boys and girls.
Behavioral modification psychotherapies, largely diffused in the anglo-saxon countries, are used here for treating severely autistic children, hospitalized in a child psychiatry service for at least one year. Using Kanner's clinical study on childhood autism, the same syndrome is being described in behavioral terms. This new approach is the basis for the therapeutic project, both on practical and theoretical grounds. To illustrate the method and its application, three observations of children hospitalized between 1976 and 1977 are presented. The results are summarized and discussed (Acta psychiat. belg., 1977, 77, 549-586).
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The social interactions of depressed and nondepressed mothers and their preschool-age children were observed and mothers' perceptions of child behavior assessed. Depressed mothers, as a group, exhibited more negative behavior than controls; however, no differences were found for maternal positive behavior or contingent responding. There was a high degree of reciprocity between child and mother behavior in both groups and there was a trend for children of the depressed mothers to be more negative than the control children. The results with cognitive measures were consistent with depressive realism in perception of social interactions: Depressed mothers recalled more negative child behavior than nondepressed mothers; however, these perceptions paralleled the observed interactions. Overall, the results suggest that maternal depression is associated with negative parent-child interactions and more negative, albeit fairly accurate, perceptions of child behavior.
Effects of a comprehensive early intervention program for low birth weight, premature infants--the Infant Health and Development Program--on mother-child interaction were examined at 30 months (N = 683). Small significant positive effects were found: Intervention mothers had higher ratings on quality of assistance; intervention children had higher ratings on persistence and enthusiasm and on an overall child rating of competence and involvement and lower ratings on percentage of time off-task; intervention dyads were rated as more synchronous. Of a set of initial status variables indexing biological and environmental risk, only 2 treatment interactions were found. Intervention group black children had higher ratings on enthusiasm and lower percentage of time off-task. Independent of treatment, maternal ethnicity and education were significant predictors of maternal and dyadic ratings, while ethnicity and birth weight predicted child ratings. Implications for early intervention and center-based care are discussed.
We report data on behaviour and possibly associated psychopathology in 24 children and adolescents between 9 and 22 years of age, with the childhood type of myotonic dystrophy. The patients were recruited through a patients association, as family members from patients with myotonic dystrophy (DM). In 41% of the subjects a score in the clinical abnormal range was found on the Child Behavior Checklist (completed by parents and by teachers). In 62% of the subjects, a child psychiatric diagnosis was found using a standardised psychiatric interview. The most frequent child psychiatric diagnoses were Attention Deficit with Hyperactivity Disorder and Anxiety Disorder.
The purpose of this study was to examine the antecedents of child compliance and noncompliance. Both maternal and child behaviors served as predictors. Fifty-six clinic-referred children and their mothers served as subjects. Data were collected in the home setting by independent observers. Four multiple regression analyses were performed. The results indicated that the behavior immediately preceding child compliance or noncompliance typically was the best predictor. Furthermore, the antecedents for child compliance and noncompliance differed. For maternal antecedents, the type of command that served as the best predictor for child compliance and noncompliance differed; however, the final predictor equation was similar for the two types of child behaviors. For child antecedents, compliance was best predicted by compliance and noncompliance was best predicted by noncompliance. The results were discussed in terms of Patterson's coercion hypothesis.
BACKGROUND: Epidemiological data indicate that approximately 20% of children have psychosocial problems, yet less than 2% of children are seen by mental health specialists each year. Primary care physicians tend to identify children with psychosocial problems when parents discuss concerns with them. OBJECTIVE: To examine factors related to physicians' attention to parental disclosures. DESIGN: Parents reported the psychosocial functioning of themselves and their children. Physicians reported the psychosocial functioning of 75 children and whether the parent disclosed psychosocial concerns to them. SETTING: Ambulatory care clinic of a community-based, university-affiliated, residency training program. PARTICIPANTS: Seventy-five parents of children aged 2 to 16 years who presented for routine primary care, and 26 physicians. MAIN OUTCOME MEASURES: Beck Depression Inventory (parental distress), Eyberg Child Behavior Inventory (child behavior problems), physician and parent report. RESULTS: Physicians identified 50.0% of children with clinically significant behavior problems. Logistic regression indicated that parental disclosure was the only significant predictor of physician identification (P < .002). When children had clinically significant behavior problems, physicians were more likely to report disclosures by parents (45.0% vs 5.7% for parents of children with and without behavior problems, respectively). Physicians were more likely to report parental disclosure when parents reported personal psychosocial distress (38.9% for distressed vs 5.7% nondistressed parents). CONCLUSIONS: Parental disclosure of concerns was a better predictor of physician identification of child psychosocial problems than was the presence of child behavior problems. Physicians responded more frequently to the disclosures of potential problems by parents of children with clinically significant psychosocial problems. They also attended more frequently to disclosures about behavior problems when the parent was also experiencing psychosocial distress.
OBJECTIVE: Sexual behavior in children can cause uncertainty in the clinician because of the relationship between sexual abuse and sexual behavior. Consequently, it is important to understand normative childhood sexual behavior. DESIGN: Sexual behavior in 1114 2- to 12-year-old children was rated by primary female caregivers. These children were screened for the absence of sexual abuse. A 38-item scale assessing a broad range of sexual behavior (Child Sexual Behavior Inventory, Third Version) was administered along with the Child Behavior Checklist and a questionnaire assessing family stress, family sexuality, social maturity of the child, maternal attitudes regarding child sexuality, and hours in day care. RESULTS: Sexual behavior was related to the child's age, maternal education, family sexuality, family stress, family violence, and hours/week in day care. Frequencies of sexual behaviors for 2- to 5-, 6- to 9-, and 10- to 12-year-old boys and girls are presented. CONCLUSIONS: A broad range of sexual behaviors are exhibited by children who there is no reason to believe have been sexually abused. Their relative frequency is similar to two earlier studies, and this reinforces the validity of these results.
Feeding is one of many important ways that parents nurture their infants and children. When parents are overly concerned about feeding, they can exacerbate temporary feeding difficulties and misbehaviors by their inappropriate responses to the child's behavior. Child health supervision visits provide opportunities for the early detection of feeding problems, for education about early feeding experiences and typical child behavior at mealtimes, and for suggestions about the prevention of feeding problems. Handouts and printed materials can provide useful guidelines for introducing solid foods and for managing children's mealtime behavior. Early detection might reduce the likelihood that minor feeding disturbances will develop into severe feeding problems. Behavior management strategies and a pleasant social context for mealtimes can improve children's eating and mealtime behavior. Impairments in the parent-infant relationship may lead to serious feeding problems and referrals to appropriate support services are necessary. Prevention and early treatment of feeding problems can be facilitated by health education about early food experiences and the common developmental behaviors that occur as children grow and develop.
The behavior of children in 21 child abusive and 21 nonabusive matched comparison families were compared using home observations performed by professional independent observers and parental report measures (Becker Bipolar Adjective Checklist, Child Behavior Checklist, Parent Daily Report). Parental report measures of child conduct problems differed significantly between the two groups, independent observations showed few significant differences in rates of either child or parental behaviors. Results are discussed in terms of the validity of parental perceptions and reports of child problem behaviors, the informativeness of differing reports for diagnosis and clinical treatment, and the need to gather corroboration across various sources and settings before clinical decisions are made that may irrevocably alter a child's future development.