Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood mental health conditions. An ADHD diagnosis is associated with adverse near- and long-term outcomes such as academic difficulties, social deficits, and poor family relationships. Behavioral Parent Training (BPT) is a common evidence-based treatment for childhood ADHD associated with significant and large-magnitude improvements across multiple functional domains; however, nearly two-thirds of children exhibit persistent symptoms and impairment following treatment. Empirical evidence has established parents’ quality of BPT skill use as an important mechanism of BPT response, but less is known about the factors that predict parents’ skill use. The goal of the current study was to explore whether parental cognitive errors (i.e., distorted cognitions parents hold regarding their parenting and their child) and treatment engagement attitudes (i.e., how interesting and helpful parents find treatment) predict skill use quality. The current study comprised a secondary data analysis of a randomized control trial of the Child Life and Attention Skills (CLAS) program (N=199), a behavioral intervention for children with ADHD-Inattentive Presentation. First, an exploratory factor analysis was conducted to determine whether subdomains of cognitive errors exist within this population, and two factors were observed: parent behavior errors (i.e., distorted cognitions about parents’ own parenting behavior) and child behavior errors (i.e., distorted cognitions parents have regarding their child’s behavior). This two-factor structure was then utilized in mediation analyses to examine the effect of parent and child behavior errors on quality of skill use via treatment engagement attitudes. Results from these analyses demonstrated that parent behavior errors significantly predicted quality of skill use, such that parents with higher levels of parental behavior errors demonstrated lower quality skill use, but no evidence of mediation was observed. Finally, moderated mediation models explored the impact of parent psychopathology (i.e., parental ADHD and depression) on mediational relations and found no evidence of moderation. Findings suggest that targeting parental cognitive errors, particularly cognitions about parents’ own parenting behavior, may be a novel target to improve BPT skill use and child outcomes.

Disordered weight control behaviors (DWCB) are a pervasive and serious public health issue associated with a wide variety of psychological and physiological problems. Using the transdiagnostic cognitive behavioral model and an intersectional framework, this study uses latent class analysis to examine DWCB in a national longitudinal sample (N = 2,874) of late adolescents and emerging adults (19-22 years) with focus on gender and race/ethnicity. Three latent classes were identified cross-sectionally across all timepoints: A restriction behaviors group, a combined restriction and compensatory behaviors group, and a group exhibiting low DWCB. Women of all racial/ethnic groups were consistently more likely than were men to classify in the restriction behaviors class, and Black and Hispanic women were more likely to classify in the combined behaviors class in waves 6 and 7. Longitudinally, two classes were identified: A low stable and a higher stable class. Women of all racial/ethnic groups were more likely to classify in the high stable class compared with White men, however, no other racial/ethnic differences emerged. Hispanic men were more likely to classify in the high stable group. This study highlights the utility of transdiagnostic, intersectional, cross-sectional, and longitudinal approaches to studying DWCB in nonclinical populations. More work is needed to examine the influence of restriction and combined DWCB behaviors on adolescent and emerging adult development and functioning. In addition, this work underlines the need for more nuanced measurement of disordered eating pathology in national studies and epidemiological research. Finally, this study demonstrates the need for continual focus on intersectionality frameworks and the addition of cultural and identity-related variables in disordered eating research to promote wellbeing, health, and equity for all individuals.

Using data from a randomized, experimental trial of a brief family-based preventive intervention for parentally-bereaved families, this study evaluated whether participation in the Family Bereavement Program (FBP) when the offspring were in childhood/adolescence (ages 8 to 16) improved competencies when the offspring were emerging/young adults (ages 23 to 32). Participants were 244 emerging/young adults; data used were from assessments at pretest, posttest, 6 years post-intervention, and 15 years post-intervention. In addition to testing the direct effects of the program, developmental cascade effects models were used to test the relations between program-induced improvements in positive parenting and decreased negative life events at posttest and subsequent effects on domains of competence and behavior problems in adolescence/emerging adulthood (ages 14 to 22) and four developmental competencies of emerging/young adulthood: academic, peer, romantic, and work competence. Results supported a cascading effects model of program effects on competence outcomes. In the full sample, there were significant mediation effects of the intervention to decreased negative life events at posttest to increased grade-point average (GPA) at the 6-year follow-up to higher academic and work competence at the 15-year follow-up. For females only, two additional significant mediational pathways of the FBP occurred. The FBP led to an increase in peer competence 6 years post-intervention, which was associated with an increase in work competence 15 years post-intervention. Also, the FBP led to a decrease in externalizing problems in adolescence/emerging adulthood, but externalizing problems were positively associated with work competence. For males, additional mediation effects of the FBP on work competence occurred. The FBP decreased negative life events. However, higher negative life events were associated with lower externalizing problems in adolescence/emerging adulthood, and externalizing problems were positively associated with work competence. For males only, a significant three-pathway mediation effect of the intervention occurred on increased positive parenting at posttest to increased romantic attachment at the 6-year follow-up to higher romantic competence at the 15-year follow-up. Peer competence showed continuity over development. Mediational analyses highlighted the role of program-induced improvements in parenting, reductions in exposure to negative life events, and earlier developmental competencies on competence outcomes in emerging/young adulthood. Implications for promoting resilience in parentally-bereaved, at-risk youth are discussed.

Family disruption, or the separation of children from caregivers, has been well-established in prior literature as a risk factor for child maladjustment; however, little is known about how family disruption impacts youth into adulthood, particularly how it influences children’s later parenting of their own offspring. The present study examined whether cumulative family disruption (i.e., parental hospitalization, death, incarceration, divorce) in childhood exerts effects on children’s parenting of their own offspring in adulthood, beyond other demographic characteristics and risk factors. Further, several potential mechanisms were hypothesized to underlie the association between family disruption in the first and second generation (G1-G2) family and later parenting provided from second-generation (G2) adults to third-generation (G3) children. Mediators included conflict and disorganization in the G1-G2 family and dysregulation in the G2 child.

Participants (N = 236 in models that included multiple G2 siblings; N = 110 in models without siblings) were drawn from a larger sample of at-risk (i.e., alcoholic) and comparison families followed longitudinally for over 30 years and across three generations. Four mediation models were estimated to examine effects of two separate G1-G2 family disruption components (deviance-related and health-related disruption) on parenting of G3, mediated by family conflict, family disorganization, and G2 dysregulation. Results indicated that health-related disruption impairs consistency of parenting provided to G3 offspring through conflict in the G1-G2 family. A direct effect of health-related disruption was also seen on parental monitoring. There were no direct or mediated effects of deviance-related disruption on parenting. Implications and future directions will be discussed.

The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.

Anxiety is one of the most common psychiatric disorders among children yet characterized by lower use of mental health services. Preventive efforts have demonstrated promise in the ability to reduce anxiety symptoms. However, as evidence-based interventions move into real-world settings, there is a need to systematically examine potential implementation factors that may affect program outcomes. The current study investigates the relations between different aspects of implementation and their effect on outcomes of a school-based preventive intervention targeting anxiety symptoms. Specifically, the study examines: (1) the measurement of quality of delivery, (2) specific relations among implementation components, (3) relations between these facets and anxiety program outcomes. Implementation data were collected from nine school-based mental health staff and observer ratings. Program outcomes (pretest and immediate posttest) were measured from 59 participants and their parents (mostly mothers) in the intervention condition. Implementation components included adherence, quality of delivery, time spent, participant responsiveness, and perceived usefulness of program materials. Program outcomes included child-reported emotional expressivity, physiological hyperarousal, negative cognitions, social skills, self-efficacy, and child and parent reported levels of child anxiety. Study findings indicated that quality of delivery was best captured as two facets: skillful presentation and positive engagement. Adherence and quality of delivery were associated with greater participant responsiveness, although time spent was not. Significant relations were found between some implementation components and some program outcomes. Further efforts can be used to optimize the translation of evidence-based programs into real-world settings.

Although substantial research has examined individual, family, and peer factors that contribute to predicting adolescent alcohol use, limited attention has been devoted to the unique role of romantic partners and little consideration has been given to the potential importance of romantic relationship seriousness. Data from Waves I and II of the National Longitudinal Study of Adolescent Health (Add Health) were used to assess the relation between romantic relationship seriousness and binge drinking and drinking consequences one year later among 14-18 year-olds (n= 928 adolescents; 54.1% female). Main effects of relationship seriousness and moderating effects of adolescent age, partner age, adolescent age by partner age, parental alcoholism, and gender were examined separately for each drinking outcome using zero-inflated Poisson regression (ZIP) models. Relationship seriousness and study covariate interactions were also examined. ZIP models estimate (a) a logistic regression that distinguishes between individuals whose values can only be zero on the outcome (i.e., a structural zero class) and individuals with count values ranging from zero to any other positive integer (i.e., a non-structural zero class), and (b) a Poisson regression predicting count values among the non-structural zero class. Results showed trends towards significance for relations between relationship seriousness and binge drinking and drinking consequences among non-structural zero classes. As hypothesized, increased relationship seriousness predicted less frequent binge drinking and fewer drinking consequences. The relation between relationship seriousness and binge drinking was moderated by peer alcohol use; the negative relation between relationship seriousness and binge drinking frequency was significant among adolescents who reported 0-2, but not 3, close friends who drink. The relation between relationship seriousness and number of drinking consequences was moderated by gender, adolescent delinquency (covariate), peer alcohol use (covariate), and Wave I drinking consequences (control variable). Specifically, a significant relation between relationship seriousness and number of drinking consequences was revealed only for females and only for adolescents who reported high consequences at Wave I, and was significant among adolescents who reported 0-2 close friends who drink and low delinquency. Results indicate that relationship seriousness can protect adolescents in terms of drinking outcomes, which could have implications for prevention efforts.

ABSTRACT

This cross-sectional study examined whether the temperament dimensions of negative emotionality, positive emotionality, and impulsivity moderated the relation between interparental conflict and children’s internalizing and externalizing problems. The sample consisted of 355 divorced mothers and their children (9-12 years old) who participated in a randomized controlled trial of a preventive parenting intervention for divorcing families. Children provided reports of their experiences of interparental conflict and internalizing and externalizing problems; mothers provided reports of children’s temperament and internalizing and externalizing problems. The relations were examined separately for child report and mother report of outcomes using multiple regression analyses. Results found no support for the interactive effect of interparental conflict and temperament dimensions on children’s internalizing or externalizing problems. Consistent with an additive model of their effects, interparental conflict and temperament dimensions were directly and independently related to the outcomes. There was a significant, positive effect of interparental conflict and negative emotionality on children’s internalizing and externalizing problems. Positive emotionality was significantly, negatively related to internalizing and externalizing problems. Impulsivity was significantly, positively related to externalizing problems only. The patterns of results varied somewhat across mother and child report of interparental conflict on externalizing problems and positive emotionality on internalizing problems. The results of this study are consistent with the previous research on the significant main effects of interparental conflict and temperament dimensions on children’s internalizing and externalizing problems. These findings suggest that children’s environment and intrapersonal characteristics, represented by children’s experiences of interparental conflict and temperament, both uniquely contribute to children’s post-divorce internalizing and externalizing problems.

Research suggests that early family relationships have critical influences on later physical and psychological health, but most studies have focused on the influence of mothers ignoring the unique impacts of fathers. One mechanism by which families may transmit risk is by repeated activation of the hypothalamic-pituitary-adrenal (HPA) axis in the short-term that leads to adult neurobiological dysregulaton, evident in hyper- or hypo-cortisol levels. Using 218 father-child dyads from the Parent and Youth Study (PAYS), the current study investigated whether father involvement in adolescence predicted youth cortisol AUCg and reactivity to a stress task in young adulthood, and whether this relation was mediated by youth perceptions of mattering to their fathers in adolescence. Results revealed that higher father-reported father involvement predicted lower cortisol AUCg in youth when mattering was included in the model, although father involvement was not a statistically significant predictor of AUCg or cortisol reactivity when mattering was not included. Additionally, children who reported higher father involvement also reported higher feelings of mattering, but this association was only statistically significant for girls and European American youth. Youth feelings of mattering did not predict their cortisol reactivity or AUCg in young adulthood. Results suggest that future research should include fathers when investigating the effects of family relationships on youth psychophysiological development.

There are significant and wide-ranging health benefits of physical activity, yet the majority of adolescents in the United States do not engage in the recommended amount. This poses a significant public health challenge. Parents have a substantial influence on adolescents' levels of activity, indicating that parenting may be an especially salient target of interventions designed to promote physical activity. The current study tested the hypothesis that a family intervention to promote effective parenting would have a positive collateral effect on adolescent physical activity. This study also tested whether the increase in activity was mediated by changes in parental monitoring and family relationship quality. Furthermore, the current study assessed whether adolescent gender moderated the relationship between parental monitoring and physical activity, such that increased parental monitoring predicted increases in physical activity for girls, but not for boys. Participants were 232 adolescents at risk for behavior problems drawn from a larger randomized controlled trial of the Family Check-Up. Adolescents completed questionnaires and participated in a family assessment with their caregivers in the 6th through 9th grades. Youth randomized to the intervention reported significantly more physical activity at follow-up relative to controls. Results failed to confirm the role of family factors as mediators of the effect of the intervention on physical activity. When gender was considered as a moderator, it appeared that parental monitoring was strongly and positively correlated with physical activity for girls, but not for boys. While the mechanism by which the Family Check-Up leads to increased physical activity remains unclear, its robust effects suggest that family intervention can be used to promote physical activity and might therefore have further-reaching health benefits.