Substance use disorder and posttraumatic stress disorder symptomology on behavioral outcomes among juvenile justice youth

BACKGROUND AND OBJECTIVES: Substance use behaviors have been identified as a risk factor that places juveniles at greater risk for engaging in delinquent behaviors and continual contact with the juvenile justice system. Currently, there is lack of research that explores comorbid factors associated with substance use, such as post-traumatic stress disorder (PTSD) symptoms, that could help identify youth who are at greatest risk. The aim of the present study was to examine if PTSD symptomology moderated the relationship between substance use disorder (SUD) symptoms and externalizing behaviors and commission of a violent crime; hypothesizing that risk would be heightened among youth with elevated SUD and PTSD symptomology compared to those with elevated SUD symptoms but lower PTSD symptoms. METHOD: The study included 194 predominantly male (78.4%), non-White (74.2%) juvenile justice youth between the ages of 9-18 (M = 15.36). Youth provided responses to assess PTSD symptoms, SUD symptoms, and externalizing behaviors. Commission of a violent crime was based on parole officer report. RESULTS: Findings indicated that SUD symptomology was associated with greater externalizing behaviors at high levels of PTSD symptomology. At low levels of PTSD symptomology, SUD symptoms were inversely associated with externalizing behaviors. An interactive relationship was not observed for commission of violent crimes. CONCLUSIONS: Findings suggest that the association between SUD symptoms and externalizing behaviors among juvenile offenders may be best explained by the presence of PTSD symptomology. SCIENTIFIC SIGNIFICANCE: Addressing PTSD rather than SUD symptoms may be a better target for reducing risk for externalizing behaviors among this population of youth (Am J Addict 2019;28:29-35)

Maternal depression and youth internalizing and externalizing symptomatology: severity and chronicity of past maternal depression and current maternal depressive symptoms

Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58 % male) ages 8 to 12 over a span of 3 years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed.The current work was supported by grants from the National Institutes of Health (MH066077, PI: Martha C. Tompson, PhD; MH082861, PI: Martha C. Tompson, PhD;). (MH066077 - National Institutes of Health; MH082861 - National Institutes of Health)Published versio

Predicting children's externalizing symptoms from dyadic and triadic measures of family systems

textAccording to Family Systems Theory, the whole family system is greater than the sum of its parts. The purpose of this study is to investigate this claim by examining marital, parent-child, and triadic (mother-father-child) interactions as simultaneous predictors of children's externalizing symptoms. Longitudinal data from 108 families were used to investigate three hypotheses: 1) parents' negative responses to their toddlers' negative emotions will predict their children's later externalizing symptoms, 2) marital negativity will relate to both mothers and fathers displaying more negative patterns of emotional socialization, and 3) competitive coparenting -- assessed in triadic family interactions during toddlerhood (age 24 months) -- will predict children's later externalizing symptoms at age 7, after accounting for the effects of significant dyadic family interactions (specifically, mothers' and fathers' emotional socialization assessed at 24 months). Results demonstrated spillover from marital negativity to mothers’ negative emotion socialization. Competitive coparenting predicted children's later emotion socialization after controlling for infant temperament, family income, child gender, and dyadic predictors of children's externalizing symptoms; mothers' negative emotional socialization also remained a significant predictor. This study emphasizes the importance of examining the family holistically and has important implications for designing more effective whole-family interventions to reduce the development of children’s externalizing symptoms.Human Development and Family Science

Sleep Problems in Children With Autism Spectrum Disorder

The purpose of the current study was to examine the effect of restricted and repetitive behaviors (RRBs) on the relationship between sleep problems and externalizing behaviors in young children with autism spectrum disorder (ASD). Sixty-six participants with ASD and a mean age of 4 years and their parents participated in the study. Parents reported on their child’s sleep, ASD symptoms, and externalizing behavior during a one-time lab visit. Bivariate correlations and a mediation analysis were conducted to assess the associations between sleep problems, externalizing behavior, and RRB. Results suggested that children with higher scores in measures of RRB had higher scores in sleep problems and externalizing behavior. Results also suggested that RRB partially mediated the relationship between sleep problems and externalizing behavior. Implications for the early identification of sleep and behavior problems, as well as ASD symptoms, are discussed

Discrepancy between Parents and Children in Reporting of Distress and Impairment: Association with Critical Symptoms

Background: We examined discrepant parent–child reports of subjective distress and psychosocial impairment. Method: Parent–child pairs (N = 112 pairs) completed the Health Dynamics Inventory at intake for outpatient therapy. Results: Average parent scores were significantly higher than average child scores on distress, impairment, and externalizing symptoms, but not internalizing symptoms. There were significant associations between parent–child discrepancy (i.e. children who reported greater distress or impairment than parents or vice versa) and child endorsement of several notable symptoms (rapid mood swings, panic, nightmares, and suicidal ideation). Conclusion: Parents tended to report more externalizing symptoms, distress, and impairment than children reported; however, when children report more distress and impairment than parents, this may indicate serious psychological problems

Emotion Regulation and Parental Bonding in Families of Adolescents With Internalizing and Externalizing Symptoms

Parental bonding and emotional regulation, while important to explain difficulties that may arise in child development, have mainly been studied at an individual level. The present study aims to examine alexithymia and parental bonding in families of adolescents with psychiatric disorders through different generations. The sample included a total of 102 adolescent patients with psychiatric disorders and their parents. In order to take a family level approach, a Latent Class Analysis was used to identify the latent relationships among alexithymia (Toronto Alexithymia Scale), perceived parental bonding (Parental Bonding Instrument) and the presence of adolescent internalizing or externalizing psychiatric symptoms (Youth Self-Report). Families of internalizing and externalizing adolescents present different and specific patterns of emotional regulation and parenting. High levels of adolescent alexithymia, along with a neglectful parenting style perceived by the adolescent and the father as well, characterized the families of patients with internalizing symptoms. On the other hand, in the families with externalizing adolescents, it was mainly the mother to remember an affectionless control parental style. These results suggest the existence of an intergenerational transmission of specific parental bonding, which may influence the emotional regulation and therefore the manifestation of psychiatric symptoms

An exploratory study on internet addiction, somatic symptoms and emotional and behavioral functioning in school-aged adolescents

Objective: In the last two decades there has been a significant transformation regarding the use of new technologies. Despite growing acknowledgement concerning the different activities and functions of digital technologies, there remains a lack of understanding on how technology overuse may negatively impact both physical and psychosocial well-being. Although researchers have begun to explore the meaning and implications of excessive Internet use in non-clinical populations of children and adolescents, there is still little consistent knowledge on the topic. This study aimed to extend existing knowledge on the excessive use of the Internet among school-aged adolescents, focusing on its association with recurrent somatic symptoms, depressive risk and behavioral and emotional problems. Method: Two hundred and forty adolescents (51.9% females) aged between 10 and 15, participated in this study. Data was collected using the Children’s Somatization Inventory, the Internet Addiction Test, the Children’s Depression Inventory, the Youth Self Report and the Emotion Regulation Questionnaire. Structural Equation Model analysis was used to analyse the data. Results: Approximately 21.8% of participants reported excessive Internet use based on Young’s criteria. Higher levels of Internet use were associated with somatic and depressive symptoms as well as emotional and behavioral problems. Depressive Symptoms predicted both Internet Addiction (b = 0.304, p < 0.001) and Internalizing (b = 0.542, p <0.001) and Externalizing problems (b = 0.484, p < 0.001). Internet Addiction also significantly predicted both Internalizing (b = 0.162, p = 0.02) and Externalizing problems (b = 0.183, p = 0.02). Finally, Structural Equation Modeling showed that the indirect effect of Depressive Symptoms (via Internet Addiction) on Internalizing or Externalizing problems were significant. Conclusions: Longitudinal studies are needed to confirm these findings and to identify the mechanisms linking Internet use, somatic symptoms and adaptive functioning

The longitudinal development of emotion regulation capacities in children at risk for externalizing disorders

The development of emotional regulation capacities in children at high versus low risk for externalizing disorder was examined in a longitudinal study investigating: a) whether disturbances in emotion regulation precede and predict the emergence of externalizing symptoms; and b) whether sensitive maternal behavior is a significant influence on the development of child emotion regulation. Families experiencing high (n=58) and low (n=63) levels of psychosocial adversity were recruited to the study during pregnancy. Direct observational assessments of child emotion regulation capacities and maternal sensitivity were completed in early infancy, at 12 and 18-months, and at 5-years. Key findings were as follows. First, high risk children showed poorer emotion regulation capacities than their low risk counterparts at every stage of assessment. Second, from 12-months onwards, emotion regulation capacities showed a degree of stability, and were associated with behavioral problems, both concurrently and prospectively. Third, maternal sensitivity was related to child emotion regulation capacities throughout development, with poorer emotion regulation in the high risk group being associated with lower maternal sensitivity. The results are consistent with a causal role for problems in the regulation of negative emotions in the etiology of externalizing psychopathology, and highlight insensitive parenting as a potentially key developmental influence

Children exposed to intimate partner violence: Identifying differential effects of family environment on children\u27s trauma and psychopathology symptoms through regression mixture models

The majority of analytic approaches aimed at understanding the influence of environmental context on children\u27s socioemotional adjustment assume comparable effects of contextual risk and protective factors for all children. Using self-reported data from 289 maternal caregiver-child dyads, we examined the degree to which there are differential effects of severity of intimate partner violence (IPV) exposure, yearly household income, and number of children in the family on posttraumatic stress symptoms (PTS) and psychopathology symptoms (i.e., internalizing and externalizing problems) among school-age children between the ages of 7–12 years. A regression mixture model identified three latent classes that were primarily distinguished by differential effects of IPV exposure severity on PTS and psychopathology symptoms: (1) asymptomatic with low sensitivity to environmental factors (66% of children), (2) maladjusted with moderate sensitivity (24%), and (3) highly maladjusted with high sensitivity (10%). Children with mothers who had higher levels of education were more likely to be in the maladjusted with moderate sensitivity group than the asymptomatic with low sensitivity group. Latino children were less likely to be in both maladjusted groups compared to the asymptomatic group. Overall, the findings suggest differential effects of family environmental factors on PTS and psychopathology symptoms among children exposed to IPV. Implications for research and practice are discussed