Factors Related to the Likelihood of Hiring a Health Advocate

This study was designed to explore factors related to the likelihood of hiring a health advocate. Independent variables were selected from the health service use model to capture predisposing, enabling, and illness-level factors. Participants were 889 adults (M age = 50.9 years, SD = 17.9 years, 52% female) recruited from a large cultural park in San Diego, California during the spring and summer of 2008. Participants read a description of a health advocate and completed a brief set of questions on age, gender, confidence in health care, effort maintaining health, self-rated health, and the likelihood of hiring a health advocate. Hierarchical regression analysis revealed that participants age 40-64 , non-Caucasians , participants who exerted more effort maintaining their health , and participants 65 and older who were less satisfied with their social support reported greater likelihood of hiring a health advocate. Findings were similar to those of studies that applied the health service use model to predict use of other health services, such as medical visits. These findings suggest factors that health care organizations offering health advocacy services could consider when targeting potential clients

Changes in youth's experiences of child maltreatment across developmental periods in the LONGSCAN consortium.

The present study applied person-centered data analytic techniques to identify groups of youth with allegations for combinations of maltreatment types during preschool, early and late childhood

Developmental transitions in presentations of externalizing problems among boys and girls at risk for child maltreatment

The present study examined the impact of children’s maltreatment experiences on the emergence of externalizing problem presentations among children during different developmental periods. The sample included 788 youth and their caregivers who participated in a multisite, prospective study of youth at-risk for maltreatment. Externalizing problems were assessed at ages 4, 8, and 12, and symptoms and diagnoses of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed at age 14, during interviews with youth and caregivers. Information about maltreatment allegations was coded from official records. Latent transition analysis identified three groups of youth with similar presentations of externalizing problems (“well adjusted,” “hyperactive/oppositional,” and “aggressive/rule-breaking”) and transitions between groups from ages 4, 8, and 12. A “defiant/deceitful” group also emerged at age 12. Girls were generally more likely to present as well adjusted than boys. Children with recent physical abuse allegations had an increased risk for aggressive/rule-breaking presentations during the preschool and preadolescent years, while children with sexual abuse or neglect allegations had lower probabilities of having well-adjusted presentations during middle childhood. These findings indicate that persistently severe aggressive conduct problems, which are related to the most concerning outcomes, can be identified early, particularly among neglected and physically and sexually abused children

Prevention of serious conduct problems in youth with attention deficit/hyperactivity disorder

The purpose of this review is to discuss issues in the prevention of serious conduct problems among children and adolescents with attention deficit/hyperactivity disorder (ADHD). The authors began by reviewing research on the common genetic and environmental etiological factors, developmental trajectories, characteristics and impairments associated with ADHD and comorbid oppositional defiant and conduct disorders. Next, the authors presented empirically based models for intervention with children and adolescents with ADHD that are at risk of developing serious conduct problems and detailed the evidence supporting these models. Researchers have demonstrated the utility of medication and psychosocial intervention approaches to treat youth with these problems, but current evidence appears to support the superiority of multimodal treatments that include both approaches. Future directions for researchers are discussed

A Step Beyond Maternal Depression and Child Behavior Problems: The Role of Mother–Child Aggression

Previous researchers have identified problematic mother–child interaction patterns as a potential pathway through which maternal depressive symptoms impact child behavior problems, but could not establish the temporal precedence of these associations. This longitudinal study investigated mother–child aggression as a mechanism in the association between maternal depressive symptoms that occurred during infancy and subsequent child behavior problems among high-risk families. Two hundred thirty-four socioeconomically disadvantaged families were recruited from neighborhoods with high rates of family violence. During infancy (12–18 months), early childhood (4 years), and middle childhood (6 years), mothers reported their current depressive symptoms and use of psychological and physical aggression with their child. During early and middle childhood, mothers reported their children’s behavior problems. Using path analyses, a temporal process was identified in which mother–child aggression during early childhood mediated the association between maternal depressive symptoms during infancy and higher levels of externalizing behavior problems during middle childhood. Mother–-child aggression did not mediate the association between maternal depressive symptoms during infancy and higher levels of internalizing behavior problems during middle childhood. Early maternal depressive symptoms that occur during infancy are important risk factors for subsequent mother–child aggression, which, in turn, contributes to more child externalizing behavior problems. Therefore, screening mothers for depressive symptoms and providing intervention and prevention services to improve mother–child interactions may be crucial to preventing the exacerbation of externalizing behavior problems. Additional research is needed to identify pathways to child internalizing behavior problems

Additive Effects of Parent Adherence on Social and Behavioral Outcomes of a Collaborative School–Home Behavioral Intervention for ADHD

The present study evaluated the impact of the Collaborative Life Skills Program (CLS), a novel school-home psychosocial intervention, on social and behavioral impairments among children with attention and behavior problems. Fifty-seven ethnically/racially diverse children (70 % boys) with attention and/or behavior problems in the second through fifth grades participated in a pilot study. Ten school-based mental health professionals were trained and then implemented the intervention at their respective schools. Children significantly improved from pre- to post-treatment on parent, teacher, and report card ratings of children's social and behavioral functioning. Treatment improvements were consistent for children with and without co-occurring disruptive behavior problems. The impact of the intervention was enhanced when parents used the intervention strategies more regularly, according to both clinicians' and parents' reports. Findings support the emphasis of CLS on coordinating intervention strategies across contexts to facilitate the generalization of treatment-related improvements in social and behavioral functioning

Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type

The current study investigates potential pathways between inattentive symptom severity, positive and negative parenting practices, and functional impairment (i.e., academic, social, and home impairment) in a sample of children diagnosed with attention-deficit/hyperactivity disorder, Predominantly Inattentive Type (ADHD-I). Participants included 199 children and their parents and teachers enrolled in a randomized clinical trial investigating the efficacy of an integrated psychosocial intervention for children with ADHD-I. Boys constituted slightly more than half the sample; children averaged 8.6 years of age (range = 7-11) and were from varied ethnic/racial backgrounds. As part of the initial screening and assessment procedures, parents and teachers completed questionnaires assessing child behavior and parent/family functioning. Results supported both main effects of symptoms and parenting on impairment, as well as a mediational path between symptoms and impairment via parenting, as observed by parents in the home setting. Specifically, higher severity of inattention was associated with higher rates of homework, social, and home impairment. Negative parenting contributed to homework and home impairment, and positive and negative parenting contributed to social impairment, incrementally above and beyond the impact of inattention symptom severity alone. Negative parenting partially mediated the relationship between inattentive symptom severity and impairment, such that higher rates of inattention were associated with higher rates of negative parenting, which in turn was associated with higher rates of homework, social, and home impairment. Results provide support for underlying mechanisms for associations between symptoms and impairment in children with ADHD-I and identify potential intervention targets to improve impairment experienced by these children