Role of Parent and Peer Relationships and Individual Characteristics in Middle School Children's Behavioral Outcomes in the Face of Community Violence

This study examines processes linking inner‐city community violence exposure to subsequent internalizing and externalizing problems. Hypothesized risk and protective factors from 3 ecological domains—children's parent and peer relationships and individual characteristics—were examined for mediating, moderating, or independent roles in predicting problem behavior among 667 children over 3 years of middle school. Mediation was not found. However, parent and peer variables moderated the association between exposure and internalizing problems. Under high exposure, normally protective factors (e.g., attachment to parents) were less effective in mitigating exposure's effects than under low exposure; attachment to friends was more effective. Individual competence was independently associated with decreased internalizing problems. Variables from all domains, and exposure, were independently associated with externalizing problems. Protective factors (e.g., parent attachment) predicted decreased problems; risk factors (e.g., friends' delinquency) predicted increased problems. Results indicate community violence reduction as essential in averting inner‐city adolescents' poor behavioral outcomes.     

Co-development of internalizing and externalizing behavior problems during early childhood among child welfare-involved children

Using parallel-process latent growth curve modeling, we examine developmental trajectories of internalizing and externalizing behavior problems and identify early risk factors for behavior problems among 329 child welfare-involved children followed from age 2 years to 5 years. Data are drawn from the National Survey of Child and Adolescent Well-Being II. On average, internalizing behavior problems remained stable, while externalizing behavior problems decreased over time. Higher initial levels of internalizing behavior problems were associated with higher initial levels of externalizing behavior problems. Rates of change also had positive cross-domain relationships. Child neglect, exposure to intimate partner violence (IPV), insecure caregiver-child attachment, and caregiver mental health problems were associated with higher initial levels of internalizing and externalizing behavior problems. Exposure to IPV, out-of-home care, and caregiver drug use predicted rates of change in behavior problems. Our findings highlight the importance of comprehensive assessment and treatment for co-occurring internalizing and externalizing behavior problems in young children involved in the child welfare system. Results also indicate the need for identifying and addressing early risk factors to prevent early onset and continued development of behavior problems in high-risk children.     

Effect of Environmental Risk and Externalizing Comorbidity on Internalizing Problems Among Economically Disadvantaged African American Youth

This study examined the effects of racial discrimination, community violence, and stressful life events on internalizing problems among African American youth from high‐poverty neighborhoods (N = 607; 293 boys; M_age = 16.0 years, SD = 1.44 years). Mediated effects via externalizing problems on these relations were also examined, given the high comorbidity rate between internalizing and externalizing problems. Externalizing problems partially mediated the effect of stressful life events on internalizing problems and fully mediated the effect of racial discrimination for boys but not for girls. Exposure to violence had a significant indirect effect on internalizing problems via externalizing problems. The findings call for greater attention to internalizing problems among African American youth and pathways to internalizing problems via externalizing problems.     

The Consequences of Parental Underestimation and Overestimation of Youth Exposure to Violence

This study investigated differences in parent and child estimates of the child's exposure to violence. Using data (N = 1,517) from the Project on Human Development in Chicago Neighborhoods, analyses related differences between parent and child reports of the child's exposure to violence to the child's psychosocial functioning. Most parents (66%) underestimated their children's exposure to violence. Further, parental underestimation was associated with the child's internalizing and externalizing problems and delinquent behaviors but parental overestimation was not. Family support partially mediated these associations. Parental underestimation of the child's exposure to violence, therefore, reflected lower levels of family support, which in turn led to more internalizing and externalizing problems and delinquency for the child.     

Residential mobility predicts behavioral problems for children living in non-parental care during the transition to kindergarten

The present study examines the extent to which residential mobility during the transition to kindergarten (cumulative moves during prekindergarten and kindergarten) is related to externalizing and internalizing behavior problems for children from low-income families who are living in non-parental care. A second, exploratory aim of this study was to investigate whether family service receipt moderated these relations. Data were obtained from the Head Start Impact Study. The sample included 300 children (53% male) who were eligible for Head Start. Residential mobility was conceptualized as three dichotomous variables: never moved, moved 1–2 times, and moved 3 or more times during the prekindergarten and kindergarten years. Predictor and outcome data were collected in the spring of prekindergarten and kindergarten. Moving three or more times was significantly related to more externalizing and internalizing behavior problems in kindergarten, controlling for family and child covariates, as well as for children's behavior problems in prekindergarten. Receipt of family services moderated the association between moving three or more times and externalizing problems, but not internalizing problems. This relation was in the opposite direction than expected, however, such that children who moved frequently and received more services demonstrated more externalizing problems than their peers. Implications of study findings for supporting highly mobile children living in non-parental care and directions for future research are discussed.     

Friendship in children with internalizing and externalizing problems: A preliminary investigation with the Pictorial Assessment of Interpersonal Relationships

This study examined the relationship between friendship representation and internalizing and externalizing problems in school-aged children. One hundred Caucasian 6–7 year-old children (50 males and 50 females) and their mothers took part in the study. The Draw-a-Man Test, the Pictorial Assessment of Interpersonal Relationships, and the Child Behavior Checklist (CBCL/6-18) were used. Children with internalizing problems, externalizing problems, comorbid internalizing and externalizing problems, and a control group were compared on their pictorial representations of friendship. Results showed that children with externalizing problems included more pictorial indices of each friend's autonomy and a larger imbalance of importance between them; children with internalizing problems drew themselves as less similar to their friends. In conclusion, children's pictorial representation allows exploring some aspects of their tacit knowledge about the relationship with a best friend, which is not easily expressed verbally by young children. Finally, the implications of these findings for theoretical and empirical research development on friendship are discussed.     

The differential effects of family violence on adolescent adjustment

The present study examined the effects of different types of domestic violence (i.e., being a victim of parent-child violence and witnessing interparental violence) on adolescent adjustment. The sample included a large, racially/ethnically and socioeconomically diverse group of high school students. Findings revealed that this sample experienced and witnessed high levels of family violence. Two hierarchical regression analyses were conducted with externalizing behavior problem and internalizing behavior problem scores as the outcome variables. Variables were entered in three blocks with numerous sociodemographic variables entered first as covariates, the amounts of parent-child violence and witnessing interparental violence entered in the second block, and the interaction of gender and violence variables and interaction of the two violence variables in the third. Results revealed the amounts of parent-child violence and interparental violence witnessed were significant predictors of both externalizing and internalizing behavior problems. Significant effects were also found for the interaction between parent-child violence and interparental violence. The implications of the findings are discussed.     

Moderating effects of race on internalizing and externalizing behaviors among children of criminal justice and child welfare involved mothers

This study examined whether the influences of multiple maternal criminal justice involvement (MCJI), community adversity, and violence exposure on children's internalizing and externalizing behaviors were moderated by race. The study included 409 children of criminal justice and child welfare involved mothers, ages 5–15 who participated in the National Survey on Child and Adolescent Well-Being (NSCAW). Results indicated that race, defined as Black vs. non-Black, moderated the associations between multiple MCJI and internalizing and externalizing behaviors. Decomposition of the regression effects indicated that non-Black children exposed to multiple MCJI, as compared to non-Black children who were not exposed to multiple MCJI, exhibited significant increases in both internalizing and externalizing behaviors, while Black children who experience multiple MCJI, on average, showed no increases. Similarly, race moderated the association between exposure to community adversity and externalizing behaviors. The decomposition of regression effects indicated that non-Black children who experienced higher levels of community adversity exhibited increases in externalizing behaviors, while Black children showed no increases. Criminal justice and child welfare practice and policy implications are discussed.     

Change in externalizing problems over time among ethnic minority youth exposed to violence

Youth exposed to violence, many of whom are from racial/ethnic minority backgrounds, are at high risk for externalizing problems such as aggressive and oppositional behavior, conduct problems, and delinquency. Most interventions target youth with already high levels of such problems, while selective prevention efforts have received less attention. It is important for researchers, policy makers and practitioners to understand how such problems develop and change over time, and how selective prevention may impact externalizing problems. In this study, we examined one-year trajectories of externalizing problems in 883 low-income, ethnic minority youth exposed to violence who participated in randomized controlled trials testing a prevention program for high-risk youth called the Strengthening Families Program. We found three trajectories of externalizing problems: Low Externalizing (43% of the sample had consistently low levels of externalizing symptoms), Persisters (39% of the sample had consistently high levels of externalizing symptoms), and Improvers (18% of the sample had initially high levels of externalizing symptoms that decreased over time). There were demographic differences between the three trajectories with individuals in the Low Externalizing trajectory more likely to be female and younger than those in the other two trajectories and Persisters and Improvers had significantly more problems with baseline internalizing symptoms, family conflict, and parenting behavior compared to the Low Externalizing trajectory. Logistic regressions then tested several predictors of membership in the Persisters trajectory compared to the Improvers trajectory, controlling for all covariates simultaneously. Only baseline parenting behavior and intervention group membership significantly predicted trajectory membership, and these were small and unreliable effects. Thus, children with varying levels of violence exposure, co-occurring emotional/behavioral problems and family issues, and varying demographics (e.g., age and gender) may do equally well over time, but engagement in this type of intervention may increase the likelihood that high levels of externalizing problems are ameliorated over time.     

Maltreatment history as persistent risk: An extension of Li and Godinet (2014)

Using individual growth curves with mixed models, this study examined the influence of maltreatment on the trajectories of both internalizing and externalizing behavioral problems from early childhood (age 4) to late adolescence/emerging adulthood (age 16) in the LONGSCAN samples of children with early maltreatment exposure or early risk for maltreatment. Maltreatment reports for each child were used to create a time-varying predictor, which was assessed on an ongoing basis in the LONGSCAN study. Child/youth emotional and behavioral problems were measured at ages 4, 6, 8, 10, 12, 14, and 16 using the Child Behavior Checklist. Maltreatment allegations significantly predicted subsequent trajectories of both internalizing and externalizing problems. For both types of problems, the effect of repeated maltreatment was on the rate of change (the trajectory), and in the case of externalizing problems, this effect grew more pronounced through age 16. Although behavioral problems may not be seen in younger children who experience maltreatment, these children are at ongoing risk for such problems as they grow older, and this risk is either maintained through adolescence (in the case of internalizing problems) or increases in strength through adolescence (in the case of externalizing problems). Maltreatment history is a persistent risk factor for child outcomes through adolescence. Assessment for recent maltreatment, as well as for earlier history of maltreatment, in adolescent children would improve treatment and service plans for children with behavioral and emotional problems through adolescence.     

The development of a systematic approach to mental health screening in Child Advocacy Centers

We report on efforts to implement a new protocol of mental health screening for children seen in Child Advocacy Centers (CACs), including the results from the first year of implementation with 1685 families. The parent-reported child screening results (obtained on 46.3% of children) indicate that while many children were not experiencing significant symptoms of internalizing or externalizing problems, a subset of children had very elevated scores. At the one-week and one-month screening, consistent predictors of more severe internalizing problems included age, a parent or step-parent as the offender, and having been removed from the home. For externalizing problems, consistent predictors included Caucasian ethnicity and having been removed from the home. By the one-week follow-up, about half of those interviewed (50.8%) had entered counseling or had an appointment pending. The likelihood of initiating mental health services was increased when the alleged abuse type was sexual, when the child had been removed from the home, and when the child's internalizing and externalizing symptoms were more severe. Surveys of the CAC staff implementing the new process suggest that it helped them understand the needs of the children, though their ability to reach some families was a barrier to implementation.     

Internalizing and externalizing behavioral problems of American Indian children in the child welfare system

Children involved in the child welfare system display elevated or clinically significant behavioral problems. However, there is a dearth of literature on the behavioral problems of American Indian children following child welfare involvement. Grounded in Patterson's Family Adjustment and Adaptation Response theory, this study fills that gap. Baseline, 18-month, and 36-month follow-up data from the National Survey of Child and Adolescent Well-being were utilized. The sample (n = 3498) consisted of American Indian, African American, and Caucasian children ages 2–16 at baseline (M = 8.13 years old, SD = 3.85) and 51.7% were female. Nearest neighbor propensity score matching analyses were used to estimate the effect of race on clinically significant internalizing and externalizing behavioral problems. Findings suggest that although externalizing behavioral problems do not differ based on race after controlling for other important factors, internalizing behavioral problems do differ. American Indian children are more likely to display clinically significant internalizing behavioral problems.     

Compulsory residential care: An examination of treatment improvement of individual and family functioning

The aim of the present study was to examine the treatment progress of both adolescent's and their families' functioning in a new compulsory residential treatment program. The sample consisted of 339 admitted adolescents (56.3% boys). The mean age at time of entry was 15.69 (SD = 1.30). Adolescents stayed on average 9.42 months (SD = 4.66) in a new residential treatment program. Data on adolescents' internalizing and externalizing problems were assessed using self-reports, parent reports, and group care worker reports. In addition, adolescents reported their substance use and delinquency and parents also reported family functioning and level of perceived parental stress. The findings revealed a significant decrease in adolescents' self-reported internalizing and externalizing problems, delinquency, and substance use. According to parent ratings, a significant improvement was found concerning adolescents' problem behaviors during treatment. However, according care worker ratings, adolescents showed no improvement on internalizing problems and showed an increase in externalizing problems. Concerning families, although there was no improvement in family functioning, parental stress significantly improved over time. Further research should examine whether improvements experienced during treatment are maintained after treatment.     

Substance use in youth adopted from foster care: Developmental mechanisms of risk

Children who enter foster care are at unique risk for developing substance abuse due to experiencing early life stressors. A large body of research has revealed robust effects of various stressors on later substance use, implicating the role of early neurobiological changes that create chronic internalizing problems. However, less literature has investigated externalizing behavior as a mechanism underlying this relationship. Moreover, few studies have examined these mechanisms through a model of cumulative risk. The present study examined whether the prospective association between cumulative pre-adoptive risk (e.g., maltreatment, age at placement, foster placement instability, ever having lived with birth parent) and adolescent/young-adult substance use was mediated by childhood internalizing and externalizing problems in youth adopted from foster care. Participants included 82 adoptees, most with histories of prenatal substance exposure (72%). We tested parent-rated internalizing and externalizing problems across 5 years in childhood as simultaneous mediators of cumulative risk and level of substance use 11–15 years later. Bootstrapping mediation procedures, controlling for age, prenatal substance exposure, adolescent/young adult mental health symptomatology, and youth participation in follow-up, revealed a significant indirect effect of cumulative risk on substance use through childhood internalizing problems, but not externalizing problems. These results underline the importance of mitigating early risk for children in the child welfare system and call for targeting childhood emotion dysregulation to reduce likelihood of substance abuse among previously high-risk adoptees. Nevertheless, low rates of substance use overall in the present sample underscore the positive impact of adoptive placement on mitigating risk for substance abuse among foster youth.     

Exploring Gender Differences on Internalizing and Externalizing Behavior Among Maltreated Youth: Implications for Social Work Action

This purpose of this study was to explore the moderating influence of gender on the relationship between child maltreatment and internalizing symptoms (e.g., affective and somatic problems) and externalizing behavior (e.g., rule breaking behavior and aggression) among children aged 7–12 years old. Using a longitudinal comparison group design and a sample of 300 youth of which 56% (n = 168) had substantiated cases of child maltreatment, results of a structural equation modeling revealed that internalizing symptoms exerted a mediating influence that was conditioned by gender. Only girls’ internalizing symptoms were found to mediate the link between child maltreatment and externalizing behavior while a direct relationship between maltreatment and externalizing behavior was found among boys. These findings provide evidence for gender differences in the pathways between being child maltreatment and maladaptive thoughts, feelings, and behaviors. Thus, adapting evidence-based strategies that target gender specific internalizing behaviors and externalizing behaviors among maltreated youth may significantly reduce the risk of short and long-term maladaptive behavior.     

Behavioral adjustment of Chinese adoptees: The role of pre-adoption experiences

PurposeIn the current study we examined associations between children's pre-adoption experiences (type of pre-adoption care and early deprivation) and their adaptive and maladaptive behavioral adjustment. Associations with prosocial behavior, attention problems, internalizing and externalizing behavioral problems were investigated.MethodsParental ratings of pre-adoption experiences and behavioral adjustment of 891 adopted Chinese girls aged between 4 and 12 year were obtained. The children were adopted from institutional care (n = 595), foster care (n = 66) or a combination of institutional and foster care (n = 228). Prosocial behavior was assessed using the Strengths and Difficulties Questionnaire (SDQ). Attention problems, internalizing and externalizing behavioral problems were assessed using the Child Behavior Checklist for ages 4–18 (CBCL). In addition to the main effects of pre-adoption experiences, we tested interaction effects between pre-adoption experiences and age at adoption, controlling for several family and child background variables.ResultsHierarchical regression analyses revealed that type of pre-adoption care was not associated with behavioral adjustment. Early deprivation, on the other hand, was negatively associated with prosocial behavior, and positively associated with attention problems, internalizing and externalizing problems. Interaction analyses revealed no significant associations.ConclusionsThe results showed that pre-adoption deprivation increased the risk for less optimal behavioral adjustment. The effects however were small, leaving room for other explaining factors both in the pre- and post-adoption environment of the child.     

The impact of repeated maltreatment on behavioral trajectories from early childhood to early adolescence

Using multilevel model for change, this study examined the trajectories of both internalizing and externalizing behavioral problems from early childhood to early adolescence among a cohort of 685 children with early alleged maltreatment from age 4 through age 12. These children were recruited from five study sites using the LONGSCAN archive data. Repeated allegation of maltreatment for each child was treated as a time-varying variable and was tracked continuously and assessed at each measurement of the child behavioral problems. Child behavioral problems were measured at ages 4, 6, 8, 10, and 12 using the Child Behavior Checklist. Findings indicated that repeated maltreatment significantly predicted subsequent trajectories of both internalizing and externalizing problems. In both cases, the effect of repeated maltreatment was on the slope, rather than on the intercept which was reflected in the trajectories. Repeated maltreatment was associated with significantly steeper increases in both internalizing and externalizing problems over time. Although there were no differences in early behavioral assessments (e.g., age 4 and age 6), both internalizing and externalizing behaviors emerged later and became more pronounced over time among those with repeated maltreatment (e.g., since age 8) compared to those without. Although behavioral problems may not be seen in younger children who experience multiple maltreatment, it is prudent to be aware that the impact may likely emerge in later ages of the child. Thus, ongoing monitoring and assessment of treatment needs for children who have had multiple occurrence of maltreatment becomes imperative.     

Caregiver–Adolescent Dyadic Disagreement and Problem Behaviors of Adolescents in the Child Welfare System

Parents and adolescents often provide different ratings of youths' behavior problems, yet few studies have examined such disagreement and its effect on later adjustment, especially among at‐risk adolescents. The purpose of this study was to investigate, among a sample of adolescents in foster care, whether the degree of caregiver–adolescent disagreement on adolescents' internalizing problems would be associated with adolescent externalizing problem behaviors over time. Two measures of adolescent caregiver agreement, the Pearson's r and intraclass correlations, were used with data drawn from a nationally representative study of children on foster care. Growth curve analyses of 180 adolescents revealed that the higher adolescent and caregiver agreement on adolescents' internalizing problems at Wave I, the slower the increase in externalizing problems over time.     

Predicting Well‐Being and Internalizing Symptoms in Late Adolescence From Trajectories of Externalizing Behavior Starting in Infancy

This study aimed to examine the long‐term prediction of well‐being and internalizing symptoms from trajectories of externalizing behavior problems in 921 children from a population‐based sample. We found that a high stable trajectory of externalizing behavior from infancy (age 1.5) to mid‐adolescence (age 14.5) predicted lower scores on life satisfaction and flourishing for both girls and boys (age 18.5). The high stable trajectory also predicted higher levels of depressive symptoms in boys and anxiety symptoms in girls (age 18.5). The findings are noteworthy as they document how a person‐oriented study of externalizing behavior problems starting in infancy can predict well‐being and internalizing in late adolescence. The findings underline the importance of early health promotion and problem intervention efforts.     

Changes in Externalizing and Internalizing Problems of Adolescents in Foster Care

Using a developmental psychopathology framework, this study aimed to examine changes in externalizing and internalizing problems of adolescents in foster care and to determine whether type of maltreatment, gender, and age influenced trajectories. Authors used 3 waves of data from the National Survey of Child and Adolescent Well‐Being. Growth‐curve analyses of 106 adolescents aged 13–16 in foster care revealed that externalizing and internalizing problems decreased over time. Adolescents, particularly boys, placed in foster care as a result of sexual abuse, physical abuse, or neglect demonstrated faster decreases in externalizing problems and, similarly but to a weaker degree, internalizing problems than did those placed in foster care as a result of other forms of maltreatment.