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Objectives Methods Results Conclusions Attention‐deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental condition and is characterized by inattention, hyperactivity, and impulsivity. Research suggests that some populations, such as females and individuals with high intelligence quotients may be a risk for late ADHD diagnosis and subsequent treatment. Our goal is to advance our understanding of ADHD diagnosis, by examining (1) how child sex and cognitive abilities together are related to the age of diagnosis and (2) whether symptom presentation, current internalizing and externalizing symptoms, and demographic factors are related to age of diagnosis.Our analyses contained children who completed the required tests (N = 568) from a pre‐existing dataset of 1380 children with ADHD from the Province of Ontario Neurodevelopmental Disorders (POND) Network (pond‐network.ca). First, we conducted a moderation analysis with sex as the predictor, cognitive abilities as the moderator, and age of diagnosis as the outcome. Second, we conducted correlation analyses examining how symptom presentation, current internalizing and externalizing symptoms, and demographic factors are related to age of diagnosis.Higher IQ was related to a later age of diagnosis. Higher hyperactive–impulsive symptoms and externalizing symptoms were related to an earlier age of diagnosis. Internalizing symptoms were trend associated with a later age of diagnosis in girls. Higher socioeconomic status and non‐White maternal ethnicity were related to later age of diagnosis.IQ, sex, ADHD symptomology, internalizing symptoms, externalizing symptoms, and socio‐demographic factors affect the age of diagnosis. [ABSTRACT FROM AUTHOR]

Background: Children with affective dysregulation (AD) show an excessive reactivity to emotionally positive or negative stimuli, typically manifesting in chronic irritability, severe temper tantrums, and sudden mood swings. AD shows a large overlap with externalizing and internalizing disorders. Given its transdiagnostic nature, AD cannot be reliably and validly captured only by diagnostic categories such as disruptive mood dysregulation disorder (DMDD). Therefore, this study aimed to evaluate two semi-structured clinical interviews—one for parents and one for children. Methods: Both interviews were developed based on existing measures that capture particular aspects of AD. We analyzed internal consistencies and interrater agreement to evaluate their reliability. Furthermore, we analyzed factor loadings in an exploratory factor analysis, differences in interview scores between children with and without co-occurring internalizing and externalizing disorders, and associations with other measures of AD and of AD-related constructs. The evaluation was performed in a screened community sample of children aged 8–12 years (n = 445). Interrater reliability was additionally analyzed in an outpatient sample of children aged 8–12 years (n = 27). Results: Overall, internal consistency was acceptable to good. In both samples, we found moderate to excellent interrater reliability on a dimensional level. Interrater agreement for the dichotomous diagnosis DMDD was substantial to perfect. In the exploratory factor analysis, almost all factor loadings were acceptable. Children with a diagnosis of disruptive disorder, attention-deficit/hyperactivity disorder, or any disorder (disruptive disorder, attention-deficit/hyperactivity disorder, and depressive disorder) showed higher scores on the DADYS interviews than children without these disorders. The correlation analyses revealed the strongest associations with other measures of AD and measures of AD-specific functional impairment. Moreover, we found moderate to very large associations with internalizing and externalizing symptoms and moderate to large associations with emotion regulation strategies and health-related quality of life. Conclusions: The analyses of internal consistency and interrater agreement support the reliability of both clinical interviews. Furthermore, exploratory factor analysis, discriminant analyses, and correlation analyses support the interviews' factorial, discriminant, concurrent, convergent, and divergent validity. The interviews might thus contribute to the reliable and valid identification of children with AD and the assessment of treatment responses. Trial registration: ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963. Registered 27 June 2018. [ABSTRACT FROM AUTHOR]

Background: Previous studies have linked adolescent motherhood to adverse neurodevelopmental outcomes in offspring, yet the sex-specific effect and underlying mechanisms remain unclear. Methods: This study included 6952 children aged 9–11 from the Adolescent Brain Cognitive Development study. The exposed group consisted of children of mothers < 20 years at the time of birth, while the unexposed group was composed of children of mothers aged 20–35 at birth. We employed a generalized linear mixed model to investigate the associations of adolescent motherhood with cognitive, behavioral, and autistic-like traits in offspring. We applied an inverse-probability-weighted marginal structural model to examine the potential mediating factors including adverse perinatal outcomes, family conflict, and brain structure alterations. Results: Our results revealed that children of adolescent mothers had significantly lower cognitive scores (β, − 2.11, 95% CI, − 2.90 to − 1.31), increased externalizing problems in male offspring (mean ratio, 1.28, 95% CI, 1.08 to 1.52), and elevated internalizing problems (mean ratio, 1.14, 95% CI, 0.99 to 1.33) and autistic-like traits (mean ratio, 1.22, 95% CI, 1.01 to 1.47) in female. A stressful family environment mediated ~ 70% of the association with internalizing problems in females, ~ 30% with autistic-like traits in females, and ~ 20% with externalizing problems in males. Despite observable brain morphometric changes related to adolescent motherhood, these did not act as mediating factors in our analysis, after adjusting for family environment. No elevated rate of adverse perinatal outcomes was observed in the offspring of adolescent mothers in this study. Conclusions: Our results reveal distinct sex-specific neurodevelopmental outcomes impacts of being born to adolescent mothers, with a substantial mediating effect of family environment on behavioral outcomes. These findings highlight the importance of developing sex-tailored interventions and support the hypothesis that family environment significantly impacts the neurodevelopmental consequences of adolescent motherhood. [ABSTRACT FROM AUTHOR]

Lifetime and temporal co-occurrence of substance use disorders (SUDs) is common and compared with individual SUDs is characterized by greater severity, additional psychiatric comorbidities, and worse outcomes. Here, we review evidence for the role of generalized genetic liability to various SUDs. Coaggregation of SUDs has familial contributions, with twin studies suggesting a strong contribution of additive genetic influences undergirding use disorders for a variety of substances (including alcohol, nicotine, cannabis, and others). GWAS have documented similarly large genetic correlations between alcohol, cannabis, and opioid use disorders. Extending these findings, recent studies have identified multiple genomic loci that contribute to common risk for these SUDs and problematic tobacco use, implicating dopaminergic regulatory and neuronal development mechanisms in the pathophysiology of generalized SUD genetic liability, with certain signals demonstrating cross-species and translational validity. Overlap with genetic signals for other externalizing behaviors, while substantial, does not explain the entirety of the generalized genetic signal for SUD. Polygenic scores (PGS) derived from the generalized genetic liability to SUDs outperform PGS for individual SUDs in prediction of serious mental health and medical comorbidities. Going forward, it will be important to further elucidate the etiology of generalized SUD genetic liability by incorporating additional SUDs, evaluating clinical presentation across the lifespan, and increasing the granularity of investigation (e.g., specific transdiagnostic criteria) to ultimately improve the nosology, prevention, and treatment of SUDs. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis explores the effectiveness of teacher interventions supporting children with externalizing behaviors based on teacher and child outcomes. A systematic search was conducted using 5 electronic databases. From 5714 papers, 31 papers that included interventions delivered directly to teachers and aimed to benefit either teachers and/or children with externalizing behaviors were included. The review focused on qualified teachers working with children aged 2–13. The results of the current meta-analysis revealed a positive effect of teacher intervention on teacher and child outcomes, including the increased use of teacher-appropriate strategies, as well as significant and moderate improvements in teacher–child closeness, and small reductions in teacher–child conflict. For child outcomes, the interventions reduced externalizing behavior problems and ADHD symptoms and enhanced prosocial behavior. Only one fully blinded analysis for conduct problems was possible and revealed a moderate but significant reduction in favor of intervention. These findings provide evidence to support the role of teacher interventions for both teachers and children with externalizing behaviors. Future research should include more PBLIND measurements so that MPROX findings can be confirmed. More research should be done to evaluate the influence of teacher interventions on teachers' well-being. [ABSTRACT FROM AUTHOR]

Dimensional conceptualizations of psychopathology hold promise for understanding the high rates of comorbidity with posttraumatic stress disorder (PTSD). Linking PTSD symptoms to transdiagnostic dimensions of psychopathology may enable researchers and clinicians to understand the patterns and breadth of behavioral sequelae following traumatic experiences that may be shared with other psychiatric disorders. To explore this premise, we recruited a trauma‐exposed online community sample (N = 462) and measured dimensional transdiagnostic traits of psychopathology using parceled facets derived from the Personality Inventory for DSM‐5 Faceted–Short Form. PTSD symptom factors were measured using the PTSD Checklist for DSM‐5 and derived using confirmatory factor analysis according to the seven‐factor hybrid model (i.e., Intrusions, Avoidance, Negative Affect, Anhedonia, Externalizing Behaviors, Anxious Arousal, And Dysphoric Arousal). We observed hypothesized associations between PTSD factors and transdiagnostic traits indicating that some transdiagnostic dimensions were associated with nearly all PTSD symptom factors (e.g., emotional lability: rmean =.35), whereas others showed more unique relationships (e.g., hostility–Externalizing Behavior: r =.60; hostility with other PTSD factors: rs =.12–.31). All PTSD factors were correlated with traits beyond those that would appear to be construct‐relevant, suggesting the possibility of indirect associations that should be explicated in future research. The results indicate the breadth of trait‐like consequences associated with PTSD symptom exacerbation, with implications for case conceptualization and treatment planning. Although PTSD is not a personality disorder, the findings indicate that increased PTSD factor severity is moderately associated with different patterns of trait‐like disruptions in many areas of functioning. [ABSTRACT FROM AUTHOR]

• Over 99% of 7- and 8-year-old children reached adult street-crossing competency after training in a virtual reality pedestrian environment. • On average, children required ten 30-minute training sessions to master competency, and the extent of training required varied widely across children. • In univariate analyses, male gender, higher scores on visual memory, visual perception, processing speed, and working memory tasks, and fewer externalizing symptoms were all positively associated with faster mastery of pedestrian skills. • In a multivariable model, only child age significantly predicted speed of mastery, with older children learning quicker. • Implementation of child pedestrian safety training in virtual reality is recommended, but must be conducted cautiously to ensure children are adequately trained. Introduction : Pedestrian injuries represent a leading cause of child death globally. One prevention strategy is teaching children street-crossing skills. Virtual reality (VR) has emerged as a strategy to offer repeated street-crossing practice and overcome ethical barriers of training children in live traffic. This study addressed two questions pertinent to implementation of child pedestrian safety training within VR: (a) how much training do children require to achieve adult street-crossing competency, and (b) what individual differences might facilitate children to acquire that competency more efficiently? Methods: Five hundred 7- and 8-year-olds were recruited. Children completed pedestrian safety training within VR for up to 25 thirty-minute training sessions until they achieved adult levels of mastery. At baseline, four cognitive-perceptual skills (visual memory, visual perception, processing speed, working memory) and parent-reported externalizing symptomatology were assessed. Results: On average, children achieved adult pedestrian safety competency after 10.0 training sessions (SD = 4.8). Just one child (<1%) failed to achieve adult pedestrian functioning after 25 training sessions. In univariate analyses, boys took slightly longer than girls to achieve adult functioning, and visual memory, visual perception, processing speed, working memory, and fewer externalizing symptoms were all positively associated with shorter time to mastery. In a multivariable model, only child age was a statistically significant predictor. Conclusion: Almost all participants achieved adult street-crossing skills competency through VR training, although they required about 10 sessions on average. Analysis of predictor variables confirmed that nearly all 7- and 8-year-olds are trainable. Practical Application: Implementation of VR pedestrian safety training is recommended, but must be conducted cautiously to ensure children are not permitted to engage independently in traffic until they are assessed and demonstrate sufficient skills. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Establish the longitudinal cross-lagged associations between maltreatment exposure and child behavior problems to promote screening and the type and timing of interventions needed. METHODS: The Longitudinal Studies of Child Abuse and Neglect, a multiwave prospective cohort study of maltreatment exposure, enrolled children and caregivers (N = 1354) at approximately age 4 and followed them throughout childhood and adolescence. Families completed 7 waves of data collection with each wave occurring 2 years apart. Maltreatment was confirmed using official case records obtained from Child Protective Services. Six-month frequencies of behavior problems were assessed via caregiver-report. Two random-intercept, cross-lagged panel models tested the directional relations between maltreatment exposure and externalizing and internalizing behaviors. RESULTS: Maltreatment exposure predicted increases in externalizing behaviors at ages 8 (b = 1.06; 95% confidence interval [CI] 0.14-1.98), 12 (b = 1.09; 95% CI 0.08-2.09), and 16 (b = 1.67; 95% CI 0.30-3.05) as well as internalizing behaviors at ages 6 (b = 0.66; 95% CI 0.03-1.29), 12 (b = 1.25; 95% CI 0.33-2.17), and 14 (b = 1.92; 95% CI 0.76-2.91). Increases in externalizing behaviors predicted maltreatment exposure at age 12 (odds ratio 1.02; 95% CI 1.00-1.05). CONCLUSIONS: Maltreatment exposure is robustly associated with subsequent child behavior problems, strengthening inferences about the directionality of these relations. Early screening of externalizing behaviors in pediatric settings can identify children likely to benefit from intervention to reduce such behaviors as well as prevent maltreatment exposure at entry to adolescence. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) engage in less physical activity than typically-developing peers. This can result in serious negative consequences for individual well-being and may contribute to the physical, behavioral, and emotional challenges associated with ASD. This study explored the potential benefits of trainer-led, individualized, physical fitness sessions specialized for ASD. Eleven individuals (ages 7–24 years) with ASD were assessed at baseline and following 15 fitness sessions. Participants demonstrated improvements in core and lower-body strength and reductions in restricted and repetitive patterns of behavior, along with non-significant but marked reductions in issues with daytime sleepiness. Results suggest the merit of specialized fitness programs and emphasize the need for larger and more rigorous research studies on this topic. [ABSTRACT FROM AUTHOR]

Previous studies suggest that child behavior problems were associated with higher levels of parenting stress and depressive symptoms in parents of children with autism spectrum disorder (ASD). Parents' coping strategies have been found to provide potential buffering effects. Thus, this study investigated the mediation effect of coping strategies on the relationships between child behavior problems, parenting stress and depressive symptoms in Taiwanese mothers of children with ASD. Participants were 128 children with ASD (mean age = 32.32 months, SD = 10.43) and their mothers. All mothers completed a battery of questionnaires on parenting stress, depressive symptoms, coping strategies and child behavior problems. Principal components factor analysis identified three coping categories: Problem-focused coping, avoidance coping, and distraction coping. Problem-focused coping was correlated with decreased parenting stress and depressive symptoms, whereas avoidance coping was associated with increased parenting stress and depressive symptoms. In addition, problem-focused coping mediated the relationship between child externalizing behavior problems and parenting stress. In conclusion, problem-focused coping could be an effective strategy to deal with the stress issues on mothers of preschool-age children with ASD, and potentially may decrease the possibilities of negative outcomes. [ABSTRACT FROM AUTHOR]

Internalising disorders are one of the most common mental health problems in children under 12 years, yet mixed findings exist for current treatment options. This pilot involves a novel 10-session intervention, BEST-Foundations, to treat internalising symptoms in children using a family-inclusive model. Initial findings and feasibility using a mixed-methods approach are reported. Twenty-two participants from eight families (n = 8 children; n = 8 mothers; n = 6 fathers) participated in an uncontrolled single treatment design. Included children (aged 3–11 years) reported clinical-level internalising symptoms on the Child Behaviour Checklist. Data were collected across four timepoints: baseline, pre-intervention, post-intervention, and 4-weeks follow-up. As predicted, mothers reported large improvements in child internalising symptoms pre-post (SMD = −.83; 95% CI = 50.58–70.42) and maintained pre to follow-up (SMD = −.92; 95% CI = 50.14–69.11). Sustained improvements were also found in externalising problems and total problems. Qualitative analysis indicated families reported positive improvements in targeted areas including parent confidence and parent–child relationships. Findings demonstrate initial feasibility data and effect size estimates comparable to previous trials using the "BEST" framework, and larger than CBT-based interventions. Results are considered preliminary due to the small sample. Further evaluation is warranted, showing the value of family-inclusive interventions to treat child internalising problems. What is already known about this topic: Modifiable family-based risk and protective factors influence internalising symptoms in children. Currently, inconclusive support exists for targeted treatment options for child internalising symptoms, highlighting the need to explore novel, feasible, evidence-based approaches for children under 12 years. Parental involvement in treatment is considerably heterogeneous, and the inclusion of fathers is lacking. What this topic adds: The BEST-Foundations intervention translates from theory to practice, demonstrating initial feasibility with families in improving internalising symptoms in children under 12 years. Fathers may express initial hesitation, yet engaging them in treatment is important. Parents reported improved confidence and perspective taking after taking part in the BEST-Foundations intervention. [ABSTRACT FROM AUTHOR]

The significant population of Chinese rural-to-urban migrant children has sparked considerable domestic and international concern regarding their disadvantaged family circumstances and their escalating prevalence of internalizing and externalizing problems. Derived from the resource substitution hypothesis, non-cognitive factors such as personality traits may act as "substitution" resources for educational outcomes of children from less privileged families. Yet, the compensatory role of personality traits as substitution resources in children's mental health has received limited attention, including that of migrant children. This study examined the interplay of trait-like grit and family SES on emotional and conduct problems among Chinese migrant and urban children. The current sample consisted of 770 migrant children (Mage = 10.45 and SDage = 0.68 years; 38.4% girls) and their 222 urban counterparts (Mage = 10.34 and SDage = 0.46 years; 45.5% girls). Moderated polynomial regressions with response surface analysis on a two-wave data with an interval of over six months showed that grit served as a "substitution" resource for the less socioeconomically advantaged children. The compensatory effect of perseverance of effort on urban children's emotional problems and that of consistency of interest on migrant children's conduct problems were visualized. Moreover, the two compensatory effects were found to be robust and unique, even after children's effortful control, a grit-related construct, was taken into account. These findings not only support the resource substitution hypothesis, but also underscore the protective role that grit plays in children under less privileged environments. [ABSTRACT FROM AUTHOR]

The sharp rise over the past decade in young children's access to various forms of screen media (e.g., smartphones, tablets, TVs) has posed new and significant challenges to caregivers in managing children's use of this type of media. For caregivers of young children with externalizing behavior problems, managing children's time with screen media is especially important and challenging. In this article, we summarize evidence of bidirectional links between early externalizing behavior problems and unhealthy screen media use in young children and discuss the extent to which prior interventions have responded to the needs of caregivers of children with these problems. We propose a conceptual model for an intervention to promote healthy screen media use for children with externalizing behavior problems that leverages current behavioral parenting interventions. [ABSTRACT FROM AUTHOR]

Adolescents' perceptions of parent and peer norms about externalizing behaviors influence the extent to which they adopt similar attitudes, yet little is known about how the trajectories of perceived parent and peer norms are related to trajectories of personal attitudes across adolescence. Neural development of midline regions implicated in self–other processing may underlie developmental changes in parent and peer influence. Here, we examined whether neural processing of perceived parent and peer norms in midline regions during self-evaluations would be associated with trajectories of personal attitudes about externalizing behaviors. Trajectories of adolescents' perceived parent and peer norms were examined longitudinally with functional neuroimaging (n = 165; ages 11–16 years across three waves; 86 girls, 79 boys; 29.7% White, 21.8% Black, 35.8% Latinx, 12.7% other/multiracial). Behavioral results showed perceived parent norms were less permissive than adolescents' own attitudes about externalizing behaviors, whereas perceived peer norms were more permissive than adolescents' own attitudes, effects that increased from early to middle adolescence. Although younger adolescents reported less permissive attitudes when they spontaneously tracked perceived parent norms in the ventromedial and medial pFCs during self-evaluations, this effect weakened as they aged. No brain–behavior effects were found when tracking perceived peer norms. These findings elucidate how perceived parent and peer norms change in parallel with personal attitudes about externalizing behaviors from early to middle adolescence and underscore the importance of spontaneous neural tracking of perceived parent norms during self-evaluations for buffering permissive personal attitudes, particularly in early adolescence. [ABSTRACT FROM AUTHOR]

Background and aims: Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use. Design: Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states. Setting and participants: Adolescent‐parent dyads (n = 1927; adolescents in grade 7, age ≈13 years) were recruited from Australian schools during 2010/11 (Wave 1). Adolescents were surveyed annually until 2016/17 (n = 1503; age ≈19 years; Wave 7) and parents were surveyed annually until 2014/15 (Wave 5). Measurements Alcohol, tobacco, cannabis and 3,4‐methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3–7. Potential confounders were collected at Waves 1–6 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status. Findings Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5–7: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (<9%) adolescents transitioning out. More externalizing problems (odds ratio [OR] = 1.10; 99.6% confidence interval [CI] = 1.07–1.14), parental heavy episodic drinking (OR = 1.22; 99.6% CI = 1.07–1.40), parental illicit substance use (OR = 3.56; 99.6% CI = 1.43–8.86), peer alcohol use (OR = 5.68; 99.6% CI = 1.59–20.50) and peer smoking (OR = 4.18; 99.6% CI = 1.95–8.81) were associated with transitioning to polysubstance use. Conclusions: Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adolescents' school engagement, mental health, and substance use have been major concerns during the COVID‐19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health‐related outcomes within an adolescent cohort followed during the pandemic. METHODS: During 3 semi‐annual follow‐up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self‐efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting. RESULTS: Relative to in‐person instruction, students in remote instruction reported lower academic self‐efficacy (Beta: −0.11; 95% confidence interval [CI]: −0.22, −0.01) and school connectedness (Beta: −0.37; 95% CI: −0.48, −0.25), greater odds of past 30‐day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30‐day e‐cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86). CONCLUSIONS: Multiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources. [ABSTRACT FROM AUTHOR]

Given the need for a swift, systematic way to identify students with internalizing and externalizing behavior patterns to connect these students with appropriate supports, we present new findings of the Student Risk Screening Scale–Internalizing and Externalizing (SRSS-IE). In this article, we examined (a) factor structure of the SRSS-IE and (b) the extent to which measurement invariance holds across gender, special education status, race, and ethnicity, as well as time point (fall, winter, spring) within each school level (elementary, middle, high). The sample includes 124 schools from four U.S. geographic regions in their first year of implementing the SRSS-IE collected over a 10-year span. Using confirmatory factor analysis procedures accounting for the nesting of students within teachers' classrooms, we confirmed a two-factor structure (internalizing and externalizing) and determined three items may be removed from the instrument while maintaining adequate model fit, pending replication with schools in later stages of screening implementation. All model comparisons between configural, metric, scalar, and strict models met invariance criteria within a time point. Longitudinal models also met these invariance criteria. We discuss educational implications, limitations, and directions for future research. [ABSTRACT FROM AUTHOR]

Traditionally, the mental health field has focused on psychological symptoms and distress, and health is considered the absence of illness. An alternative view suggests that optimal mental health must include the presence of positive characteristics in addition to the absence of illness. Accordingly, a dual-factor model of mental health includes measures of both psychopathology and positive subjective well-being to determine an individual's mental health status. The current study investigated this dual-factor model by examining whether subjective well-being and psychopathology combine to produce distinct mental health profiles in emerging adults. A sample of 559 university students completed self-report surveys indicating their life satisfaction and internalizing and externalizing symptoms. Cluster analysis yielded four unique mental health groups. The well-adjusted cluster included individuals with high life satisfaction and low internalizing and externalizing symptoms. The dissatisfied cluster consisted of individuals with low externalizing, but also low life satisfaction and slightly above-average levels of internalizing. The externalizing cluster had high life satisfaction but also high externalizing psychopathology, and the troubled cluster exhibited low life satisfaction and high levels of both psychopathology symptoms. The clusters also differed in their personality traits, coping responses, and automatic thoughts, with the most favorable pattern across all three dimensions exhibited by the well-adjusted cluster. These findings highlight the importance of considering positive indicators of mental health in addition to measures of psychopathology and support the use of an empirical classification procedure in determining the mental health status of emerging adults. [ABSTRACT FROM AUTHOR]

China has a high prevalence of child maltreatment and a culture accepting of harsh parenting with no consensus regarding its adverse outcomes. The current study seeks to address this issue by synthesising the effects of harsh parenting on the socio‐emotional outcomes of Chinese children and youths through a systematic review of relevant literature. A systematic search was conducted to collect articles published from 1991 to 2021 based on the PRISMA guidelines. This study captured the bivariate relationships between harsh parenting and the socio‐emotional outcomes of children and youths between the ages of 6–17. Forty‐five studies met the inclusion criteria. Three domains of socio‐emotional outcomes, including internalising problems, externalising problems, and social outcomes were identified. Studies consistently reported evidence of the significant association between harsh parenting and various externalising problems. However, mixed results were found regarding the association between harsh parenting and internalising problems. No study examined the physical health outcomes. More research is needed to further clarify the relationship between harsh parenting and internalising problems as well as health outcomes. [ABSTRACT FROM AUTHOR]

Cannabis use may be a modifiable risk factor for mental health problems; however, the role of cannabis use frequency in population seeking mental health and addiction services remains unclear. This study aimed to: 1) compare the prevalence and functional impact of psychiatric symptoms among frequent, infrequent, and non-users of cannabis; and 2) evaluate the associations between cannabis use frequency and functional impact of psychiatric symptoms in help-seeking individuals. Data from the Mental Health and Addictions (MHA) Central Intake system in Nova Scotia, Canada was used. Participants aged 19–64 who received MHA Intake assessments from September 2019 to December 2021 with complete information about substance use were included (N = 20,611). Cannabis use frequency over past 30 days was categorized into frequent (>4 times a month), infrequent (≤4 times a month), and non-use. Psychiatric symptomatology consists of five domains: mood, anxiety, psychosis, cognition, and externalizing behaviors. Multivariate ordinal logistic regression was used to examine the associations between cannabis use frequency and functional impact of psychiatric symptoms. Frequent and infrequent cannabis users had a higher prevalence of psychiatric symptoms in each domain than non-users, while no significant differences were found between frequent and infrequent users. Frequent cannabis use was associated with greater functional impact of psychiatric symptoms in each domain compared to non-users, while infrequent use was only associated with greater functional impact of externalizing behaviors. Frequent cannabis use is associated with increased prevalence and functional impact of psychiatric symptoms among adults seeking mental health services. • The association between frequency of cannabis use with different psychiatric symptom domains is not well understood. • Studies of people with mental health needs can provide evidence to regulate harmful cannabis misuse. • Frequent cannabis use was associated with greater functional impact of each psychiatric domain compared to non-users. • Infrequent cannabis use was associated with greater functional impact of externalizing behaviors compared to non-users. [ABSTRACT FROM AUTHOR]

To examine the additive or moderating influences of caregiver COVID-19–related stress, social support, and discrimination on children's behavior problems across racially diverse populations. In this Environmental influences on Child Health Outcomes (ECHO) cohort study (N = 1,999 caregiver/child pairs), we operationalized caregiver COVID-19–related stress in 2 ways: first, as the number of stressors (eg, financial concerns, social distancing); and second, as the level of pandemic-related traumatic stress symptoms reported via questionnaires administered between April 2020 and August 2022. At the same assessment visit, caregivers also reported their current levels of discrimination, and a subsample (n = 968) reported their emotional and instrumental support. Either concurrently or at a later assessment visit, caregivers reported on their children's internalizing and externalizing behavior problems using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18). Multivariable analyses controlling for maternal education, marital status, child age, and child sex revealed that COVID-19–related stress (caregiver stressors and symptoms) and discrimination were positively associated, and that perceived support was negatively associated with child internalizing and externalizing behavior problems. Unexpectedly, neither emotional nor instrumental support attenuated the relationship between caregiver COVID-19–related stressors nor traumatic stress symptoms and child behavior problems. In the subset of Black American participants, caregiver perceived discrimination moderated the relationship between caregiver COVID-19 traumatic stress symptoms and child internalizing problems, such that the association was stronger at higher levels of discrimination. Our findings highlight the potential importance of relieving caregiver stress and increasing caregiver social support to optimize children's behavioral outcomes. [ABSTRACT FROM AUTHOR]

In 2018, the child welfare system in Ontario, Canada, expanded the age of protection to include 16 and 17 year olds for the purpose of mitigating risk of harm for older adolescents. To date, there is little information regarding investigations of older adolescents, particularly in Ontario; this study will address this gap. Data used for this analysis were drawn from the Ontario Incidence Study of Reported Child Abuse and Neglect‐2018. The Ontario Incidence Study of Reported Child Abuse and Neglect‐2018 sample data were weighted to derive an annual incidence estimate of 155 649 maltreatment‐related investigations conducted in Ontario in 2018. Child, caregiver, household, and investigation characteristics were compared across three age groups: children (0–10), younger adolescents (11–15), and older adolescents (16–17). Characteristics and differences in the likelihood of a service response (referral to nonchild welfare services, transfer to ongoing child welfare services, or placement in out‐of‐home care during the investigation) were examined descriptively and using chi‐square automatic interaction detection. Half of investigations involving older adolescents received a service response, and they were more likely to receive a service response when there were concerns about future risk of harm, where there were concerns about the relationship between the adolescent and their caregivers, where internalizing or externalizing symptoms were noted, where caregivers had few social supports, and where the household experienced economic hardship. These findings suggest that older adolescents are being triaged for circumstances that reflect concerns about their vulnerability, including mental health needs, attachment concerns, and caregiver isolation. [ABSTRACT FROM AUTHOR]

Depressed youth frequently present with comorbid symptoms. Comorbidity is related to a poorer prognosis, including treatment resistance, academic problems, risk of suicide, and overall impairment. Studies examining the latent structure of depression support the notion of multiple presentations of depressed youth; however, it is unclear how these presentations are represented among acutely impaired youth. Participants (n = 457) in this naturalistic study were admitted to a psychiatric inpatient unit (Mean age = 14.33 years, SD = 1.94;76% female;46.6% Black/African-American). Selected subscales from the parent-report Behavior Assessment System for Children, Second Edition, were utilized as indicators in a latent profile analysis. Subgroups were validated based on their relationships with meaningful clinical correlates (e.g., family factors, discharge diagnosis) and further described by their associations with demographic variables. A five-class model provided the best balance of fit and parsimony. Subtypes of depressed youth included Predominantly Depressed (39.1%), Oppositional (28.2%), Severely Disruptive (12.3%), Anxious-Oppositional (11.6%), and Anxious-Withdrawn (8.8%). Comorbid symptoms were present in four of the five classes (60.9% of sample). High levels of externalizing symptoms were a prominent clinical feature associated with three classes (52.1% of the sample). Construct validity of the respective classes was demonstrated by differential association with clinical correlates, family characteristics, and demographics. Findings suggest that depressed youth presenting for acute inpatient psychiatric care displayed varied clinical presentations. The identified latent groups aligned with existing research reflecting comorbidity with anxiety, inattention, and externalizing disorders. Findings underscore the need for an increased clinical appreciation of comorbidity and encourage more targeted and effective prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Discrepancies between teacher and parent reports of children's externalizing behaviors are well documented. However, less research has examined the associations these different ratings have with objective indicators of functioning in other domains. The goal of this study was to compare the strength of association of parent and teacher reports of externalizing behaviors with children's early academic skills. The sample consisted of 695 children (376 boys, 318 girls, 1 unknown) who ranged between 48 months and 63 months of age (mean age = 55.05; SD = 3.63) at time of initial assessment. Children completed standardized measures of early academic skills; parents and teachers completed the Conners Rating Scale. Steiger's Z tests were performed to compare the strength of associations between parent and teacher ratings on children's early academic skills. Multi-level regressions examined the unique predictive variance each rater accounted for. Teacher ratings of inattentive and oppositional defiant behaviors had stronger associations with children's early academic skills than did parent ratings for most measures of early academic skills, but there were no significant differences for ratings of hyperactive/impulsive behaviors. Multivariate analyses revealed that only teacher ratings of inattentive behaviors accounted for notable portions of unique variance in early academic skills. Children's externalizing behaviors were related to their early academic skills. However, these results suggest that teachers contributed more unique variance, possibly due to their access to a normative reference group. [ABSTRACT FROM AUTHOR]

In this article, we examined predictive validity of the newly defined Student Risk Screening Scale–Internalizing and Externalizing (SRSS-IE 9, with nine items) when used by teachers for the first time, with a sample of 24,535 elementary students from 74 schools in four U.S. geographic regions. Results indicated fall externalizing and internalizing latent factors as well as subscale scores (SRSS-E5 and SRSS-I4, respectively) from the SRSS-IE 9 predicted year-end behavioral outcomes (office discipline referrals, suspensions, and nurse visits), academic outcomes (reading and math scores and course failures), as well as referrals to special education for elementary students. SRSS-IE 12 subscale scores for externalizing (SRSS-E7) and internalizing (SRSS-I5) using the original 12-item version subscales were similarly predictive of these outcomes. We discussed educational implications, limitations, and directions for future inquiry. [ABSTRACT FROM AUTHOR]

Purpose: Physical dating aggression is prevalent within young adulthood, yet little is known about within-relationship effects of physical dating aggression on psychosocial adjustment. The present study uses an intensive longitudinal design to capture proximal changes (i.e., one month later, and across 6 months) in psychosocial adjustment following physical dating aggression. Methods: Between 2014 and 2016, data was collected in six monthly waves from 120 participants ages 18–25 (50% female, M age Wave 1 = 22.44; 10% African American, 17.5% Hispanic. 62.5% Caucasian). Results: Both immediate changes in the level of psychosocial adjustment and the growth trajectory of psychosocial adjustment were examined. Wave 1 physical dating aggression was associated with immediate changes in internalizing and trauma symptoms. Further, Wave 1 physical dating aggression predicted increased growth in both externalizing and internalizing symptoms. Conclusions: Findings highlight that psychological consequences of physical dating aggression may emerge quickly, with implications for potential increased risk for subsequent involvement in physical dating aggression. [ABSTRACT FROM AUTHOR]

We investigated longitudinal relations between siblings' problem and prosocial behavior, measured by the Strengths and Difficulties Questionnaire, among different sibship sizes in the UK's Millennium Cohort Study. We identified 3436 families with two children and 1188 families with three children. All children (cohort members and their older sibling [OS]) had valid data on behavior at two time points (in 2004 and 2006). Using structural equation model, we found that for internalizing and externalizing problems, OSs (MOS1 = 6.3 years, MOS2 = 9.1 years at T1) exerted a dominant effect on younger siblings (Mage = 3.12 years at T1; 49.7% boys) across sibship sizes. For prosocial behavior, there was OS dominance in two‐child families and youngest sibling dominance in three‐child families. [ABSTRACT FROM AUTHOR]

This longitudinal study examined the interactive effects of individual- and classroom-level teacher−child relationships on developing externalizing, internalizing, and prosocial behaviors in kindergarten children over time. On two occasions separated by about 1 year, data were collected from 473 kindergarten children (52% boys, Mage = 4.36 years) and their class teachers and mothers in Hong Kong, China. Class teachers reported the closeness and conflict in their relationships with each participating child of their class at Time 1, and mothers reported the child's externalizing, internalizing, and prosocial behaviors at Times 1 and 2. Results indicated that controlling for child age, gender, grade, maternal education, and prior levels of child adjustment, individual-level teacher−child closeness was negatively associated with internalizing behaviors, and individual-level teacher−child conflict was positively associated with child externalizing behaviors over time. Classroom-level teacher−child closeness and conflict emerged as moderators. The longitudinal association between individual-level teacher−child closeness and externalizing behaviors was negative in low-closeness classrooms but not in high-closeness classrooms. However, the longitudinal association between individual-level teacher−child conflict and child prosocial behaviors was negative in low-conflict classrooms but not in high-conflict classrooms. Despite the statistical significance of the cross-level interaction effects, they were of small effect sizes and explained only very small amounts of variance. Theoretically, our findings demonstrated the interplay of the individual- and classroom-level teacher−child relationships in shaping children's psychosocial adjustment over time. Practically, our findings highlighted the importance of enhancing teachers' awareness of the affective quality of their relationships with children at both classroom and individual levels, which could potentially impede or promote child development. [ABSTRACT FROM AUTHOR]

Unlike internalizing and externalizing symptoms, psychotic symptoms (e.g., hallucinations, delusions) are manifestations of personality disorders (PDs) that are more controversial and poorly understood. This leaves clinicians with very little guidance for clinical practice, especially for diagnosis. What is more, most reviews have focused strictly on the links between psychotic symptoms and the categorically defined borderline PD, which contrasts with the growing movement that emphasizes a dimensional perspective (especially in psychology). Thus, the objectives of this critical review will be to (a) expose typical cases where PDs and psychotic symptoms might cooccur; (b) assess the state of scientific knowledge surrounding PD and psychotic symptoms; and (c) provide clinicians and researchers with recommendations to keep the field moving forward. We conclude that researchers and clinicians should move past the false "PD or psychosis" dichotomy since they often cooccur, avoid (as far as possible) making psychotic symptoms an exclusion criterion in PD research to enhance ecological validity, and consider dimensional PD diagnosis as a potential unifying solution to the dilemma posed by this cooccurrence. [ABSTRACT FROM AUTHOR]

Inhibition (a temperamental profile characterized by elevated levels of avoidance behaviors) is associated with increased likelihood for developing anxiety and depression, whereas exuberance (a temperamental profile characterized by elevated levels of approach behaviors) is associated with increased likelihood for developing externalizing conditions (e.g., attention deficit/hyperactivity disorder and conduct disorder). However, not all children who exhibit high levels of approach or avoidance behaviors develop emotional or behavioral problems. In this preregistered study, we assessed context‐dependent profiles of approach and avoidance behaviors in 3‐year‐old children (N = 366). Using latent profile analysis, four groups were identified: nonsocial approachers, social approachers, social avoiders, and nonsocial avoiders. Analyses revealed that there were minimal differences in internalizing and externalizing symptoms across the four context‐dependent groups. However, exploratory analyses assessed whether high levels of approach or avoidance combined across contexts, similar to findings reported in prior work, were related to psychopathology. Children identified as high in avoidance behavior at 3 years of age were more likely to show internalizing symptoms at 3 years of age but not at 5 years of age. Children high in approach were more likely to meet criteria for anxiety and externalizing disorders by age 5 years. These findings further our understanding of individual differences in how young children adjust their behavior based on contextual cues and may inform methods for identifying children at increased likelihood for the development of emotional and behavioral problems. Research Highlights: Context‐dependent approach and avoidance profiles were identified in 3‐year‐old children using a person‐centered approach.Children who were high in approach behavior, regardless of context, at age three had a higher likelihood for developing an anxiety or externalizing disorder by age five.These findings may help identify children at increased risk of developing emotional and behavioral problems. [ABSTRACT FROM AUTHOR]

• Family accommodation has not been explored in youth with misophonia. • Accommodation was common and more frequent in anxious youth. • Family accommodation directly predicted misophonia severity. • Accommodation may be an important intervention target. Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was moderately to strongly associated with misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature. A notable study limitation is that the measure of misophonia did not delineate between adaptive versus maladaptive accommodations. Excessive and maladaptive accommodation may be one potential candidate to target in interventions when considered within a broader treatment plan. Importantly, adaptive accommodations should also be considered in day-to-day management if they improve functioning and quality of life. [ABSTRACT FROM AUTHOR]

Aggression is a costly public health problem with severe and multi‐faceted negative consequences and thus, identifying factors that contribute to aggression, particularly in understudied populations, is necessary to develop more effective interventions to reduce the public health cost of aggression. The goal this study was to test whether difficulties regulating emotions moderated the association between posttraumatic stress disorder (PTSD) symptoms and aggression in a community sample of predominantly Black females with high levels of trauma exposure. Furthermore, we explored unique relations between PTSD symptom clusters and distinct subscales of difficulties regulating emotions and aggression. The sample included 601 community participants recruited from an urban public hospital. Symptoms were assessed using self‐report measures including the Difficulties in Emotion Regulation Scale (DERS) and Behavioral Questionnaire‐Short. Regression analyses were conducted using PTSD symptoms and total DERS to test their interaction as predictors for aggression (using BQ‐Short). We found that higher levels of PTSD arousal symptoms and difficulty controlling impulses when upset were positively related to aggression. We also conducted an exploratory analysis to examine the association between PTSD symptom clusters using the Alternative Symptom Clusters hybrid model. The results suggest that some PTSD symptoms (externalizing behavior) and some emotion dysregulation processes (difficulties controlling impulses when upset), relate to aggression in independent, rather than multiplicative ways. These results offer insights for new directions of research that focuses on the independent association between specific emotion dysregulation processes and PTSD symptoms on aggression. [ABSTRACT FROM AUTHOR]

Excessive screen time in children is a growing concern for parents and healthcare providers worldwide because it frequently leads to behavioral problems. Although executive dysfunction is proposed to be one of the contributing factors to maladaptive behaviors, little is known about the link between screen time and behaviors. This study aimed to identify whether executive dysfunction contributes to the negative behaviors of children exposed to excessive screen time. A cross-sectional study was conducted on preschool-aged children from public and private schools in Chiang Mai, Thailand. The parents/guardians of each child completed the questionnaires regarding clinical characteristics and screen time use, the Behavior Rating Inventory for Executive Function-Preschool (BRIEF-P), and the Strengths and Difficulties Questionnaire (SDQ). Children with more than one hour of media exposure per day were considered to have excessive screen time. Multivariable Gaussian regression was analyzed to compare the BRIEF-P and SDQ scores between the excessive and appropriate screen time groups. Causal mediation analysis was performed to examine the effects of total screen time on increasing behavioral problems with executive functioning as a mediator. A total of 1,126 preschoolers were included in the analyses. After controlling for age, sex, socioeconomic status, and maternal education, the excessive screen time group had significantly higher BRIEF-P global executive composite score than the appropriate screen time group (mean difference of global executive composite score = 1.49, 95% CI [0.12, 2.86], and p = 0.033). Concurrently, there were significant differences in externalizing behavior subscales and SDQ total difficulties scores between the excessive and appropriate screen time groups (mean difference of total difficulties score = 0.90, 95% CI [0.29, 1.50], and p = 0.004). A significant average causal mediation effect (ACME) of screen time on behavioral problems mediated through executive functioning was β = 0.28, 95% CI [0.13–0.44], which was more than half of the total effect (54.9%, 95% CI [37.4–100%]). The current study suggests that the increase in behavioral issues in preschoolers might be partly explained by the direct effect of excessive screen time and the mediating effect of impaired executive functioning. Our results may raise concerns about the necessity to limit screen time and monitor for executive function deficits and behavioral problems in young children with high screen time. [ABSTRACT FROM AUTHOR]

This paper departs from a deductive premise seeking to apply the theory of "collectivised system of refugee responsibility" to the EU-Egypt migration arrangements. In its basic form, the theory proffers the funding and oversight of the wealthy North to assert protection, and integration of refugees in southern countries. At face value, the design and structure of the EU-Egypt migration arrangements appear to reflect this formula: EU funding in return for Egyptian principled accommodation of refugees. A profounder analysis of these deals, nevertheless, discerns the emergence of an alternative linguistic and legal discourse that priorities security and control over the humanitarian cause. Practice, as well, demonstrates that neither the EU is willing to undertake any refugees' oversight roles, nor Egypt is vying for EU funding. To the contrary, Egypt's generous funding of EU commercial interests and ruthless crackdown on refugees represent Egypt's basic offerings to appease the EU and garner its political support. [ABSTRACT FROM AUTHOR]

The EU-Turkey Statement of March 2016 aimed to end irregular migration from Turkey to the European Union (EU). Since 2016, the relationship between Turkey and the EU has undergone significant changes. While the EU fulfilled only two of its promises under the Statement, Turkey suspended the implementation of the return component of the Statement in 2020 and stopped readmitting third-country nationals from Greece. Meanwhile, recent judgments delivered by the European Court of Human Rights, such as Akkad v. Turkey and G.B. and others v. Turkey , have shed new light on conditions facing refugees, asylum seekers, and migrants in Turkey. This article aims to analyse the implementation of the EU-Turkey Statement as of 2024 by examining to what extent Turkey and the European Union, as well as its Member States, have fulfilled their pledges and acted in line with the course of action agreed under the Statement. It also aims to investigate to what extent Turkey's assumed status as a safe third country has changed over the years. Given that the number of irregular passages towards the EU through Turkey has decreased considerably and that the return component of the Statement is not currently implemented, we argue that the assessment of whether Turkey is safe should be made with reference to refugees, asylum seekers, and migrants contained in Turkey as a result of the EU-Turkey Statement arrangements not just those returned under the EU-Turkey Statement. [ABSTRACT FROM AUTHOR]

Children's screen time increased as a result of the COVID-19 pandemic. In the summer of 2021, we explored the association between high screen time over a period of one year since May 2020 and behavioural problems among children and adolescents. The data were derived from the French EpiCov cohort study, collected in spring 2020, autumn 2020, and spring 2021. Participants (N = 1089) responded to online or telephone interviews about one of their children aged 3 to 14 years. Screen time was categorized as high if the daily mean screen time exceeded recommendations at each collection time. The Strengths and Difficulties Questionnaire (SDQ) was completed by parents to identify internalizing (emotional or peer problems) and externalizing (conduct problems or hyperactivity/inattention) behaviours in their children. Among the 1,089 children, 561 (51.5%) were girls, the average age was 8.6 years (SD 3.7). Internalizing behaviours: High screen time was not associated with internalizing behaviours (OR [95% CI] 1.20 [0.90–1.59]) or emotional symptoms (1.00 [0.71–1.41]) while it was associated with peer problems (1.42 [1.04–1.95]). Externalizing behaviours: High screen time was associated with externalizing problems (1.63 [1.01–2.63]) and conduct problems (1.91 [1.15–3.22]) only among older children aged 11 to 14 years. No association with hyperactivity/inattention was found. In a French cohort, exploration of persistent high screen time in the first year of the pandemic and behaviour difficulties in Summer 2021 resulted in mixed findings according to behaviour's type and children's age. These mixed findings warrant further investigation into screen type and leisure/school screen use to enhance future pandemic responses appropriate for children. [ABSTRACT FROM AUTHOR]

Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys. [ABSTRACT FROM AUTHOR]

This study examined differences in internalizing and externalizing behaviors between school-aged boys and girls diagnosed with autism spectrum disorder (ASD). Eighty-nine children between the ages of 8 and 16 years participated in this study: 17 girls (M = 11.5 years, SD = 2.3) and 72 boys (M = 11.3 years, SD = 2.2). Participants were matched on the Autism Diagnostic Observation Schedule, Second Edition and Full-Scale IQ (FSIQ > 64). The results indicated that, girls had higher reported instances of Bullying, less Anger Control, and poorer Emotional Self-Control than boys on the Behavior Assessment System for Children, Second Edition. Groups did not differ on subscales of the Social Communication Scale. While evidence of increased externalizing behaviors is less common in girls, there is evidence supporting these differing behaviors that warrant further research. [ABSTRACT FROM AUTHOR]

This study aims to provide a new perspective on the relationship between problematic Internet use and externalizing problem behaviors among adolescents. Some studies have focused on the relationship between problematic Internet use and externalizing problem behaviors. However, research on the underlying mechanism is still insufficient. Additionally, peer relationship, mental health and parental knowledge has been ignored as a crucial factor. Altogether, 7101 Chinese rural adolescents aged 13–19 years completed an anonymous self-report questionnaire. The results show that: (1) problematic Internet use has a negative effect against the development of externalizing problem behaviors; (2) peer relationship and mental health both have a mediating role in the relationship between problematic Internet use and externalizing problem behaviors; (3) problematic Internet use can indirectly affect externalizing problem behaviors through the chain mediation of peer relationship and mental health; (4) parental knowledge has the potential to moderate the indirect impact by diminishing the association between problematic Internet use and externalizing problem behaviors; and (5) the impact of problematic Internet use on externalizing problem behaviors has significant gender differences. The negative impact was greater on boys than on girls. In relation to these findings, this study has discussed the possible reasons and made some practical suggestions to improve Internet use among rural adolescents. [ABSTRACT FROM AUTHOR]

Background: Research on factors underlying socioeconomic status (SES)-related inequalities in child development mainly focuses on single countries and specific influential factors. Only few studies scrutinize to what extent differences in children's early behavioural outcomes vary across countries and whether the processes that account for them are common or context-specific. Objective: The aim of this study was to explore SES-related inequalities and explanatory factors in 3- to 4-year-old children's externalising behaviour as well as their generalisability across outcome variables (hyperactivity, conduct problems) and countries. Methods: The study uses harmonised data from three longitudinal large-scale studies conducted in the United Kingdom (UK), the United States (US), and the Netherlands and a decomposition method to comparatively analyse early SES-related gaps and explanatory factors. Results: Results show that the extent of parental education-related gaps varied across countries. The included explanatory factors accounted for significant amounts of gaps in hyperactivity and conduct problems. Yet, while family income and maternal depressive feelings significantly explained gaps in each facet of externalising behaviour across all three countries, other factors were country-specific. In the US and the UK, health-related factors were additionally relevant for explaining early gaps in both child outcomes; in the UK, also structural aspects of the family significantly explained gaps in conduct problems; no other factors contributed to the explanation of gaps in the Netherlands. Conclusions: Mechanisms that might reduce SES-related inequalities in child behaviour and that may be helpful when constructing appropriate interventions are partially similar, yet also significantly different between countries and child outcomes. [ABSTRACT FROM AUTHOR]

Background: The positive youth development (PYD) framework orients developmental scholarship to focusing on youth's strengths rather than deficits, however, validity evidence on PYD measures among ethnic-minority youth is limited. Objectives: The objectives of the current study were to (a) examine the factor structure of a PYD measure within a Latin American adolescent sample and (b) test associations between PYD constructs and adjustment indicators. Methods: The sample included 288 Latin American students from the Southwest (Mage = 13.69 years, SD = 0.56; 47.7 female; 86.3% U.S.-born). Participants reported their PYD (i.e., Competence, Confidence, Character, Connection, and Caring) and academic performance. Mothers reported on youth's internalizing and externalizing behaviors. The internal structure of the PYD measure was assessed through confirmatory factor analyses (CFAs) and model comparisons. Criterion evidence was evaluated via regressions between the Five C's, academic performance, internalizing, and externalizing behaviors. Results: The five-correlated factor structure best fit the data with certain modifications. Character was negatively associated with externalizing behavior. All C's were positively related to academic performance. Conclusions: The results provide empirical support for the five-correlated factor model within a sample of Latin American adolescents, but modifications were necessary to maximize model fit. Dropping items within the values diversity subscale highlight the need for cultural assets within PYD measurement models for ethnic-minority youth, to best reflect their appraisals of diversity as minoritized individuals. Additionally, our findings suggest that the C's are salient to specific indices of Latin American adolescents' adjustment. [ABSTRACT FROM AUTHOR]

This systematic review evaluated the treatment effects of communication-focused parent-mediated interventions (CF-PMT), a form of intervention that involves therapists observing parent-child interactions and giving feedback to parents on how they can practice positive parenting strategies to prevent or reduce externalizing behaviours in children with developmental disabilities. A literature search was conducted on three electronic databases. To be included in the review, studies had to: evaluate CF-PMT where therapists give feedback after observing parent-child interactions; examine changes in externalizing behaviours amongst children with any forms of developmental disability; and adopt a randomised controlled trial study design. Fifteen studies met eligible criteria for the literature review, of those, 13 studies had available data on changes in the primary (child externalizing behaviours) and secondary outcomes (parental stress, child linguistic abilities and child social responsiveness). We found significant treatment effects for CF-PMT in reducing child externalizing behaviours (d = −.60) but not for any of the secondary outcomes. A sensitivity analysis showed a small but significant treatment effect for parental stress (d = −.18). Considerable bias was observed due to the lack of available information reported by studies on aspects measured by the Mixed Methods Appraisal Tool. Overall, we found evidence to support the benefits of complex interventions which incorporate direct parent-child observations and feedback to improve behavioural outcomes amongst children with developmental disabilities. [ABSTRACT FROM AUTHOR]

Identifying neural and cognitive mechanisms in externalizing problems in childhood is important for earlier and more targeted intervention. Meta-analytic findings have shown that smaller N2 event-related potential (ERP) amplitudes, thought to reflect inhibitory control, are associated with externalizing problems in children. However, it is unclear how (i.e., through which cognitive processes) N2 amplitudes relate to externalizing problems. We examined whether inhibitory control may be a cognitive process that links N2 amplitudes and externalizing problems in early childhood. Children (N = 147, 74 girls) were assessed at four time points, spanning 3–7 years of age. Children's externalizing behavior was assessed via questionnaires completed by mothers, fathers, and teachers/secondary caregivers. Children's inhibitory control was assessed using eleven performance-based tasks and two questionnaires. Developmental scaling linked differing measures of inhibitory control and externalizing behavior across ages onto the same scale. Children's N2 amplitudes were extracted from electroencephalography data collected during a go/no-go task. Smaller N2 amplitudes were associated with externalizing problems and poorer inhibitory control. A concurrent analysis of indirect effects revealed that poorer inhibitory control partially explained the association between smaller N2 amplitudes and externalizing problems, even when controlling for the child's age, sex, and socioeconomic status. This is among the first studies to link N2 amplitudes, inhibitory control, and externalizing problems during early childhood. Findings suggest that smaller N2 amplitudes may be an early neural indicator of inhibitory control deficits and externalizing psychopathology. Moreover, inhibitory control may be an important target for early intervention in the development of externalizing psychopathology. [ABSTRACT FROM AUTHOR]

Psychometrically sound parenting instruments are a critical aid in guiding clinical assessments of adolescent behavioral outcomes, particularly among clinical samples of adolescents. However, there is a paucity of research on these parenting instruments among adolescents with histories of substance use disorders (SUDs) who represent a high-risk clinical population for whom parents are critical in their recovery process. This study investigated the psychometric properties of an abridged 17-item Alabama Parenting Questionnaire (APQ) in a sample of 294 adolescents (45% female, mean age = 16 years) and their parents (84% female) recruited from substance use treatment facilities as part of a longitudinal parent study. Confirmatory factor analyses established the factor fit of the abridged APQ, and path analyses assessed the predictive validity of the APQ constructs in relation to adolescent externalizing behaviour symptoms 6 months later. Results suggested the hypothesized three-factor model consisting of Positive Parenting, Poor Monitoring, and Inconsistent Discipline parenting constructs represented a satisfactory fit to the data, with minor modifications in scale content for both adolescent and parent versions. All three latent factors were moderately correlated in the adolescent-reported version, but there was no evidence that Inconsistent Discipline and Poor Monitoring were significantly correlated in the parent-reported version. Additionally, results supported the predictive validity of these constructs related to adolescent externalizing behavioral outcomes. Overall, results of the present study support the utility of a multi-informant abridged parenting assessment. However, some items of the Parental Monitoring and Inconsistent Discipline constructs may not be strong indicators of parenting practices among youth in recovery from SUDs. We conclude with suggestions for future research efforts as well as clinical implications of parenting measures among adolescents with SUD histories. [ABSTRACT FROM AUTHOR]

Objective: College students experience a variety of stressors that can increase the risk for mental health concerns, like depression. It is crucial for practitioners working on college campuses to understand the relationship among stressful life events, depression, and coping strategies. The purpose of this study was to explore life stressors' impact on reported depressive symptoms and how adaptive and maladaptive coping strategies moderate that relationship in college students. Participants: Data was used from a comprehensive health behavior survey. Participants included 969 college students. Methods: Multivariable logistic models were used to examine the association between stressful events, depression, and coping strategies. Results: Results from multiple logistic regression analyses indicated that college students who experienced life stressors and participated in more negative than positive coping strategies were 2.49 (95% CI = 1.34, 4.63) times more likely to experience depression. Conclusions: Implications and creative interventions are provided for mental health practitioners working on college campuses. [ABSTRACT FROM AUTHOR]

There is a pressing need for effective interventions targeting mental disorders for service-involved youth across child welfare, correctional and mental health residential settings. Identifying effective common practice elements (CPEs) is a promising direction toward developing effective, flexible, and feasible therapeutic interventions. The aims of this study were: 1) to identify CPEs in treatment programs for adolescents with internalizing and/or externalizing disorders across residential settings, 2) to identify which CPEs are present in effective versus all trials, and 3) to estimate whether the presence of each CPE is associated with treatment effects. A systematic search identified 24 trials of programs targeting adolescent internalizing and/or externalizing symptoms, yielding 148 effect estimates. Discrete practices were coded into CPE categories across effective trials and the full sample. Eleven CPEs were identified and employed as moderators in three-level meta-analyses. We found large significant moderator effects of two elements on externalizing symptoms: Emotion recognition and differentiation, and Psychoeducation. No CPE was significantly related to effects on internalizing outcomes. The results illustrate the difference between CPE frequency and association with effect, favoring a combination of the two approaches. Emotion recognition and differentiation, and Psychoeducation should be prioritized in novel interventions targeting adolescent externalizing behavior in residential settings. [ABSTRACT FROM AUTHOR]

The current study examined the associations among negative beliefs about parenting, harsh parenting, and child externalizing behavior using a prospective longitudinal design. We assessed the influence of negative beliefs about parenting before becoming a parent on later family processes (e.g., harsh parenting) in early childhood, and child outcomes (e.g., externalizing behavior) across early childhood. The study included 249 target participants followed from adolescence to adulthood, after becoming a parent. Negative beliefs about parenting was assessed when the target was 18 years old (Time 1), negative beliefs about parenting, harsh parenting, and child externalizing behavior were assessed when the child was two to four (Time 2), and negative beliefs about parenting and child externalizing behavior were assessed again when the child was three to five years old (Time 3). Results showed negative beliefs about parenting before becoming a parent (Time 1) was related to harsh parenting (Time 2), which was related to child externalizing at Time 2, which was associated with child externalizing at Time 3. Negative beliefs about parenting at Time 1 was also related to negative beliefs at Time 2, which was associated with child externalizing at Time 2, then to child externalizing at Time 3. Finally, negative beliefs about parenting was stable from Time 1 to Time 3. In sum, negative beliefs about parenting affected parenting behaviors distally and child behaviors proximally. These findings have program and policy implications that suggest beliefs held in late adolescence may have an impact on later family processes and future child outcomes. Highlights: Negative beliefs about parenting in adolescence, before becoming a parent, influences later use of harsh parenting. Negative beliefs about parenting remains stable from adolescence to when their child is between the ages of three and five. Negative beliefs about parenting has concurrent effects on child externalizing behavior. [ABSTRACT FROM AUTHOR]

Combat exposure (CE) and military sexual trauma (MST) are among the most common types of traumatic experiences faced by veterans and active duty servicemembers and, as such, have both garnered increased research focus over the past decades. However, there has not yet been a critical review of the literature to examine the distinct clinical presentations associated with different trauma types. This is particularly important, as understanding distinct clinical profiles could help researchers and clinicians refine treatment approaches based on trauma type. To address this question, we conducted a search of the available literature in PsycINFO and PubMed prior to October 2022. We identified 43 articles evaluating the distinct and overlapping clinical symptoms of CE and MST. Study findings were conceptually organized by psychiatric condition. In general, there was substantial variability in study methodology including sample size, composition, and operationalizations of CE and MST. Despite this variability, notable patterns emerged across studies. Specifically, MST and CE uniquely predicted posttraumatic stress disorder symptoms, MST was more related to depressive symptoms and suicidality than CE, and CE appeared to be more related to alcohol use and other externalizing behaviors. Gender also played a significant role in the relationship between CE, MST, and clinical variables across studies. This review suggests that individuals with a history of MST and CE likely have distinct clinical presentations and more research into these presentations could better inform assessment and treatment. Important methodological gaps in the literature are also discussed. [ABSTRACT FROM AUTHOR]

Objective: Investigating concordance between parents' mentalization and their moderating effects on the link between children's exposure to marital conflict and internalizing and externalizing behaviors. Background: Marital conflict is a risk factor for children's behavior. Mentalization is a parental strength that can protect children's well‐being in the face of adversity. Little is known about parental mentalization within the family context. Method: Cohabiting, heterosexual Israeli couples (N = 89) with a 3‐ to 5‐year‐old child were interviewed individually to assess their mentalization skills (mind‐mindedness). Reports of the child's exposure to marital conflict using the O'Leary‐Porter Scale of Marital Conflict and externalizing and internalizing behaviors using the Child Behavior Checklist were obtained. Results: There was limited accord between parents' mentalization within each couple. The positive associations between conflict exposure and children's internalizing and externalizing behaviors were mitigated when the parents' mentalization skills were matched or when the mother's mentalization skills were high. A significant three‐way interaction emerged such that the contribution of the father's mentalization skills to the prediction of children's externalizing and internalizing behavior depended on the mentalization skills of the mother and the level of exposure to conflict. Conclusion: Coordinated, high levels of parental mentalization can mitigate the negative impact of exposing children to parental conflict. Implications: Parental mentalization can mitigate children's exposure to marital conflict. Enhancing parental mentalization is an important treatment goal for the family and for the child. Family interventions can benefit from evaluating each parent's initial parental mentalization skills to determine whether the parental couple share a similar level of this capacity. Detecting and addressing gaps between the parents in their parental mentalization skills can facilitate coordinated and shared parenting. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to examine associations among parents' familism values, adolescents' cultural resources, and externalizing behavior among Latinx youth in the Midwestern United States. Method: Participants were 267 Latinx adolescents (M age = 15.58 years; SD = 1.28 years; 45% girls; 82.8% Mexican American) and their mothers/mother figures who completed individually administered interviews comprised of standardized measures. Structural equation modeling was used to test several alternative mediational models in which youth ethnic identity and familism values served as potential cultural mechanisms linking parents' familism values to lower levels of youth externalizing behavior. Results: Results showed that mothers' familism values were positively associated with youth ethnic identity which was positively associated with youth familism values; in turn, youth familism values were inversely associated with externalizing behavior. The findings did not differ by youth gender or nativity (U.S.-born vs. foreign-born youth). Conclusions: These findings provide support for cultural resilience perspectives by highlighting the protective role of ethnic identity and familism values among U.S. Latinx adolescents. Public Significance Statement: U.S. Latinx youth are at increased risk of developing externalizing behaviors such as aggression and substance use. Our study showed that mothers' familism values, youth ethnic identity, and youth familism values were linked, either directly or indirectly, to less externalizing behavior among U.S. Latinx youth, suggesting that these cultural resources are protective. Interventions that enhance these resources may help prevent or reduce externalizing behavior among U.S. Latinx adolescents. [ABSTRACT FROM AUTHOR]