Trajectories and Predictors of Children's Early-Starting Conduct Problems: Child, Family, Genetic, and Intervention Effects

Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest

The relationship between childhood maltreatment and subsequent offending/victimization is well established. However, the magnitude of this relationship for different levels of child protection services (CPS) involvement is poorly understood, due to measurement issues, lack of longitudinal data, and reliance on reports of substantiated maltreatment, which can underestimate the impact of maltreatment. This study examined associations between CPS involvement during childhood (ages 0 to <11 years) and police services contact (as a victim and/or a person of interest) for criminal incidents in early adolescence (11 to ~14 years), differentiated according to levels of CPS involvement (i.e., no risk of significant harm [non-ROSH], unsubstantiated ROSH, substantiated ROSH, and out-of-home care; each examined relative to no CPS contact). Data for 71,465 children were drawn from the New South Wales Child Development Study, an intergenerational, longitudinal investigation that uses administrative records from CPS and police alongside other health, justice, and education data. Multinomial regression analyses were conducted to determine associations between increasing levels of CPS involvement and police contact as a victim only, a person of interest only, and as both victim and person of interest while accounting for covariates (i.e., child's sex, Aboriginal, and/or Torres Strait Islander background, socioeconomic status, maternal age at child's birth, and parental offending history). Children exposed to any of the four levels of CPS involvement had higher odds of police contact, relative to children with no CPS involvement. Odds ratios were higher for contact with police as both a victim and a person of interest, compared to police contact as a victim or a person of interest only. These findings highlight that children with even unsubstantiated CPS reports (i.e., non-ROSH and unsubstantiated ROSH reports) are at heightened risk of police contact compared to children who are unknown to CPS, underlining the need to support all families in contact with CPS.

Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence

Introduction

Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence.

Materials and Methods

The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children's symptom classes. Other covariates included parent depressive symptoms at child ages 4-5 and child race and ethnicity.

Results

Analyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c' = .57) effects of socioeconomic stress on children's symptom class membership in the mediation analysis were significant (p <.001).

Discussion

Study findings suggest that intervening on modifiable bioecological stressors-including parenting behaviors and socioeconomic stressors-may provide important protective influences on children's internalizing symptom trajectories.

Maternal parenting stress and social-emotional problems of Chinese preschoolers: The role of the mother-child relationship and maternal adverse childhood experiences

BACKGROUND

Previous research suggests that maternal parenting stress is a significant predictor of social-emotional problems in children. However, little is known regarding the mother-child relationship and the effect of maternal adverse childhood experiences (ACEs) on this association.

METHODS

Three waves of longitudinal panel data were collected from 2893 Chinese preschoolers with a follow-up interval of 6 months. The mothers of preschoolers were asked to complete anonymous questionnaires concerning demographic variables, maternal ACEs and parenting stress in Wave 1, mother-child relationships in Wave 2, and children's social-emotional problems in Wave 3. The parallel mediation model was conducted to analyze the mediating role of three dimensions of mother-child relationships, and the moderation model was conducted to examine the moderating role of maternal ACEs.

RESULTS

The results showed that maternal parenting stress predicted children's social-emotional problems directly or indirectly through the mother-child relationship, with an intimate mother-child relationship mediating this main effect negatively but a conflicted and dependent mother-child relationship mediating this main effect positively. In addition, moderating results indicated that the main effect of maternal parenting stress on children's social-emotional problems was more marked among participants with at least one maternal ACEs than those without maternal ACEs. Furthermore, the moderating effect was only detected in children whose mothers had a high school education or less.

LIMITATIONS

The subjectivity of mothers' reports may somewhat reduce the credibility due to the possible overestimation or underestimation of children's social-emotional problems.

CONCLUSION

These findings provide new evidence for the effects of maternal parenting stress on children's social-emotional development and highlight the need for more attention to children with mothers having ACE exposure, lower educational level and poor parent-child relationships.

Developmental trajectories of conduct problems and time-varying peer problems: the Bergen child study

BACKGROUND

While it is increasingly acknowledged that conduct problems and peer problems often co-occur in development, less is known about the ways in which peer problems may alter the developmental course of conduct problems for distinct subgroups.

METHODS

Using data from a large population-based study in Norway (the Bergen Child Study/youth@hordaland; 47.4% males), we estimated group-based trajectories of conduct problems and the presence of time-varying peer problems on the developmental progression of conduct problems between seven and 19 years of age. Risk factors for group membership were also examined.

RESULTS

A 3-group model of conduct problems best fit the data (non-engagers, low-engagers, moderate-stable). The presence of peer problems increased the estimated level of conduct problems for both the low-engagers and moderate-stable groups across adolescence. No differences in conduct problems were observed when peer problems were present in childhood or preadolescence for these two groups, nor for the non-engagers group at any point. Being male, having lower perceived economic wellbeing, and lower levels of parental education predicted group membership for the moderate-stable group, whilst lower paternal education predicted membership for the low-engagers group.

CONCLUSIONS

Support for developmental 'turning points' was found, suggesting that adolescence is a particularly salient time for those with conduct problems. In particular, the presence of peer problems can increase observed conduct problems at this stage in development.

Early risk factors for conduct problem trajectories from childhood to adolescence: the 2004 Pelotas (BRAZIL) Birth Cohort

Conduct problems are associated with an increased risk of a wide range of physical, mental, and social problems. However, there is still uncertainty about how early risk factors differentiate different developmental patterns of conduct problems and whether findings replicate across diverse social contexts. We aimed to identify developmental trajectories of conduct problems, and test early risk factors, in the 2004 Pelotas Birth Cohort in Brazil. Conduct problems were measured at ages 4, 6, 11, and 15 years from caregiver reports on the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Conduct problem trajectories were estimated using group-based semi-parametric modeling (n = 3938). Multinomial logistic regression was used to examine associations between early risk factors and conduct problem trajectories. We identified four trajectories: three with elevated conduct problems, including early-onset persistent (n = 150; 3.8%), adolescence-onset (n = 286; 17.3%), and childhood-limited (n = 697; 17.7%), and one with low conduct problems (n = 2805; 71.2%). The three elevated conduct problem trajectories were associated with a wide range of sociodemographic risk factors, prenatal smoking, maternal mental health, harsh parenting, childhood trauma, and child neurodevelopmental risk factors. Early-onset persistent conduct problems were particularly associated with trauma, living without a father figure, and attention difficulties. The four trajectories of conduct problems from ages 4 to 15 years in this Brazilian cohort have similar longitudinal patterns to those identified in high-income countries. The results confirm previous longitudinal research and developmental taxonomic theories on the etiology of conduct problems in a Brazilian sample.

Polygenic risk for major depression, attention deficit hyperactivity disorder, neuroticism, and schizophrenia are correlated with experience of intimate partner violence

Research has suggested that mental illness may be a risk factor for, as well as a sequela of, experiencing intimate partner violence (IPV). The association between IPV and mental illness may also be due in part to gene-environment correlations. Using polygenic risk scores for six psychiatric disorders - attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BPD), major depressive disorder (MDD), neuroticism, and schizophrenia-and a combined measure of overall genetic risk for mental illness, we tested whether women's genetic risk for mental illness was associated with the experience of three types of intimate partner violence. In this cohort of women of European ancestry (N = 11,095), participants in the highest quintile of genetic risk for ADHD (OR range: 1.38-1.49), MDD (OR range: 1.28-1.43), neuroticism (OR range: (1.18-1.25), schizophrenia (OR range: 1.30-1.34), and overall genetic risk (OR range: 1.30-1.41) were at higher risk for experiencing more severe emotional and physical abuse, and, except schizophrenia, more severe sexual abuse, as well as more types of abuse and chronic abuse. In addition, participants in the highest quintile of genetic risk for neuroticism (OR = 1.43 95% CI: 1.18, 1.72), schizophrenia (OR = 1.33 95% CI: 1.10, 1.62), and the overall genetic risk (OR = 1.40 95% CI: 1.15, 1.71) were at higher risk for experiencing intimate partner intimidation and control. Participants in the highest quintile of genetic risk for ADHD, ASD, MDD, schizophrenia, and overall genetic risk, compared to the lowest quintile, were at increased risk for experiencing harassment from a partner (OR range: 1.22-1.92). No associations were found between genetic risk for BPD with IPV. A better understanding of the salience of the multiple possible pathways linking genetic risk for mental illness with risk for IPV may aid in preventing IPV victimization or re-victimization.

Effects of a preventive parenting intervention for bereaved families on the intergenerational transmission of parenting attitudes: Mediating processes

This study evaluated whether the Family Bereavement Program (FBP), a prevention program for parentally bereaved families, improved parenting attitudes toward parental warmth and physical punishment in young adult offspring 15 years after participation and identified mediational cascade pathways. One hundred fifty-six parents and their 244 offspring participated. Data were collected at pretest (ages 8-16), posttest, and six- and 15-year follow-ups. Ethnicity of offspring was: 67% non-Hispanic Caucasian, 16% Hispanic, 7% African American, 3% Native American, 1% Asian or Pacific Islander, and 6% other; 54% were males. There was a direct effect of the FBP on attitudes toward physical punishment; offspring in the FBP had less favorable attitudes toward physical punishment. There were also indirect effects of the FBP on parenting attitudes. The results supported a cascade effects model in which intervention-induced improvements in parental warmth led to fewer externalizing problems in adolescence/emerging adulthood, which in turn led to less favorable attitudes toward physical punishment. In addition, intervention-induced improvements in parental warmth led to improvements in anxious romantic attachment in mid-to-late adolescence/emerging adulthood, which led to more favorable attitudes toward parental warmth in emerging/young adulthood. These findings suggest that the effects of relatively brief prevention programs may persist into subsequent generations.

Genetic patterning for child psychopathology is distinct from that for adults and implicates fetal cerebellar development

Childhood psychiatric symptoms are often diffuse but can coalesce into discrete mental illnesses during late adolescence. We leveraged polygenic scores (PGSs) to parse genomic risk for childhood symptoms and to uncover related neurodevelopmental mechanisms with transcriptomic and neuroimaging data. In independent samples (Adolescent Brain Cognitive Development, Generation R) a narrow cross-disorder neurodevelopmental PGS, reflecting risk for attention deficit hyperactivity disorder, autism, depression and Tourette syndrome, predicted psychiatric symptoms through early adolescence with greater sensitivity than broad cross-disorder PGSs reflecting shared risk across eight psychiatric disorders, the disorder-specific PGS individually or two other narrow cross-disorder (Compulsive, Mood-Psychotic) scores. Neurodevelopmental PGS-associated genes were preferentially expressed in the cerebellum, where their expression peaked prenatally. Further, lower gray matter volumes in cerebellum and functionally coupled cortical regions associated with psychiatric symptoms in mid-childhood. These findings demonstrate that the genetic underpinnings of pediatric psychiatric symptoms differ from those of adult illness, and implicate fetal cerebellar developmental processes that endure through childhood.

Family processes and structure: Longitudinal influences on adolescent disruptive and internalizing behaviors

OBJECTIVE

The present study revisits the assumption in American culture, based in "family privilege," that children fare better in two-parent households by longitudinally examining associations between family structure, process, and adolescent behavior.

BACKGROUND

Societal assumptions and cross-sectional research suggest that there is a difference in child adjustment across varying family structures. Relatedly, the family process literature emphasizes the importance of parent-child relationship quality in addition to family structure on child adjustment.

METHOD

We utilized a longitudinal, prospective design that assessed family structures on nine occasions covering a 12-year period beginning when the target child was 2 years of age for a large (N = 714), ethnically and racially diverse sample of low-income families. We examined the relation between self-reported, teacher-reported, and primary caregiver-reported adolescent disruptive and internalizing problem behavior across family structures and parent-child relationship quality.

RESULTS

Across seven identified family structures, adolescent behavior did not differ after accounting for middle-childhood adjustment and relevant contextual factors. However, consistent with family process models of child adjustment, positive parent-child relationship quality predicted lower rates of adolescent maladaptive behavior.

CONCLUSION

These findings serve to combat stigma related to family structures that deviate from married parents raising their children and highlight the need for interventions designed to foster positive parent-child relationships.

IMPLICATIONS

Policy makers and practitioners should aim to support efforts to foster positive parent-child relationships across types of family structures and refrain from promoting or discouraging the formations of specific family structure types.

Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care: A Randomized Clinical Trial using the Family Check-Up

This study evaluated acceptability, engagement in prevention, and efficacy of a primary care screening-and-referral-to-prevention program to reduce substance use in early adolescence. Screening tools were the Youth Risk Index and Transmissible Liability Index and prevention consisted of the Family Check-Up (FCU). Three hundred sixty-one 10- to 13-year-olds from low resource neighborhoods (85.9% African American; 52.4% female) screened "at risk" during primary care visits and were randomized to the FCU (n = 123) or usual care (n = 238). Screening was acceptable to parents and youths: nearly 95% of each rated it as important, about 90% of each were happy with or did not mind it, and only 2.4% of parents did not want their child to be screened at their next check-up. Of parents who had a chance to receive the FCU (or waitlist-control), 87.5% followed through with researchers while 93.5% who were offered FCU engaged in it. FCU efficacy primarily involved interactions such that youth with greater risk at baseline experienced larger benefits. At 12-month follow-up, FCU was associated with 11% reduced risk of initiating a new substance per substance that had been initiated before baseline; greater reductions in tolerance of deviance among those with higher tolerance of deviance at baseline; and a main effect of reduced anxiety, but no effect for conduct problems. Pediatric well-child check-up screening can identify high-risk youth before, or in the initial stages of, problematic SU; engage families in a preventive intervention; and reduce rates of substance use and related risk factors.

Educational performance and conduct problem trajectories from childhood to adolescence: Observational and genetic associations in a Brazilian birth cohort

BACKGROUND

Educational difficulties are an important potential influence on both the onset and course of children's conduct problems. This study evaluated the association between school failure and children's conduct problems in Brazil, a context with high rates of both conditions, using both observational and genetic approaches.

METHODS

Prospective, population-based, birth cohort study in Pelotas city, Brazil. Parents reported on conduct problems four times between ages 4-15 years, and group-based trajectory analysis was used to classify 3469 children into trajectories of childhood-limited, early-onset persistent, adolescence-onset, or low conduct problems. School failure was measured as having repeated a school grade up to age 11, and a polygenic risk score (PRS) predicting educational attainment was calculated. Multinomial adjusted regression models were used to estimate the association between school failure (observational measure and the PRS) and conduct problem trajectories. To consider possible variation in effects of school failure by social context, interactions were tested with family income and school environment (using both observational and PRS methods).

RESULTS

Children repeating a school grade had increased odds of being on to childhood-limited (OR: 1.57; 95% CI 1.21; 2.03), adolescence-onset (OR: 1.96; 95% CI 1.39; 2.75), or early-onset persistent trajectory (OR: 2.99; 95% CI 1.85; 4.83), compared to the low conduct problem trajectory. School failure also predicted increased risk for early-onset persistent problems versus the childhood-limited problems (OR: 1.91; 95% CI 1.17; 3.09). Using a genetic PRS approach, similar findings were observed. Associations varied according to the school environment: school failure had larger effects on children in better school environments.

CONCLUSION

School performance, whether measured in terms of repeating school grades or genetic susceptibility, was consistently associated with trajectories of child conduct problems into mid-adolescence. We also found a larger association for children in better school environments.

Parenting in the Context of the Child: Genetic and Social Processes

The focus on the role of parenting in child development has a long-standing history. When measures of parenting precede changes in child development, researchers typically infer a causal role of parenting practices and attitudes on child development. However, this research is usually conducted with parents raising their own biological offspring. Such research designs cannot account for the effects of genes that are common to parents and children, nor for genetically influenced traits in children that influence how they are parented and how parenting affects them. The aim of this monograph is to provide a clearer view of parenting by synthesizing findings from the Early Growth and Development Study (EGDS). EGDS is a longitudinal study of adopted children, their birth parents, and their rearing parents studied across infancy and childhood. Families (N = 561) were recruited in the United States through adoption agencies between 2000 and 2010. Data collection began when adoptees were 9 months old (males = 57.2%; White 54.5%, Black 13.2%, Hispanic/Latinx 13.4%, Multiracial 17.8%, other 1.1%). The median child age at adoption placement was 2 days (M = 5.58, SD = 11.32). Adoptive parents were predominantly in their 30s, White, and coming from upper-middle- or upper-class backgrounds with high educational attainment (a mode at 4-year college or graduate degree). Most adoptive parents were heterosexual couples, and were married at the beginning of the project. The birth parent sample was more racially and ethnically diverse, but the majority (70%) were White. At the beginning of the study, most birth mothers and fathers were in their 20s, with a mode of educational attainment at high school degree, and few of them were married. We have been following these family members over time, assessing their genetic influences, prenatal environment, rearing environment, and child development. Controlling for effects of genes common to parents and children, we confirmed some previously reported associations between parenting, parent psychopathology, and marital adjustment in relation to child problematic and prosocial behavior. We also observed effects of children's heritable characteristics, characteristics thought to be transmitted from parent to child by genetic means, on their parents and how those effects contributed to subsequent child development. For example, we found that genetically influenced child impulsivity and social withdrawal both elicited harsh parenting, whereas a genetically influenced sunny disposition elicited parental warmth. We found numerous instances of children's genetically influenced characteristics that enhanced positive parental influences on child development or that protected them from harsh parenting. Integrating our findings, we propose a new, genetically informed process model of parenting. We posit that parents implicitly or explicitly detect genetically influenced liabilities and assets in their children. We also suggest future research into factors such as marital adjustment, that favor parents responding with appropriate protection or enhancement. Our findings illustrate a productive use of genetic information in prevention research: helping parents respond effectively to a profile of child strengths and challenges rather than using genetic information simply to identify some children unresponsive to current preventive interventions.

Systematic Review: Molecular Studies of Common Genetic Variation in Child and Adolescent Psychiatric Disorders

OBJECTIVE

A systematic review of studies using molecular genetics and statistical approaches to investigate the role of common genetic variation in the development, persistence, and comorbidity of childhood psychiatric traits was conducted.

METHOD

A literature review was performed using the PubMed database, following PRISMA guidelines. There were 131 studies meeting inclusion criteria, having investigated at least one type of childhood-onset or childhood-measured psychiatric disorder or trait with the aim of identifying trait-associated common genetic variants, estimating the contribution of single nucleotide polymorphisms (SNPs) to the amount of variance explained (SNP-based heritability), investigating genetic overlap between psychiatric traits, or investigating whether the stability in traits or the association with adult traits is explained by genetic factors.

RESULTS

The first robustly associated genetic variants have started to be identified for childhood psychiatric traits. There were substantial contributions of common genetic variants to many traits, with variation in single nucleotide polymorphism heritability estimates depending on age and raters. Moreover, genetic variants also appeared to explain comorbidity as well as stability across a range of psychiatric traits in childhood and across the life span.

CONCLUSION

Common genetic variation plays a substantial role in childhood psychiatric traits. Increased sample sizes will lead to increased power to identify genetic variants and to understand genetic architecture, which will ultimately be beneficial to targeted and prevention strategies. This can be achieved by harmonizing phenotype measurements, as is already proposed by large international consortia and by including the collection of genetic material in every study.

Relations between Early Childhood Paternal Depression and Preschool- and School-age Psychosocial Functioning

Objective: The present study used a longitudinal design to examine associations between paternal depressive symptoms in toddlerhood and children's psychosocial adjustment during the preschool and school-age periods. Maternal depressive symptoms and intervention status were tested as moderators of associations between paternal depressive symptoms and child maladjustment.Method: The sample (n = 264, 48% female, 62% White, 14% Black, 14% bi-racial, 11% another racial group, and 86% non-Hispanic/Latinx) represented a subsample of families from the Early Steps Multisite Study, a clinical randomized trial testing the effectiveness of the Family Check-Up among low-income families using Women, Infants, and Children Nutritional Supplement Services in three communities varied in urbanicity. Fathers and mothers reported their levels of depressive symptoms at child age 2, primary caregivers (mostly mothers) contributed measures of child adjustment at ages 5, 8.5, and 9.5, and teachers completed questionnaires about child adjustment at ages 8.5 and 9.5.Results: Direct relations were found between paternal depressive symptoms and primary caregivers' reports of children's preschool and school-age internalizing problems. Furthermore, higher levels of paternal depression were associated with higher levels of children's later adjustment problems at preschool-age when maternal depressive symptoms were mild or higher. The Family Check-Up attenuated relations between paternal depressive symptoms and children's internalizing problems at school-age.Conclusions: These findings have important implications for future research on preventing children's early-emerging problem behaviors at home, suggesting that addressing paternal depressive symptoms in early childhood may be an important intervention target, especially in the context of maternal depression.

The Impact of the COVID-19 Pandemic on Children's Conduct Problems and Callous-Unemotional Traits

The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children's mental health.

Polygenic risk for aggressive behavior from late childhood through early adulthood

Twin studies suggest a substantial role for genes in explaining individual differences in aggressive behavior across development. It is unclear, however, how directly measured genetic risk is associated with aggressive behavior at different moments across adolescence and how genes might distinguish developmental trajectories of aggressive behavior. Here, a polygenic risk score derived from the EAGLE-Consortium genome-wide association study of aggressive behavior in children was tested as predictor of latent growth classes derived from those measures in an adolescent population (n = 2229, of which n = 1246 with genetic information) and a high-risk sample (n = 543, of which n = 335 with genetic information). In the population sample, the polygenic risk score explained variation in parent-reported aggressive behavior at all ages and distinguished between stable low aggressive behavior and moderate and high-decreasing trajectories based on parent-report. In contrast, the polygenic risk score was not associated with self- and teacher-reported aggressive behavior, and no associations were found in the high-risk sample. This pattern of results suggests that methodological choices made in genome-wide association studies impact the predictive strength of polygenic risk scores, not just with respect to power but likely also in terms of generalizability and specificity.

Practitioner Review: Parenting interventions for child conduct problems: reconceptualising resistance to change

Parenting interventions based on social learning theory have received extensive empirical support in the treatment of child conduct problems; yet, they fail to produce lasting gains in as many as a third of cases. Perspectives on these poor outcomes have been informed by numerous lines of research, and practitioner recommendations for improving such outcomes have often emphasized processes related to clinical engagement. In this Practitioner Review, we examine recent theory and evidence pertaining to these processes, including emerging research into the therapeutic relationship across face-to-face and eHealth treatment modalities, and the clinical engagement of both mothers and fathers. The concept of resistance to change is examined in light of these developments, and it is argued that the process of overcoming such resistance can be characterized as one of reflective practice. A novel process model based on this perspective is presented, comprising practical clinical strategies that are designed to be initiated from the earliest contacts with a family and build on one another across treatment.

Moderators of Psychosocial Intervention Response for Children and Adolescents with Conduct Problems

Objective: The purpose of this Brief Report is to synthesize the current evidence base examining moderators of psychosocial intervention response for children and adolescents with conduct problems (CP). We also provide directions for future research.Method: We focused on four categories of psychosocial interventions for the prevention and/or treatment of CP: (1) parent management training (PMT) for children, (2) other family-based interventions for adolescents, (3) youth skills training, and (4) multicomponent interventions (i.e., family-based intervention plus skills training). Emphasis is placed on findings from meta-analyses.Results: Moderation analyses have occurred more frequently for PMT than for other types of interventions. Variables for which there was consistent evidence for positive moderation included higher initial severity of CP, father engagement, higher maternal depressive symptoms, individual administration (vs. group), and treatment/targeted prevention approaches (vs. universal prevention). Variables where there was evidence for no moderation (demonstrating generalizability) included child diagnostic status and family risk in PMT, and diagnostic status and intervention setting for skills training. However, for some variables, evidence of moderation was dependent on intervention type.Conclusions: Future research should examine multiple moderators in combination; incorporate innovative techniques such as integrative data analyses, individual participant data, and class-based modeling, which may identify moderator effects that are undetected by more traditional variable-oriented moderation analyses; and conduct moderated mediation models for informing developmental theory on the interplay of risk and protective factors.

Do risk profiles moderate the relation between age of onset of disruptive behaviour and two types of externalising problems among adolescents admitted to secure residential care?

BACKGROUND

Adolescents with externalising problems in secure residential care differ in age of onset of disruptive behaviour and in cumulative risks in several domains. In order to reduce negative consequences of externalising behaviour for society and the adolescents themselves, it is important to gain more insight into the complexity and heterogeneity of disruptive behaviour in these adolescents. To look beyond the influence of single risk factors, the aim of this study is to investigate the moderator effect of co-occurring risk factors in multiple domains on the relation between age of onset of disruptive behaviour and two types of externalising problems in adolescence.

METHODS

Retrospectively collected data of 225 adolescents admitted to secure residential care were analysed. The four risk profiles were based on co-occurring pre-admission risk factors in four domains, which were identified in a previous study by latent class analysis. Multiple regression models were used to test whether the independent variable age of onset and dummy-coded moderator variable risk profiles had statistically significant associations with aggressive behaviour and rule-breaking behaviour of the adolescents, as reported by professional caregivers in the first months of admission.

RESULTS

Risk profiles moderated the relation between age of onset of disruptive behaviour and rule-breaking behaviour. Adolescents with childhood-onset disruptive behaviour within the risk profile with mainly family risks showed more rule-breaking behaviour in the first months of their admission to secure residential care than adolescents with an onset in adolescence within the same risk profile. Risk profiles, however, did not moderate the relation between age of onset of disruptive behaviour and aggressive behaviour.

CONCLUSION

Heterogeneity of aggressive and rule-breaking behaviour was established in this study by finding differences on these two types of externalising behaviour between the childhood- and adolescence-onset groups and between the four risk profiles. Furthermore, risk profiles moderated the effect between age of onset of disruptive behaviour and rule-breaking behaviour-not aggressive behaviour-in adolescents admitted to secure residential care. While respecting the limitations, adolescents' childhood-onset disruptive behaviour within a profile with mainly family risk factors appear to be distinctive from adolescents with adolescence-onset disruptive behaviour within the same risk profile.

Genotype-environment correlation by intervention effects underlying middle childhood peer rejection and associations with adolescent marijuana use

Aggressive behavior in middle childhood can contribute to peer rejection, subsequently increasing risk for substance use in adolescence. However, the quality of peer relationships a child experiences can be associated with his or her genetic predisposition, a genotype-environment correlation (rGE). In addition, recent evidence indicates that psychosocial preventive interventions can buffer genetic predispositions for negative behavior. The current study examined associations between polygenic risk for aggression, aggressive behavior, and peer rejection from 8.5 to 10.5 years, and the subsequent influence of peer rejection on marijuana use in adolescence (n = 515; 256 control, 259 intervention). Associations were examined separately in control and intervention groups for children of families who participated in a randomized controlled trial of the family-based preventive intervention, the Family Check-Up . Using time-varying effect modeling (TVEM), polygenic risk for aggression was associated with peer rejection from approximately age 8.50 to 9.50 in the control group but no associations were present in the intervention group. Subsequent analyses showed peer rejection mediated the association between polygenic risk for aggression and adolescent marijuana use in the control group. The role of rGEs in middle childhood peer processes and implications for preventive intervention programs for adolescent substance use are discussed.

A long-term look at "early starters": Predicting adult psychosocial outcomes from childhood conduct problem trajectories

Current evidence suggests that multiple pathways of "early-starting" conduct problems exist, including persisting and declining trajectories. Since relatively little is known about the early onset-declining pathway, this study examined the long-term outcomes of different childhood conduct problem trajectories in a disproportionately high-risk sample (N = 754). Parents reported on children's conduct problems at six time points (kindergarten to grade 7). At age 25, psychosocial outcomes were assessed across five domains (psychopathology, substance use, risky sexual behavior, antisocial behavior, and adaptive outcomes). Four childhood conduct problem trajectories were identified: extremely high increasing (EHI; 3.7%), high stable (HS; 22.0%), moderate decreasing (MD; 38.8%), and low decreasing (LD; 35.5%). The EHI and HS groups displayed the poorest psychosocial functioning at age 25, whereas the LD group exhibited the most positive adjustment. Although individuals in the MD group displayed relatively positive adjustment on some outcomes, they displayed more psychopathology and lower well-being in adulthood than the LD group. These findings suggest that there are diverse pathways of early-starting conduct problems, and that all early starters are at risk for later maladjustment. However, the degree and type of risk is related to the severity of conduct problems throughout childhood.

Indirect Effects of the Family Check-Up on Youth Extracurricular Involvement at School-Age through Improvements in Maternal Positive Behavior Support in Early Childhood

Extracurricular involvement in the school-age years has widespread potential benefits for children's subsequent socioemotional development, especially for low-income youth. However, there is a dearth of research on interventions aimed at increasing school-age extracurricular involvement in low-income youth. Thus, the present study aimed to test the collateral effect of a brief, family-focused intervention for low-income families, the Family Check-Up, on children's school-age extracurricular involvement via improvements in maternal Positive Behavior Support in early childhood. The sample (n = 630, 50% female, 50% White, 28% Black/African American) represented a subsample of families from the Early Steps Multisite Study. At age 2, families were randomly assigned to the Family Check-Up or Women, Infants, and Children Nutritional Supplement Services as usual. Mother-child dyads participated in observed interaction tasks at child ages 2 and 3 that were subsequently coded to assess positive behavior support. Primary caregivers reported on children's school-age extracurricular involvement at ages 7.5, 8.5, and 9.5. Results indicated that although there was not a direct path between intervention status and children's school-age extracurricular involvement, a significant indirect path emerged from intervention group to changes in positive behavior support between ages 2 to 3 to children's school-age extracurricular involvement. The results are discussed in terms of implications for designing preventive interventions in early childhood that promote extracurricular involvement at school-age, particularly for children at risk for maladaptive outcomes.

Adolescent Psychopathology: The Role of Brain-based Diatheses, Sensitivities, and Susceptibilities

The rates of onset for several forms of psychopathology peak during adolescence, which coincides with the refinement of brain circuitry attuned to expanding social-contextual interactions, stressors, and settings. While some adolescents experience mental health difficulties, most do not develop significant problems. Conceptual work suggests that brain-based individual differences in adolescents' neurobiological susceptibility to their social contexts play a role in the development of psychopathology and well-being. In this article, I summarize evidence supporting the idea that individual differences in brain structure and function moderate the relation between adolescents' social-contextual experiences and psychopathology. I discuss why this approach is important in developmental research designed to identify adolescents at greatest risk for psychopathology or poised for positive outcomes, as well as those who may benefit most from intervention.

Dysregulated Irritability as a Window on Young Children's Psychiatric Risk: Transdiagnostic Effects via the Family Check-Up

Building on prior work using Tom Dishion's Family Check-Up, the current article examined intervention effects on dysregulated irritability in early childhood. Dysregulated irritability, defined as reactive and intense response to frustration, and prolonged angry mood, is an ideal marker of neurodevelopmental vulnerability to later psychopathology because it is a transdiagnostic indicator of decrements in self-regulation that are measurable in the first years of life that have lifelong implications for health and disease. This study is perhaps the first randomized trial to examine the direct effects of an evidence- and family-based intervention, the Family Check-Up (FCU), on irritability in early childhood and the effects of reductions in irritability on later risk of child internalizing and externalizing symptomatology. Data from the geographically and sociodemographically diverse multisite Early Steps randomized prevention trial were used. Path modeling revealed intervention effects on irritability at age 4, which predicted lower externalizing and internalizing symptoms at age 10.5. Results indicate that family-based programs initiated in early childhood can reduce early childhood irritability and later risk for psychopathology. This holds promise for earlier identification and prevention approaches that target transdiagnostic pathways. Implications for future basic and prevention research are discussed.

Family-based prevention of adolescents' co-occurring internalizing/externalizing problems through early childhood parent factors

OBJECTIVE

We evaluated whether initiating the Family Check-Up (FCU) during early childhood prevented a severe form of psychopathology in adolescence-co-occurring internalizing and externalizing problems-and whether effects operated indirectly through early childhood maternal depression and parents' positive behavior support.

METHOD

Participants were drawn from a randomized controlled trial of the FCU (50.2% FCU; 49.5% girls; 46.6% Caucasian, and 27.6% Black; 13.4% Hispanic/Latino). At Ages 2 and 3, mothers self-reported depression, and primary caregivers' (PCs') positive behavior support was coded by trained observers. PCs, alternate caregivers (ACs), and teachers reported on 14-year-olds' problem behaviors. Latent profile analyses (LPAs) identified problem behavior groups for each reporter, which were outcomes in multinomial logistic regressions (PC, n = 672; AC, n = 652; teacher, n = 667).

RESULTS

LPAs identified a low-problem, internalizing-only, externalizing-only, and co-occurring-problem group for each reporter. For PC- and AC-reported outcomes, the FCU predicted a lower likelihood that adolescents belonged to the co-occurring group relative to the low-problem, externalizing-only (p < .05), and internalizing-only (p < .05 for PC, p < 0.10 for AC) groups; these effects operated through maternal depression (p < .05). For teacher-reported outcomes, the FCU predicted a lower likelihood that adolescents belonged to the co-occurring group relative to the low-problem, internalizing-only, and externalizing-only (p < 0.05) groups; effects operated through positive behavior support (p < 0.05).

CONCLUSIONS

Early delivery of the FCU indirectly prevented adolescents' co-occurring internalizing/externalizing problems in both home and school contexts by improving the quality of the early home environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).