Universal School-Based Substance Use Prevention Using Technology-Supported Cooperative Learning

Substance use in adolescence is a significant public health issue, particularly in early-to-mid adolescence, which represents a window of risk in the etiology of substance abuse and dependence. Substance use during this development period often results from affiliation with deviant peers, who model, facilitate, and reinforce use. Existing school-based substance use prevention programs have historically aimed to build adolescent knowledge regarding the dangers of substance use and/or enhance peer refusal skills. Research finds that these programs have had some success in reducing substance use, but meta-analyses report that average effect sizes are small. In a small one-year cluster randomized trial (12 middle and high schools; N = 813 students; ClinicalTrials.gov: NCT04478240), cooperative learning (CL) was implemented with the support of specialized technology and evaluated for its ability to reduce deviant peer affiliation and, in turn, reduce substance use. CL is a structured approach to small-group learning that provides at-risk youth with the opportunity to build friendships with more prosocial youth, interrupting the process of deviant peer clustering. Multi-level modeling revealed intervention effects for deviant peer affiliation and alcohol use across the sample, while tobacco use was significantly reduced among non-White students; intervention effects for marijuana use were only marginally significant. Effects for dosage were found for all outcomes, suggesting that every lesson taught had a significant impact. We conclude that CL, delivered with the aid of specialized technology, represents a viable option for universal substance use prevention. Future research should attempt to combine this approach with evidence-based prevention curricula.

Student-centered instruction can build social-emotional skills and peer relations: Findings from a cluster-randomized trial of technology-supported cooperative learning

Given the uneven track record of adjunctive social-emotional learning (SEL) programs and waning effects by middle and high school, we propose a more integrative approach to SEL through cooperative learning (CL). CL has demonstrated the ability to improve social-emotional, behavioral, academic, and mental health benefits, but CL lessons are complex and thus can be difficult to design and consistently deliver with fidelity. The present study attempted to address this barrier by examining the effects of technology-assisted CL on five social-emotional competencies, as well as social and behavioral outcomes. Participants were 813 students (50.2% female, N = 408, and 70.7% White, N = 575) from 12 middle and high schools in the Pacific Northwest in a cluster-randomized design where six intervention schools implemented technology-assisted CL and six control schools conducted business as usual. Using multilevel modeling, intervention effects on all outcomes after 1 year were significant, with moderate to large effect sizes, inviting further evaluation of integrative approaches to SEL that are developmentally aligned with the needs of students in secondary education. Although there remains a dearth of universal school-based interventions with demonstrated impacts on social outcomes in middle and high school, the present study builds support for the use of integrative, relationship-based instructional approaches, supported by technology, to promote positive peer relations, and social competencies for this age group. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Peer learning can modify the reciprocal relationship between peer support and victimization in middle school

INTRODUCTION

This research investigated how peer victimization and support are reciprocally related and how Cooperative Learning (CL) can reverse the progressive cascade that, unchecked, can culminate in youth mental health problems.

METHODS

The sample (N = 1890; 53% male) was derived from a randomized trial of CL in 15 middle schools in the United States. Students were recruited in the 7th grade. Structural Equation Modeling (SEM) was used to fit our cross-lag difference score model across four waves of data.

RESULTS

The results indicated a reciprocal relationship between peer support and victimization across time, suggesting the potential for negative experiences with peers to become amplified over time in a "vicious cycle," negatively impacting mental health. Students in intervention schools reported significantly higher levels of peer support and lower levels of victimization, suggesting that CL can intervene in this cycle, with salutary effects on mental health; CL also demonstrated direct effects on mental health.

CONCLUSIONS

The present study indicates that low peer support can be both a precursor to and an outcome of victimization, serving to maintain a vicious cycle that compounds negative effects on student mental health. Further, results demonstrate how CL can reverse this cycle. We conclude that CL can be of particular importance to the prevention field as a universal mental health program that does not require the associated stigma of identifying youth at elevated risk for referral to treatment programs.

Costs and benefits of cooperative learning as a universal school-based approach to adolescent substance use prevention

Substance use during early adolescence implies a greater likelihood of abuse and dependence in later adolescence or adulthood. In turn, substance abuse and dependence are linked to a variety of maladaptive long-term health-related outcomes that imply significant individual and societal costs. In this paper, we evaluated an approach to substance use prevention that relies on the vital role of peers, who comprise a key risk factor for adolescent substance use. This approach (i.e., cooperative learning, CL) focuses on interrupting the process of deviant peer clustering and providing at-risk youth with the opportunity to build social skills and cultivate friendships with low-risk youth. In addition to testing the efficacy of CL in reducing the number of students who become regular substance users, we also conducted a cost-benefit analysis. Using four waves of data from a cluster-randomized trial (N = 15 middle schools, 1890 students, 47.1% female, 75.2% White, 13.9% of students were receiving special education services), we found that significantly lower percentages of students in the intervention (CL) schools became regular users of tobacco, alcohol, and marijuana. We estimated that the reduction in substance use associated with the implementation of CL resulted in total lifetime benefits of between $1027 and $4621 per student (in 2019 dollars), or between $8.79 and $39.54 for each dollar invested in CL. Benefit/cost ratios would go up to $22.54-$101.39 per dollar invested with the continual implementation of CL, assuming retraining every 5 years. Implications and future research directions are discussed.

A Longitudinal Process Model Evaluating the Effects of Cooperative Learning on Victimization, Stress, Mental Health, and Academic Engagement in Middle School

Mental health is a significant concern among young people, particularly during the COVID-19 pandemic. Notably, mental health problems can significantly reduce student performance in school, including both engagement and achievement. Both mental health problems and reduced student performance often arise due to peer victimization, which can include teasing, racial- or gender-based discrimination, and/or physical assault. Stress has been proposed as one mechanism through which victimization influences mental health, and stress can also interfere with academic performance at school, including engagement and achievement. To date, however, no research has evaluated longitudinal associations between victimization and stress, and how these longitudinal patterns may impact adolescent behavior and mental health. In this study, we used data from a 2-year cluster randomized trial of cooperative learning to evaluate an etiological process model that includes (1) longitudinal reciprocal effects between victimization and stress, and (2) the effects of both victimization and stress on student mental health and academic engagement. We hypothesized that victimization and stress would have significant reciprocal effects, and that both would predict greater mental health problems and lower academic engagement. We further hypothesized that cooperative learning would have significant effects on all constructs. We found partial support for this model, whereby stress predicted greater victimization, but victimization did not predict increased stress. While both factors were linked to student outcomes, stress was a more powerful predictor. We also found significant salutary effects of cooperative learning on all constructs. The implications of these results for student behavioral and mental health are discussed.

Reciprocated Friendship as a Mediator of the Effects of Cooperative Learning on Peer Victimization in Middle School

Peer victimization represents a pervasive problem, particularly for students in middle school. Although curriculum-based prevention programs have generated small to moderate effects on victimization, these effects tend to weaken beginning with the transition to middle school. In this study, we evaluated cooperative learning (CL) as a mechanism to prevent victimization, and evaluated reciprocated friendships as a mediator of these effects. Using four waves of data from a cluster randomized trial of CL (7 intervention and 8 control middle schools; N=1,890 students, 47.1% female, 75.2% White), we found that CL significantly reduced victimization after two years, and these effects were mediated by growth in reciprocated friendship in the first year. We conclude that CL can reduce victimization by providing a means for students to engage in extended social interactions with a wider range of peers and thus creating opportunities for students to forge stronger (i.e., reciprocated) friendships.

The Longitudinal Relationship Between Peer Relations and Empathy and their Joint Contribution to Reducing Bullying in Middle School: Findings from a Randomized Trial of Cooperative Learning

The positive peer relations arising from cooperative learning can contribute to the development of affective empathy, which in turn can reduce bullying (Van Ryzin & Roseth, 2019). However, from a theoretical perspective, the direction of effects between peer relations and empathy could be in the opposite direction, or bi-directional. In the current paper, we employed a process-oriented approach (i.e., cross-lag difference score modeling; McArdle, 2009) to investigate the longitudinal relationship between positive peer relations and affective empathy, as well as their joint effect on bullying. Using four waves of data from a cluster randomized trial including 15 middle schools (7 intervention and 8 control schools; N=1,890 students, 47.1% female, 75.2% White), we found a bi-directional or reciprocal relationship between peer relations and affective empathy, and change in both constructs predicted lower levels of bullying. Cooperative learning predicted positive change in peer relations and affective empathy, as well as lower levels of bullying. These results suggest that the structured social interactions that occur during cooperative learning can enhance student interpersonal relations, and simultaneously the experiential skill building of cooperative learning can contribute to a more profound understanding of the emotional states of others. These effects amplify one another and, in turn, significantly reduce bullying in middle school. Given that cooperative learning has already been demonstrated to enhance academic motivation and achievement (Roseth et al., 2008), we argue that cooperative learning offers an effective, attractive alternative to traditional curriculum-based bullying prevention programs (National Library of Medicine [NLM], NCT03119415).

Peer Relations and Delinquency Among Girls in Foster Care Following a Skill-Building Preventive Intervention

There is evidence that risk for delinquency is elevated among girls with foster care histories, and one correlate of delinquency is affiliating with peers who engage in delinquent behavior. Although intervention studies have shown positive effects of interventions that target delinquent peer affiliation on reductions in delinquency among adolescents with juvenile justice histories, the success of such interventions for younger girls in foster care, without prior involvement with juvenile justice, is unknown. We analyzed data from a randomized clinical trial of the middle school version of the Keep Safe intervention in a sample of girls in foster care (n = 100). The intervention was delivered to girls and foster parents during the transition to middle school. Path analysis suggested a significant intervention effect on reduction in affiliation with delinquent peers at 12 months (B = -.21). No significant mediation effects were identified. The middle school Keep Safe intervention shows promise as a preventative intervention for reducing affiliation with delinquent peers, which importantly is associated with adolescent delinquent behavior. Implications for researchers and professionals who tailor and deliver evidence-based programs for girls in foster care are discussed.

The Cascading Effects of Reducing Student Stress: Cooperative Learning as a Means to Reduce Emotional Problems and Promote Academic Engagement

Adolescents, particularly early adolescents, are vulnerable to stress created by negative peer interactions. Stress, in turn, can lead to increased mental health problems and reduced academic engagement, in addition to negative long-term consequences for cognitive development and physical health. Using four waves (2 years) of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White), we evaluated whether enhancements to peer relations, brought about through carefully structured small-group learning activities (i.e., cooperative learning), could reduce stress and emotional problems and promote academic engagement. We hypothesized that the increased social contact created by cooperative learning would promote greater peer relatedness, reducing student stress and, in turn, reducing emotional problems and promoting academic engagement. Our results confirmed these hypotheses. We conclude that cooperative learning can provide social, behavioral, academic, and mental health benefits for students.

The Effects of Cooperative Learning on Peer Relations, Academic Support, and Engagement in Learning Among Students of Color

Despite Brown vs. Board of Education, prejudice still exists in the American school system. These attitudes can give rise to negative social experiences for students of color (i.e., discrimination), negatively impacting their mental and physical health and creating disparities in educational outcomes. Rather than seeking to ameliorate these negative experiences, our approach attempts to address the underlying prejudices and, in so doing, reduce these disparities. Using 4 waves of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White), we hypothesized that cooperative learning, which has been shown to reduce prejudice in previous research, would create positive gains in peer relatedness, perceptions of academic support, and engagement in learning, and that gains would be larger for students of color; our results confirmed these hypotheses. Our findings highlight the potential role of cooperative learning in reducing disparities and creating greater equity in education.

Mediators of Effects of Cooperative Learning on Prosocial Behavior in Middle School

In this study, we tested the effects of cooperative learning on students' prosocial behavior. Cooperative learning is a small-group instructional technique that establishes positive interdependence among students and, unlike most current school-based programs, does not mandate a formal curriculum. Given the emphasis in cooperative learning on peer reinforcement for positive and helpful behavior during learning activities, we hypothesized that cooperative learning would promote higher levels of prosocial behavior, and that these effects would be mediated by peer relatedness. Using a sample of 1,890 students (47.1% female, 75.2% White) from a cluster randomized trial of 15 middle schools, we found that cooperative learning significantly enhanced prosocial behavior across two years. Mediation was only partial, however, suggesting that additional mechanisms were at work, such as changes to social norms or teacher behavior. Given that cooperative learning has been shown to enhance student engagement and academic achievement in prior research, we argue that cooperative learning should be a central component of teacher training and professional development.

The socialization of boys and men in the modern era: An evolutionary mismatch

This paper examines the misalignment between modern human society and certain male phenotypes, a misalignment that has been highlighted and explored in great detail in the work of Tom Dishion. We begin by briefly enumerating the ongoing developmental difficulties of many boys and young men and how these difficulties affect them and those around them. We then suggest that the qualities that have been advantageous for men and their families in our earlier evolution but that are often no longer functional in modern society are a source of these problems. Finally, we provide a brief review of prevention programs that can contribute to preventing this type of problematic development and eliciting more prosocial behavior from at-risk boys and men. We conclude with an overview of research and policy priorities that could contribute to reducing the proportion of boys and young men who experience developmental difficulties in making their way in the world.

Effects of cooperative learning on peer relations, empathy, and bullying in middle school

Although researchers have developed prevention programs to reduce bullying, the results are mixed, and this may be due to a degree of uncertainty in their theoretical foundation. In particular, these programs share an emphasis on empathy as a personal attribute that can be enhanced among students through the application of specific curricula that will, in turn, contribute to a reduction in bullying behavior. However, the link between empathy and bullying is unclear, as is the ability of bullying prevention programs to actually impact student empathy. In this study, we used a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White) to evaluate the impact of cooperative learning on bullying, and we evaluated whether these effects were mediated by empathy and peer relatedness. Our results indicated that cooperative learning can significantly reduce bullying, and that some of this effect is transmitted via enhancements to affective empathy. Cooperative learning also demonstrated significant positive effects on cognitive empathy, but this did not have an effect on bullying. We also found that the effects of cooperative learning on cognitive and affective empathy were mediated by improvements in peer relatedness. These findings add a degree of clarity to the literature, and also represent the first time, as far as we are aware, that an antibullying program has been found to have significant effects on both cognitive and affective empathy.

Behavioral Science and the Prevention of Adolescent Substance Abuse

This article reviews the evidence regarding behavioral science approaches to the prevention of substance use disorders. Prevention science grew out of research on family and school-based interventions that were designed to treat common behavioral problems of children and adolescents. That research showed that the amelioration of problems such as aggressive behavior could prevent the development of later problems including substance use, depression, and academic failure. We begin by reviewing evidence regarding the risk factors that contribute to the development of substance use disorders, as well as the protective factors that can reduce their likelihood. We then describe a variety of family, school, and community prevention programs that have been shown to prevent youthful use and abuse of substances. We conclude by describing the progress that has been made in getting these programs widely and effectively implemented, and the challenges we face in getting to the point where most communities are achieving considerable success in prevent substance use and the other common and costly behavioral and psychological problems of children and adolescents.

Cooperative Learning Effects on Peer Relations and Alcohol Use in Middle School

We tested a prevention approach aimed at reducing growth in alcohol use in middle school using four waves (2 years) of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White). Our approach exposed students to a broad cross-section of peers through collaborative, group-based learning activities in school (i.e., cooperative learning). We hypothesized that the increased social contact created by cooperative learning would promote greater peer relatedness, interrupting the process of deviant peer clustering and, in turn, reduce escalations in alcohol use. Our results supported these hypotheses, suggesting that the social nature of cooperative learning, and the emphasis on group work and collaboration, can provide social and behavioral as well as academic benefits for students.

An Experimental Test of Reward & Reminder as a Stand-Alone Program to Prevent Alcohol Sales to Underage Youths

Reward & Reminder has been a component of community-based preventive efforts against sales of substances (e.g., tobacco) to youth. To date, there has not been a randomized trial of Reward & Reminder as a stand-alone prevention program targeting youth access to alcohol. In this study, we addressed that gap. Data were collected as part of a randomized trial of a school- and community-based prevention program. Our analysis included 23 vendors in control communities and 33 vendors in intervention communities. We visited each vendor at least two times, and vendors in intervention communities received the Reward & Reminder protocol. Using McNemar's Test, which evaluates the degree to which the outlets in each condition moved to a different cell in the contingency table from the first visit to the second (i.e., from yes to no or vice versa), we found that the control outlets did not change (all p values were non-significant). In contrast, the test results for the intervention outlets were significantly more likely to ask for ID (p < .05) and significantly less willing to sell alcohol to young-looking project confederates (p < .05); Asked for Age did not change. We conclude that Reward & Reminder could assist in preventing underage access to alcohol.

A prospective test of the temporal sequencing of risk factor emergence in the dual pathway model of eating disorders

Prospective studies have identified risk factors that predict future onset of eating disorders, but none has provided a test of the temporal sequencing of the emergence of risk factors hypothesized in a multivariate etiologic model of eating disorder development. Using data from an 8-year prospective study of 496 adolescent girls, we first conducted receiver operator characteristic plots to identify cut-points for each risk factor that optimally predicted future onset of threshold or subthreshold bulimia nervosa, binge eating disorder, and purging disorder. We then used growth curve models to estimate the age at which each participant crossed the disorder-predictive cutpoint for each risk factor, or if they did not, during follow-up, permitting a test of whether the risk factors emerged in the sequence hypothesized in the Dual Pathway etiologic model. Overall, 47% of the 51 youth who showed onset of one of these eating disorders first showed emergence of disorder-predictive levels of perceived pressure to be thin and/or thin-ideal internalization, before showing onset of disorder-predictive levels of body dissatisfaction, before showing onset of disorder-predictive levels of dieting and/or negative affect, before showing onset of the eating disorder; another 29% had one of these steps out of order or did not cross one step in this model. Youth who did not show onset of an eating disorder were significantly less likely to cross the disorder-predictive cut-points for each risk factor or to conform to the sequence of risk factor emergence hypothesized in this model. Results provide novel support for the temporal sequencing of risk factor emergence hypothesized in this multivariate etiologic model and suggest that prevention programs that reduce perceived pressure to be thin and thin-ideal internalization among early adolescent girls with these factors should reduce eating disorder onset, as well as downstream risk factors that are also aversive (e.g., body dissatisfaction and negative affect). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cooperative Learning in Middle School: A Means to Improve Peer Relations and Reduce Victimization, Bullying, and Related Outcomes

Peer victimization is a highly stressful experience that impacts up to a third of all adolescents and can contribute to a variety of negative outcomes, including elevated anxiety, depression, drug use, and delinquency, as well as reduced self-esteem, school attendance, and academic achievement. Current prevention approaches (e.g., the Olweus program) have a mixed record in American schools. We propose a new approach to prevention that leverages theory and research surrounding the social aspects of bullying and victimization, particularly peer relations. Our approach attempts to (1) break down the process of homophily among bullies, and (2) provide a mechanism by which socially isolated students can develop new friendships. Our approach asks teachers to increase opportunities for positive peer interaction through carefully structured, group-based learning activities in school (i.e., cooperative learning). We hypothesized that these positive peer interactions would result in reductions in bullying, victimization, perceived stress, and emotional problems, as well as increases in peer relatedness, among more marginalized students. Using a cluster randomized trial with 15 rural middle schools in the Pacific Northwest (N = 1,460 7th grade students), we found that cooperative learning significantly reduced bullying, victimization, and perceived stress for marginalized students (i.e., moderated effects), and reduced emotional problems and enhanced relatedness for all students (i.e., main effects). Given that cooperative learning has already been shown to enhance student engagement and achievement in prior research, our results demonstrate that cooperative learning can be a permanent, sustainable component of teacher training and school culture.

Peer influence processes as mediators of effects of a middle school substance use prevention program

BACKGROUND

Peer influence processes have been linked to escalation in substance use during the middle school years, particularly among at-risk youth. In this study, we report on an approach to prevention that attempts to counteract peer influence by interrupting the process of deviant peer clustering, in which socially marginalized youth self-aggregate and reinforce delinquent behavior, including substance use. We aimed to interrupt this process by implementing collaborative, group-based learning activities in school (i.e., cooperative learning).

METHODS

In a cluster randomized trial in the Pacific Northwest (N = 1460 7th-grade students in 15 schools), we tested whether cooperative learning can reduce alcohol and tobacco use, and whether these effects are mediated by reductions in the amount of alcohol and tobacco use among one's friends. Intervention schools were provided with training in cooperative learning, and data were collected in September/October 2016 (baseline) and March 2017 (follow-up).

RESULTS

Results indicated that cooperative learning significantly lowered rates of growth in alcohol (β = -0.60 [-0.36|-0.84]; p < .001) and tobacco use (β = -0.58 [-0.21|-0.94]; p = .01) between baseline and follow-up in intervention schools as compared to control schools. These effects were mediated by reductions in the prevalence of alcohol and tobacco use, respectively, among self-selected friends.

CONCLUSIONS

Cooperative learning was able to significantly reduce the prevalence of both alcohol and tobacco use in friendship networks during the school year. The lower prevalence of alcohol and tobacco use among friends, in turn, reduced individual use at follow-up. This study was registered as trial NCT03119415 in ClinicalTrials.gov.

Enlisting Peer Cooperation in the Service of Alcohol Use Prevention in Middle School

This article reports on a cluster randomized trial of cooperative learning (CL) as a way to prevent escalation in alcohol use during middle school (N = 1,460 seventh-grade students, age 12-13, seven intervention and eight control schools). We hypothesized that CL, by bringing students together in group-based learning activities using positive interdependence, would interrupt the process of deviant peer clustering, provide at-risk youth with prosocial influences, and in turn, reduce escalations in alcohol use. Results indicated that CL significantly reduced growth in deviant peer affiliation and actual alcohol use, and effects for willingness to use alcohol were at the threshold of significance (p = .05). CL also attenuated the link between willingness to use alcohol and later alcohol use.

Evolving a More Nurturing Society to Prevent Adverse Childhood Experiences

This article presents a framework for evolving a society that nurtures the health and well-being of its population. We review evidence that adverse social conditions, including poverty, conflict, discrimination, and other forms of social rejection, contribute immensely to our most ubiquitous psychological, behavioral, and health problems. We then enumerate the ways that effective family and school prevention programs could ameliorate much of the social adversity leading to these problems. The widespread and effective implementation of these programs-in primary care, social services, and education-must be a high priority. Beyond the implementation of specific programs, however, we must also make a more concerted effort to promote prosocial values that support nurturing families and schools. Our society's priorities must be to generate specific policies that reduce poverty and discrimination and, in so doing, reduce the risk for negative health-related outcomes.

Trajectories of adolescent hostile-aggressive behavior and family climate: Longitudinal implications for young adult romantic relationship competence

The formation and maintenance of young adult romantic relationships that are free from violence and are characterized by love, connection, and effective problem-solving have important implications for later well-being and family functioning. In this study, we examined adolescent hostile-aggressive behavior (HAB) and family relationship quality as key individual and family level factors that may forecast later romantic relationship functioning. Guided by a family systems framework, we evaluated the reciprocal influences of adolescent hostility and family climate, to provide a more comprehensive picture of the etiology of romantic relationship functioning. We drew on a large sample (N = 974) of young adults (mean age = 19.5) that were followed starting in the fall of 6th grade, and subsequently in spring of 6th, 7th, 8th, 9th, and 10th grades prior to the young adult assessment. Using a latent difference score cross-lag model (McArdle, 2009), our results indicated that a more positive family climate was associated with decreases in HAB, but HAB was not associated with changes in family climate. Further, the influence of the family climate on HAB was consistent across all time points. HAB and family climate had different predictions for young adult romantic relationships: Increasing HAB over adolescence predicted relationship violence, while maintenance in family climate was a key predictor of relationship problem-solving skills. The only predictor of love and connection in relationships was early family functioning. Implications for developmental theory and prevention science are discussed. (PsycINFO Database Record

Being well-liked predicts increased use of alcohol but not tobacco in early adolescence

Although substance use has traditionally been linked to peer deviance, a parallel literature has explored the influence of peer social status (being "well-liked"). This literature hypothesizes that adolescents with higher status will anticipate shifts in social norms and modify their behavior earlier and/or more substantially than lower-status students. As substance use becomes more socially acceptable during early-to-mid-adolescence, higher status youth are hypothesized to reflect this shift in norms by accelerating their use more rapidly than lower status youth. Although some evidence exists to support this hypothesis, it has never been evaluated in conjunction with the opposing hypothesis (i.e., that substance use contributes to elevated peer status). In this study, we evaluated reciprocal links between peer status and substance use (i.e., alcohol and tobacco) using 3years of data from 8 middle schools in the Pacific Northwest. Social network analysis enabled us to model standard network effects along with unique effects for the influence of the network on behavior (i.e., increased substance use as a result of being well-liked) and the influence of behavior on the network (i.e., increased status as a result of substance use). Our results indicated significant bidirectional effects for alcohol use but no significant effects for tobacco use. In other words, being well-liked significantly predicted alcohol use and vice versa, but these processes were not significant for tobacco use. Prevention efforts should consider the dynamics of peer status and peer norms in adolescence with the goal of preventing escalations in problem behavior that can compromise future adjustment.

Preventing adolescent depression with the family check-up: Examining family conflict as a mechanism of change

Family-centered prevention programs are understudied for their effects on adolescent depression, despite considerable evidence that supports their effectiveness for preventing escalation in youth problem behavior and substance use. This study was conducted with 2 overarching goals: (a) replicate previous work that has implicated the Family Check-Up (FCU), a multilevel, gated intervention model embedded in public middle schools, as an effective strategy for preventing growth in adolescent depressive symptoms and (b) test whether changes in family conflict may be an explanatory mechanism for the long-term, protective effects of the FCU with respect to adolescent depression. This trial was conducted with 593 ethnically diverse families who were randomized to intervention (offered the FCU) or middle school as usual. Complier average causal effect (CACE) analysis revealed that engagers in the FCU evidenced less growth in depressive symptoms and family conflict from 6th through 9th grade, and post hoc analyses indicated that the FCU is related to lower rates of major depressive disorder. The second set of analyses examined family conflict as a mechanism of change for families who participated in the FCU. Families who reported short-term intervention benefits had significantly less escalation in family conflict over the middle school years; in turn, growth in family conflict explained risk for adolescent depressive symptoms.

Profiles of childhood trauma: Betrayal, frequency, and psychological distress in late adolescence

OBJECTIVE

With an emphasis on betrayal trauma, this study used latent profile analysis to examine how childhood traumas co-occur and whether trauma patterns differentially predicted psychological distress.

METHOD

A community sample of 806 adolescents and young adults participated. Youths reported their trauma histories, and lifetime DSM-IV disorders were assessed using a structured diagnostic interview.

RESULTS

Latent profile analysis yielded 5 profiles: high betrayal trauma physical violence and emotional abuse (HBTPE), high betrayal trauma sexual and emotional abuse (HBTSE), low betrayal trauma (LBT), parent death (PD), and a no/low trauma profile. Logistic regression analyses compared youths in the no/low trauma profile to those in the trauma profiles. Youths in the HBTPE profile were more likely to have moderate/severe major depressive disorder (odds ratio [OR] = 2.92, 95% CI [1.16, 7.32]), posttraumatic stress disorder (OR = 4.33, 95% CI [1.34, 14.03]), and hallucinations (OR = 5.03, 95% CI [2.00, 12.67]); youths in the HBTSE and LBT profiles were more likely to experience hallucinations (OR = 3.19, 95% CI [1.21, 8.39] and OR = 3.20, 95% CI [1.01, 10.19], respectively); and youths in the PD profile were more likely to have moderate/severe depression (OR = 2.42, 95% CI [1.07, 5.43]).

CONCLUSIONS

Specific trauma types co-occurred when considering type, level of betrayal, and frequency. The emergence of the 2 high betrayal trauma profiles, with differing symptom presentations, suggests that experiences of high betrayal traumas are not homogenous and specific trauma-focused interventions may be more appropriate for differing trauma profiles.

Examining Change in Therapeutic Alliance to Predict Youth Mental Health Outcomes

OBJECTIVE

To examine the link between therapeutic alliance and youth outcomes.

METHOD

The study was conducted at a group-home with 112 youth with a disruptive-behavior diagnosis. Therapeutic alliance was collected routinely via youth and staff report. Outcome data were collected using youth and staff reports of externalizing behavior as well as behavioral incidents occurring during care. Outcome data were collected following intake into services and at 6 and 12 months of care. Data were analyzed to examine (1) if youth behavior problems at intake were predictive of therapeutic alliance and (2) if changes in alliance were predictive of subsequent youth outcomes. These were conducted with a 6-month service-delivery model and replicated with a 12-month model.

RESULTS

There was some support for the first hypothesis, that initial levels of youth externalizing behavior would be related to alliance ratings; however, most of the effects were marginally significant. The second hypothesis, that changes in therapeutic alliance would be related to subsequent youth outcomes, was supported for the 6-month model, but not the 12-month model.

CONCLUSIONS

Changes in therapeutic alliance may be predictive of youth outcomes during care. Additional research into examining therapeutic alliance trajectories is warranted to improve mental health services for youth.

Genetic influences can protect against unresponsive parenting in the prediction of child social competence

Although social competence in children has been linked to the quality of parenting, prior research has typically not accounted for genetic similarities between parents and children, or for interactions between environmental (i.e., parental) and genetic influences. In this article, the possibility of a Gene x Environment (G × E) interaction in the prediction of social competence in school-age children is evaluated. Using a longitudinal, multimethod data set from a sample of children adopted at birth (N = 361), a significant interaction was found between birth parent sociability and sensitive, responsive adoptive parenting when predicting child social competence at school entry (age 6), even when controlling for potential confounds. An analysis of the interaction revealed that genetic strengths can buffer the effects of unresponsive parenting.

Sexual Risk Behavior and STI Contraction Among Young Women With Prior Juvenile Justice Involvement

Girls in the juvenile justice system are at increased risk for contracting HIV/AIDS. Sexual risk behavior was examined in 166 females with juvenile justice involvement who were followed from adolescence to young adulthood. Results indicated that childhood sexual abuse increased the incidence of unsafe sex during young adulthood, which was subsequently associated with contraction of a sexually transmitted infection (STI). Further, girls' comfort in talking with their partners about safer sex practices during adolescence moderated the association between childhood sexual abuse and unsafe sex, such that girls who had been sexually abused and were uncomfortable talking to their partners about safer sex during adolescence had an 8.5-fold increase in unsafe sex in young adulthood. The identification of behaviors amenable to intervention in the prevention of HIV/AIDS risk in this high-risk population is discussed.

Effects of multidimensional treatment foster care on psychotic symptoms in girls

OBJECTIVE

Neurodevelopmental theories of psychosis highlight the potential benefits of early intervention, prevention, and/or preemption. How early intervention should take place has not been established, nor whether interventions based on social learning principles can have preemptive effects. The objective was to test whether a comprehensive psychosocial intervention can significantly alter psychotic symptom trajectories during adolescence-a period of heightened risk for a wide range of psychopathology.

METHOD

This study was a randomized controlled trial (RCT) of Multidimensional Treatment Foster Care (MTFC) for delinquent adolescent girls. Assessment of psychotic symptoms took place at baseline and then 6, 12, 18, and 24 months post-baseline using a standardized self-report instrument (Brief Symptom Inventory). A second source of information about psychotic symptoms was obtained at baseline or 12 months, and again at 24 months using a structured diagnostic interview (the Diagnostic Interview Schedule for Children [DISC]).

RESULTS

Significant benefits for MTFC over treatment as usual for psychosis symptoms were observed over a 24-month period. Findings were replicated across both measures. Effects were independent of substance use and initial symptom severity and persisted beyond the initial intervention period.

CONCLUSION

Ameliorating nonclinical psychotic symptoms trajectories beginning in mid-adolescence via a multifaceted psychosocial intervention is possible. Developmental research on nonclinical psychotic symptoms and their prognostic value should be complemented by more psychosocial intervention research aimed at modifying these symptom trajectories early in their natural history. Clinical trial registration information-Juvenile Justice Girls Randomized Control Trial: Young Adult Follow-up; http://clinicaltrials.gov; NCT01341626.

Preventing high-risk sexual behavior in early adulthood with family interventions in adolescence: outcomes and developmental processes

Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up, FCU) were later assessed for the intervention's effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N = 998 adolescents and their families) were randomly assigned to a family-centered intervention in sixth grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23% of the intervention families engaged in the FCU and approximately 18% engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Furthermore, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed.

Adolescent deviant peer clustering as an amplifying mechanism underlying the progression from early substance use to late adolescent dependence

BACKGROUND

Early substance use co-occurs with youths' self-organization into deviant peer groups in which substance use is central to social interaction. We hypothesized that the social dynamics of deviant peer groups amplify the risk of progressing from early use to later dependence, and that this influence occurs over and above escalations in use that typically accompany early substance use and membership in deviant groups.

METHODS

Our study used a longitudinal, multimethod dataset consisting of 998 adolescents and their families. Participants were recruited from middle schools in a large metropolitan area in the Pacific Northwest. The sample was 47.3% female and ethnically diverse (42.3% European American, 29.1% African American, and 28.6% other, including biracial). We examined deviant peer clustering as a mediator between early substance use and later dependence, controlling for proximal levels of use, SES, early antisocial behavior, and parental monitoring. Tobacco, alcohol, and marijuana use were assessed at ages 12, 13, and 16-17. Past-year nicotine, alcohol, and marijuana dependence (DSM-IV) was assessed at age 19. Youth and parent reports and observational data were used to assess deviant peer clustering at age 16-17, and youth reported on antisocial behavior and parental monitoring at ages 12 and 13.

RESULTS

Early substance use predicted increased likelihood of dependence on tobacco, alcohol, and marijuana by late adolescence. Deviant peer affiliation mediated these links, even when accounting for proximal levels of substance use.

CONCLUSIONS

Early substance use not only promotes escalations in use across adolescence but also provides entry into a deviant social context that contributes to increased risk of dependence. Our results emphasize the importance of identifying and intervening in early substance use before it becomes an organizing factor in friendship selection and interaction. Deviant peer clusters are clearly an important avenue for intervention when seeking to interrupt the progression to substance dependence.

Predicting response to intensive multimodal inpatient treatment: a comparison of single- and multiple-class growth modeling approaches

In a modest body of research, personality functioning assessed via performance-based instruments has been found to validly predict treatment outcome and, to some extent, differential response to treatment. However, state-of-the-science longitudinal and mixture modeling techniques, which are common in many areas of clinical psychology, have rarely been used. In this article, we compare multilevel growth curve modeling (MLM) and latent class growth modeling (LCGM) approaches with the same data set to illustrate the different research questions that can be addressed by each method. Global Assessment of Functioning (GAF) scores collected at 6 points during the course of a long-term multimodal inpatient treatment of 58 severely and persistently mentally ill adults were used to model the trajectory of treatment outcome. Pretreatment Rorschach-based markers of personality functioning and other markers of psychiatric severity were examined as covariates in each modeling approach. The results of both modeling approaches generally indicated that more psychologically impaired clients responded less favorably to treatment. The LCGM approach revealed 2 unique trajectories of improvement (a persistently low group and a higher starting, improving group). Personality functioning and baseline psychiatric variables significantly predicted group membership and the rate of change within the groups. A side-by-side examination of these 2 methods was found to be useful in predicting differential treatment response with personality functioning variables.

From antisocial behavior to violence: a model for the amplifying role of coercive joining in adolescent friendships

BACKGROUND

Aggression is one of the more stable characteristics of child and adolescent development, and violent behavior in early adulthood is often foreshadowed by aggressive behavior in childhood and early adolescence. Considerable evidence has linked coercive family interactions to aggressive behavior in childhood, but less research has been conducted on the joint role of family and peer interaction in the escalation of aggression to violence in adulthood.

METHODS

We coded family interactions at age 12-13 and friendship interaction at age 16-17 in a multiethnic sample of youth and families. Violence in young adulthood (age 22-23) was measured using self-report, criminal records, and parent report. We tested the hypothesis that a process of 'coercive joining' in friendship interactions mediated the relationship between coercive family interactions and serious violence.

RESULTS

We found that observed coercive joining in friendships at age 16-17 predicted early-adulthood violent behavior over and above an established tendency toward antisocial behavior. We also found that observed coercive family interactions at age 12 predicted early-adulthood violence, and that coercive joining with friends fully mediated this link.

CONCLUSIONS

These results significantly extend coercion theory by suggesting that coercive joining in the context of peer groups is an additional mechanism by which coercive processes in the family are extended and amplified to violent behavior in early adulthood. Our findings suggest the importance of addressing both individual interpersonal skills and self-organizing peer groups when intervening to prevent violent behavior.

Engagement matters: lessons from assessing classroom implementation of steps to respect: a bullying prevention program over a one-year period

Steps to Respect: A Bullying Prevention Program (STR) relies on a social-ecological model of prevention to increase school staff awareness and responsiveness, foster socially responsible beliefs among students, and teach social-emotional skills to students to reduce bullying behavior. As part of a school-randomized controlled trial of STR, we examined predictors and outcomes associated with classroom curriculum implementation in intervention schools. Data on classroom implementation (adherence and engagement) were collected from a sample of teachers using a weekly on-line Teacher Implementation Checklist system. Pre-post data related to school bullying-related outcomes were collected from 1,424 students and archival school demographic data were obtained from the National Center for Education Statistics. Results of multilevel analyses indicated that higher levels of program engagement were influenced by school-level percentage of students receiving free/reduced lunch, as well as classroom-level climate indicators. Results also suggest that higher levels of program engagement were related to lower levels of school bullying problems, enhanced school climate and attitudes less supportive of bullying. Predictors and outcomes related to program fidelity (i.e., adherence) were largely nonsignificant. Results suggest that student engagement is a key element of program impact, though implementation is influenced by both school-level demographics and classroom contexts.

Direct and indirect effects of a family-based intervention in early adolescence on parent-youth relationship quality, late adolescent health, and early adult obesity

We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family Check-Up, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 years) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent-youth relationship quality (ages 12-15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent-youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent-youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity.

Cardiac Vagal Tone and Quality of Parenting Show Concurrent and Time-Ordered Associations That Diverge in Abusive, Neglectful, and Non-Maltreating Mothers

Concurrent and lagged maternal respiratory sinus arrhythmia (RSA) was monitored in the context of parenting. One hundred and forty-one preschooler-mother dyads-involved with child welfare as documented perpetrators of child abuse or neglect, or non-maltreating (non-CM)-were observed completing a resting baseline and joint challenge task. Parenting behaviors were coded using SASB (Benjamin, 1996) and maternal RSA was simultaneously monitored, longitudinally-nested within-person (WP), and subjected to MLM. Abusive and neglectful mothers displayed less positive parenting and more strict/hostile control, relative to non-CM mothers. Non-CM mothers displayed greater WP heterogeneity in variance over time in their RSA scores, and greater consistency over time in their parenting behaviors, relative to abusive or neglectful mothers. CM group also moderated concurrent and lagged WP associations in RSA and positive parenting. When abusive mothers displayed lower RSA in a given epoch, relative to their task average, they showed concurrent increases in positive parenting, and higher subsequent levels of hostile control in the following epoch, suggesting that it is physiologically taxing for abusive mothers to parent in positive ways. In contrast, lagged effects for non-CM mothers were observed in which RSA decreases led to subsequent WP increases in positive parenting and decreases in control. Reversed models were significant only for neglectful mothers: Increases in positive parenting led to subsequent increases in RSA levels, and increases in strict, hostile control led to subsequent RSA decreases. These results provide new evidence that concurrent and time-ordered coupling in maternal physiology and behavior during parenting vary in theoretically meaningful ways across CM and non-CM mothers. Implications for intervention and study limitations are discussed.

Family and peer predictors of substance use from early adolescence to early adulthood: an 11-year prospective analysis

The focus of this study was social (i.e., family and peer) influences on substance use from early adolescence to early adulthood. A large, ethnically diverse sample of early adolescents (N=998) was followed from age 12 to age 23. We tested direct and indirect effects of parental monitoring, family relationship quality, and association with deviant peers on change in substance use across time. Outcomes for tobacco, alcohol, and marijuana use were analyzed as separate pathways within the same overall model. The results suggest that a significant shift in the nature of family influence occurred across adolescence and into early adulthood, but deviant peer influence was relatively consistent across this period. Specifically, parental monitoring and deviant peer association were predictive of substance use in early adolescence, but family relationship quality was a significant predictor across the transition to high school and generally continued to predict use into later adolescence, as did association with deviant peers. Deviant peers were the only significant predictor in early adulthood. Our results also suggested that parental monitoring and family relationship quality indirectly predicted later substance use by way of deviant peers, implying that an important aspect of the family context is its influence on choice of friends and peer group composition. Implications for family-based prevention and intervention are discussed.

Girls' Tobacco and Alcohol Use During Early Adolescence: Prediction from Trajectories of Depressive Symptoms Across Two Studies

Associations between trajectories of depressive symptoms and subsequent tobacco and alcohol use were examined in two samples of girls assessed at age 11.5 (T1), 12.5 (T2), and 13.5 (T3). Two samples were examined to ascertain if there was generalizability of processes across risk levels and cultures. Study 1 comprised a United States-based sample of 100 girls in foster care; Study 2 comprised 264 girls in a United Kingdom community-based sample. Controlling for T1 aggression and T1 substance use, individual variation in intercept and slope of depressive symptoms was associated with tobacco use at T3 in both samples: greater intercept and increases in depressive symptoms increased the risk for T3 tobacco use. A similar pattern of associations was found for alcohol use in Study 1. The replicability of findings for the prediction of tobacco use from trajectories of depressive symptoms suggests potential benefit in identifying girls with elevated depressive symptoms for tobacco use prevention programs prior to the transition to secondary school.

Engaging parents in the family check-up in middle school: longitudinal effects on family conflict and problem behavior through the high school transition

PURPOSE

Adolescence is a time of significant developmental change. During this period, levels of problem behavior that had been relatively innocuous may escalate in the company of peers, with simultaneous reductions in parental monitoring and involvement. In this article, we report the results of a randomized controlled trial of the Family Check-Up (FCU), a family-centered, school-based intervention designed to forestall the escalation of adolescent problem behavior by promoting and motivating skillful parenting through the transition to high school.

METHODS

In this study, 593 ethnically diverse families were randomized to be offered the FCU when their youth were in seventh and eighth grades of middle school. We used complier average causal effect analysis to examine change in family conflict, antisocial behavior, involvement with deviant peers, and alcohol use from sixth through ninth grades.

RESULTS

Analyses revealed that when compared with a matched control group, youths whose parents had engaged in the FCU demonstrated significantly lower rates of growth in family conflict (p = .052), antisocial behavior, involvement with deviant peers, and alcohol use.

DISCUSSION

Our results extend current research on the FCU and provide support for theory that links family conflict with a variety of youth problem behavior. These results and the extant research on the FCU suggest that traditional school-based service delivery models that focus on the individual child may benefit from a shift in perspective to engage parents and families.

Validity evidence for the Security Scale as a measure of perceived attachment security in adolescence

In this study, the validity of a self-report measure of children's perceived attachment security (the Kerns Security Scale) was tested using adolescents. With regards to predictive validity, the Security Scale was significantly associated with (1) observed mother-adolescent interactions during conflict and (2) parent- and teacher-rated social competence. With regards to convergent validity, the Security Scale was significantly associated with all subscales of the Adult Attachment Scale (i.e., Depend, Anxiety, and Close) as measured 3 years later. Further, these links were found even after controlling for mother-child relationship quality as assessed by the Inventory of Parent and Peer Attachment (IPPA), and chi-square difference tests indicated that the Security Scale was generally a stronger predictor as compared to the IPPA. These results suggest that the Security Scale can be used to assess perceived attachment security across both childhood and adolescence, and thus could contribute significantly to developmental research during this period.

Affiliation with delinquent peers as a mediator of the effects of multidimensional treatment foster care for delinquent girls

OBJECTIVE

This study evaluated the ability of delinquent peer affiliation to mediate the effects of multidimensional treatment foster care (MTFC; Chamberlain, 2003) on girls' delinquent behavior.

METHOD

This study used a sample of girls from 2 cohorts (N = 166; M = 15.31 years old at baseline, range 13-17 years; 74% European American, 2% African American, 7% Hispanic, 4% Native American, 1% Asian, and 13% mixed ethnicity) and measures of delinquent behavior, including general delinquency, number of criminal referrals, and number of days in locked settings. As the mediator, we used self-reports of affiliation with delinquent peers. Our analytic plan specified an intent-to-treat analysis within the framework of a randomized controlled trial comparing MTFC with traditional community-based group care.

RESULTS

Random assignment to the MTFC program reduced girls' number of criminal referrals and number of days in locked settings at 24 months. The MTFC condition also reduced girls' exposure to delinquent peers at 12 months, which in turn reduced levels of all forms of delinquent behavior at 24 months; indirect effects were statistically significant.

CONCLUSIONS

Reduction in exposure to delinquent peers mediated MTFC effects on the number of criminal referrals and number of days in locked settings; delinquent peers also served as an intervening variable between MTFC and self-report delinquency, suggesting that, by reducing contact with delinquent peers, MTFC helped to encourage lower levels of self-report delinquency. Existing prevention and intervention programs targeting similar populations may benefit from increased attention to reductions in delinquent peer affiliation in female samples.

Attachment discontinuity in a high-risk sample

In this study, we evaluated complex patterns of attachment discontinuity across time in 133 individuals from the Minnesota Study of Risk and Adaptation. In addition to individuals who were either insecure or secure across infancy, late adolescence, and adulthood (Stably Insecure and Stably Secure, respectively), we found three additional groups: Infant/Adolescent Secure, Infant/Adult Secure, and Infant-only Secure. Changes in attachment representations in these groups across time corresponded to stresses and supports in the socio-emotional context. The two groups classified as secure in adulthood (Stably Secure and Infant/Adult Secure) experienced more positive relationship-based outcomes than the other three groups. Our results suggest that continuity may be a reflection of a stable social context as much as it is an artifact of early working models, and illustrate "homeorhetic" pathways of development, in which not only the direction but the length of a developmental pathway can constrain future developmental trajectories.

The number of sexual partners and health-risking sexual behavior: prediction from high school entry to high school exit

Precursors to adolescent health-risking sexual behavior (HRSB) were examined in a normative sample of 373 adolescents (48.0% female, n = 178). Using a variable-oriented approach, we regressed the number of sexual partners at high school exit (age 17) on parental monitoring, association with delinquent peers, romantic relationship status, problem behavior, physical maturity, and tobacco and alcohol use at high school entry (age 14); all emerged as significant predictors except alcohol use and physical maturity (we found sex differences in physical maturity and romantic relationship status, with females being more advanced in both areas). Sexual experimentation at high school entry served to partially or fully mediate the impact of these factors. A person-oriented approach, using a broader measure of HRSB, found three subgroups of adolescents: abstainers, low-risk-takers, and high-risk-takers. Results predicting membership in these groups generally followed those from the variable-oriented analysis. Implications for the prevention of HRSB and future research directions are discussed.

Mitigating HPA axis dysregulation associated with placement changes in foster care

Maltreated foster children often exhibit alterations in diurnal hypothalamic-pituitary-adrenal (HPA) axis activity that are characterized by lower cortisol levels upon waking and smaller declines in morning-to-evening cortisol levels. Previous research has shown that this dysregulated pattern is associated with high caregiver stress levels over the course of foster care placements. In contrast, therapeutic interventions that emphasize consistent and responsive caregiving have been associated with more regulated cortisol rhythms. In this paper, two related issues were explored: whether placement changes (i.e., moving between foster homes or from a foster home to a permanent placement) were associated with more blunted daily cortisol rhythms and whether a caregiver-based intervention exerted a protective effect in this context. Because the intervention program has components specifically designed to prepare foster children for placement changes and to maintain consistent parenting techniques despite them, a prevention effect on HPA axis dysregulation during placement changes was hypothesized. The results of linear mixed modeling analyses showed that placement changes predicted dysregulation in cortisol rhythms in the regular foster care group but not in the intervention foster care group. These findings are discussed in terms of implications for child welfare policy and practice.

Behavioral and social cognitive processes in preschool children's social dominance

This longitudinal, naturalistic study addressed behavioral and social cognitive processes implicated in preschool children's social dominance. In the first objective, we examined the degree to which peer aggression, affiliation, and postaggression reconciliation predicted social dominance across a school year. Consistent with predictions, all three predicted dominance early in the year while only affiliation predicted dominance later in the year, suggesting that aggression, affiliation, and reconciliation were used to establish social dominance where affiliation was used to maintain it. In the second, exploratory, objective we tested the relative importance of social dominance and reconciliation (the Machiavellian and Vygotskian intelligence hypotheses, respectively) in predicting theory of mind/false belief. Results indicated that social dominance accounted for significant variance, beyond that related to reconciliation and affiliation, in predicting theory of mind/false belief status. Results are discussed in terms of specific behavioral and social cognitive processes employed in establishing and maintaining social dominance.

Behavioral and emotional symptoms of post-institutionalized children in middle childhood

BACKGROUND

Experience in institutional/orphanage care has been linked to increased mental health problems. Research suggests that children adopted from institutions experience specific difficulties related to inattention/overactivity. Evidence of internalizing and conduct problems relative to non-adopted peers has been found in early childhood and early adolescence, but problems may not differ from other adopted children. This study clarifies the understanding of behavioral and emotional symptoms of post-institutionalized (PI) children during middle childhood.

METHODS

Eight- to eleven-year-old PI children (n=68) and two comparison groups, children internationally adopted from foster care (n=74) and non-adopted children (n=76), and their parents completed the MacArthur Health and Behavior Questionnaire related to attention-deficit/hyperactivity disorder (ADHD), externalizing, and internalizing symptoms. Group means for symptom level and number of children with symptoms above clinical cutoffs were compared.

RESULTS

PI children displayed an increased level of ADHD symptoms per parent report. PI child and parent report indicated a higher number of PI children above clinical ADHD cutoff. Both groups of internationally adopted (IA) children had higher levels of externalizing symptoms relative to non-adopted children, with parent report indicating higher numbers of IA children above the externalizing clinical threshold. Informants differed in their report of internalizing symptoms. Parents indicated that both IA groups displayed increased internalizing symptom levels and greater numbers above clinical threshold; however, children reported this to be true only for the PI group.

CONCLUSIONS

PI children differ from non-adopted peers across symptom domains in middle childhood. Whether these concerns were more broadly associated with international adoption rather than institutional care depended on symptom domain and informant. An understanding of this variability may be beneficial for treatment and intervention.

The rise in cortisol in family day care: associations with aspects of care quality, child behavior, and child sex

This study examined the increase in salivary cortisol from midmorning to midafternoon in 151 children (3.0-4.5 years) in full-time home-based day care. Compared to cortisol levels at home, increases were noted in the majority of children (63%) at day care, with 40% classified as a stress response. Observations at day care revealed that intrusive, overcontrolling care was associated with the cortisol rise. For girls, the cortisol rise was associated with anxious, vigilant behavior, while for boys the rise was associated with angry, aggressive behavior. Child behavior did not mediate or moderate relations between care quality and the cortisol rise, except for evidence that boys scoring low on angry, aggressive behavior were more sensitive to variations in warm, supportive care than boys scoring high on this behavior.