Adolescents exposed to parental depression are at increased risk of developing internalizing and externalizing disorders. The Family Group Cognitive Behavioral (FGCB) intervention (Compas et al., 2015) is an evidence-based prevention program designed to reduce this risk by enhancing youth coping skills. However, it remains unclear which youth benefit most from this intervention. Competence, an indicator of youth resilience, may help identify those most likely to respond. This randomized controlled trial examined whether baseline youth competence moderated the effect of FGCB on coping at 6-month follow-up and whether improved coping subsequently mediated reductions in anxiety and depression symptoms at 12 months. Participants included 180 youth (ages 9–15; M = 11.46 years, SD = 2.00) and their parents with a history of depression, randomly assigned to either the FGCB intervention or a written information control condition. Moderated mediation analyses revealed that FGCB significantly improved coping only among youth with average to high levels of competence. In turn, coping predicted lower internalizing symptoms. Findings highlight competence as a key factor shaping intervention response and emphasize the need for tailored prevention efforts to support at-risk youth.

Objective: The present study assessed two theory-driven mediators of the effects of a family group cognitive-behavioral (FGCB) preventive intervention for youth of parents with a history of major depressive disorder (MDD) or dysthymia on long-term youth psychopathology symptoms and diagnoses. Method: Sample included 180 parents (M-age = 41.9, 89% female, 82% White, non-Hispanic) and one of their children/adolescents ages 9-15 years (M-age = 11.4, 49% female, 74% White, non-Hispanic). Changes in the hypothesized mediators, observations of positive parenting (Iowa Family Interaction Rating Scales) and youth secondary control coping (SCC) skills (Responses to Stress Questionnaire), were assessed at 6 months. Changes in youth psychopathology symptoms were assessed on the Child Behavior Checklist and Youth Self-Report at 18- and 24-month follow-ups and MDD diagnoses with the Kiddie Schedule for Affective Disorders and Schizophrenia at 12 and 24 months. Results: Changes in youth SCC skills (e.g., acceptance, reappraisal) after the intervention mediated the effects of the FGCB program on changes in youth internalizing and externalizing symptoms at 18- and 24-month follow-ups. Effects for changes in positive parenting behaviors as a mediator were more limited. SCC skills were further shown to mediate the effects of the FGCB intervention on MDD diagnoses from 12 to 24 months. Conclusions: This study provides clear and strong evidence that changes in youth SCC skills mediated the long-term effects of preventive intervention for families of depressed parents.

In this article, we describe the development of an adapted parenting intervention for caregivers of preschoolers with externalizing behavior problems, which integrates content around screen media use into an existing evidence-based parenting intervention. We also present results of an open trial examining the feasibility, acceptability, and initial outcomes of the adapted intervention in a sample of 10 low-income caregivers of children with externalizing behavior problems who were attending a community-based therapeutic summer program. Caregivers attended a once weekly (1.5-hour) intervention group, which was embedded in an 8-week community-based therapeutic program for children with externalizing behavior, and completed questionnaires at pretest, posttest, and 1 month following the intervention, and completed interviews about their experiences. Caregiver satisfaction with the adapted intervention was high, and fidelity and attendance measures suggested the intervention was feasible. Preliminary results showed postintervention improvements in caregivers’ skills in managing screen media use, including increases in caregiver self-efficacy to manage and set limits around screen media use. Results suggest that leveraging existing parenting interventions to promote healthy media use habits may be a promising avenue to maximize reach to families with children with externalizing behavior.

OBJECTIVE:Early-onset behavior disorders (BDs) are common and costly. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early intervention for BDs in young children, is well-established; yet, common comorbidities such as internalizing symptoms are common and their impact, not well understood. The goal of the current study was to examine the potential for technology to improve BPT effects on observed parenting and child behavior outcomes for families of children recruited for clinically significant problem behavior who also presented with relatively higher internalizing symptoms.METHOD:Families with low incomes (N = 101), who are overrepresented in statistics on early-onset BDs, were randomized to an evidence-based BPT program, Helping the Noncompliant Child (HNC), or Technology-Enhanced HNC (TE-HNC). Children were ages 3 to 8 years (55.4% were boys). Child race included White (64.0%), Black or African American (21.0%), more than one race (14.0%), and Hispanic/Latinx (13.9%).RESULTS:Families in both groups evidenced improvement in internalizing symptoms at posttreatment; however, TE-HNC yielded the greatest improvement in positive parenting and child compliance at posttreatment and follow-up for children with the highest internalizing symptoms at baseline.CONCLUSIONS:TE-HNC resulted in improved parenting and child behavior outcomes for children with elevated levels of co-occurring internalizing symptoms at baseline relative to standard HNC. We posit that these added benefits may be a function of TE-HNC, creating the opportunity for therapists to personalize the treatment model boosting parent skill use with more complex presentations, although a formal test of mediation will be important in future work.

Abstract Providing positive discipline can be challenging and bewildering to parents of toddlers, tweens, and teens, especially with new theories about parenting in the news all the time. However, there are several sound approaches that cut through the confusion, are supported by science, and have stood the test of time. In short, a RARE parent is what you want to be: one who is regulated, attuned to your child, and knows how to respond effectively. Positive discipline is built on the foundation of a warm and trusting parent-child relationship, and includes clear expectations and directions, attention and praise for on-target child behaviors, and consistent consequences for off-target behaviors.

Objective: Behavioral parent training (BPT) is the standard of care for early onset behavior disorders (BDs), however, not all families benefit. Emotion regulation (ER) is one potential mechanism underlying BPT outcomes, yet there are challenges in capturing intra- and interpersonal aspects of emotion regulation within parent-child interactions that are central to BPT. This study examined how vocally encoded emotional arousal unfolds during parent-child interactions and how parents and children influence each other's arousal (Aim 1), the links between these emotion dynamics, child behavior, and parenting at baseline (Aim 2), and BPT outcome (Aim 3). Method: Families of children with BDs (N = 45) completed two interaction tasks and measures of parenting and child behavior. Parent-child dynamics of vocal fundamental frequency (f0) were modeled using actor-partner interdependence models (APIMs) and coupled linear oscillators (CLOs). Results: When considering relative levels of f0 from one talk turn to the next (APIMs), parents and children showed intrapersonal regulation and synchronizing reactivity to each other's f0. When considering the shape of oscillations (CLOs), parents and children showed intrapersonal regulation but no reactivity. Intrapersonal regulation of f0 during the interaction was slowed for parents with more maladaptive parenting and children with more behavior problems at baseline. Conclusions: This preliminary characterization of f0 in families presenting for BPT provides insights into the emotion dynamics potentially underlying parenting behavior and child behavior.

Unresolved trauma can negatively impact parenting and increase chances of child maltreatment. With the passing of the Family First Prevention Services Act (FFPSA) in 2018, new attention has been focused on strengthening family connections and expanding the community-based service array focused on preventing maltreatment and out of home placement. The purpose of this paper is twofold: (1) to describe preliminary outcomes from a pilot evaluation of a new curriculum teaching parents trauma-informed strategies to address and resolve their own trauma while supporting healthy attachment; and (2) assess the feasibility of conducting a large scale study. Forty parents involved in the state child welfare system were recruited to participate. Statistical analyses included T-tests, propensity score analysis, and repeated measures MANOVA. Assessments, which occurred at Pre and Post for the intervention group and comparable times for the quasi-waitlist group, indicated the following: A high retention rate (72%) for the intervention group, an increase in parent knowledge of trauma, skills to address trauma behavior, and parent well-being for the intervention, relative to the waitlist comparison group; and a decrease in child problem behavior in the intervention, relative to the waitlist group. Fidelity data was strong, with trainers completing 100% of activities for each module. Parental satisfaction in the intervention group was also high and costs to implement the training were reasonable. The findings of this pilot study provide strong support for evaluating the BPC in a large-scale outcome investigation.

Background: The transition to adulthood is a period of increased risk for emergent psychopathology; emerging adults with a childhood maltreatment history are at risk for poor outcomes. Method: Using a multi-measure, transdisciplinary, cross-sectional design, this study tested whether participant-reported positive parenting, a potential resilience-promoting factor, moderated the association between clinician-rated PTSD symptom severity and a transdiagnostic maladjustment biomarker, fear-potentiated startle (FPS), in a sample of 66 emerging adults ( Myears= 18.83, SD = 0.89) with a maltreatment history. We hypothesized that characteristics of effective parenting would moderate the relation between PTSD symptoms and FPS. Results: Results indicated that elevated PTSD, as measured by the CAPS, was associated with a more severe startle reaction. The magnitude of the increase in startle reactivity was moderated by parenting such that those with more positive parenting (Accepting [relative to rejecting]: b = −0.42, p < .001; Psychologically-controlling [relative to autonomy-promoting]: b = 2.96, p = .004) had significantly less reactivity across the task at higher levels of PTSD symptoms. Conclusions: Emerging adults with childhood maltreatment histories, high levels of PTSD symptoms, and who perceive present-day high-quality caregiver support may cope better with novel stressors relative to youth lacking that support, potentially translating to better psychological outcomes.

Behavior disorders (BDs) are common and, without treatment, can have long-term impacts on child and family health. Behavioral Parent Training (BPT) is the standard of care intervention for early-onset BDs; however, structural socioeconomic barriers hinder treatment outcomes for low-income families. While digital technologies have been proposed as a mechanism to improve engagement in BPT, research exploring the relationship between technology use and outcomes is lacking. Thus, this study with 34 low-income families examined the impact of parents' use of adjunctive mobile app components on treatment efficiency in one technology-enhanced (TE-) BPT program, Helping the Noncompliant Child (HNC). While parent use of the TE-HNC app and its impact on the efficiency of service delivery varied across specific components, increased app use significantly reduced the number of weeks required for families to achieve skill mastery. Implications for the design and development of behavior intervention technologies in general, as well as for BPT in particular, are discussed.

Early-onset (3–8 years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families. A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3–8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC ( n  = 54) or TE-HNC ( n  = 47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956). Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up. Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families.

BACKGROUND:Early-onset (3-8 years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families.METHODS:A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3-8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC (n = 54) or TE-HNC (n = 47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956).RESULTS:Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up.CONCLUSIONS:Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families.

ABSTRACT Objective Behavioral parent training (BPT) is the first line of treatment for preschool-aged children with attention-deficit hyperactivity disorder (ADHD); however, clinically significant improvements are not universal. In the current study, we employ a person-centered approach to create subgroups of families based on the intersection of multiple parent, child, and family pre-treatment factors. Further, we explore the utility of pre-treatment family profiles in predicting post-treatment differences in observed parenting behavior (i.e., behavioral control, parental warmth) and clinically significant change in child ADHD and oppositional symptoms. Method Longitudinal data were collected using observational and parent-, teacher- and clinician-reported assessments from 130 parent-child dyads (M age= 3.57, range = 3.0– 4.11, 73.8% male, 69.2% White, 25.6% Hispanic) participating in BPT. Results Findings from the current study suggest three distinct family profiles, which consisted of one profile with high family stress (HFS) as evidenced by elevated symptomatology across parent, child, and family-level domains, a second profile with elevated parental anxiety (PA), and a final profile with elevated parental depression (PD). These family-centered profiles were differentially associated with changes in observed parenting practices. Specifically, the PD profile (39%) demonstrated minimal improvements in behavioral control and warmth following treatment. In contrast, the HFS profile (30%) only improved in behavioral control and the PA profile (31%) improved in both parenting domains following treatment. In addition, marginally significant differences in child oppositional and ADHD symptoms were observed across profiles. Conclusions Family-centered approaches may be useful for selecting and implementing interventions.

Behavioral Parent Training (BPT) remains the current standard of care for early onset behavior disorders (BD); however, problem behaviors characterized by relatively high callous unemotional (CU) traits are linked to poorer treatment outcomes, highlighting the need for novel interventions. This study examined the relation of baseline child CU traits to changes in observed parent and child (3 to 8 years old) behavior in 101 families with low-income randomized to either a standard (Helping the Noncompliant Child, HNC) or technology-enhanced BPT program (TE-HNC). Assessments occurred at baseline, post-intervention, and at a three-month follow-up. Treatment group moderated the relation between CU traits and observed parenting behaviors and child compliance. Specifically, higher levels of child CU traits at baseline predicted lower levels of positive parenting at post-intervention and follow-up, and lower levels of child compliance at follow-up but only in the standard program (HNC). This is the first intervention study to behaviorally assess the differential impact of CU traits in standard, relative to technology-enhanced, BPT and suggests the promise of a technology-enhanced treatment model.

Parent emotion regulation and socialization have been linked to various aspects of child functioning. In the case of early-onset behavior disorders in particular, parent emotion regulation may be an important correlate of the coercive cycle implicated in early-onset behavior disorders thus, symptom presentation at baseline. Further, emotion socialization may be complicated by a pattern of parent-child interactions in which both supportive or unsupportive parenting behaviors in response to behavioral dysregulation may increase vulnerability for problem behavior in the future. Some work suggests standard Behavioral Parent Training may impact parent emotion regulation and socialization. Still little is known, however, about how such processes may vary by family income, which is critical given the overrepresentation of low-income children in statistics on early-onset behavior disorders. This study explored parent emotion regulation, socialization, and family income in a sample of socioeconomically diverse treatment-seeking families of young (3–8 years old) children. Findings suggest relations between parental emotion regulation, socialization, and child behavior although the pattern of associations differed at baseline and post-treatment and varied by family income. Clinical implications and future directions are discussed.

Objective: Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression. Method: The sample was comprised of 90 parent-child dyads (parent M (age) (=) 42, 90% female, 83.3% White; child M (age) = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model. Results: Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion. Conclusion: Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.

Parenting is a critical mechanism contributing to child and adolescent development and outcomes. The Multidimensional Assessment of Parenting Scale (MAPS) is a new measure that aims to address gaps in the literature on existing self-report parenting measures. Research to date on the MAPS includes essential steps of scale development and validation; however, replicating scale dimensionality and examining differential item functioning (DIF) based on child age and a parent or child gender is a critical next step. The current study included 1,790 mothers and fathers of sons and daughters, spanning childhood to adolescence in the United States. Item response theory (IRT) confirmed initial factor-analytic work revealing positive and negative dimensions; however, the best-fitting multidimensional model included six nested dimensions from the original seven. A few notable items displayed DIF based on child age and parent gender; however, DIF based on child gender had minimal impact on the overall score. Future directions, clinical implications, and recommendations are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Although hopelessness has been linked to depression for centuries, the diagnostic criteria for depression are inconsistent with regard to the status of hopelessness. Most research on hopelessness and depression has focused on adults. The current study examined this relation in children and adolescents. Integrative data analyses with a pooled sample (N = 2466) showed that clinical levels of hopelessness multiplied the odds of having a clinical diagnosis of depression 10-fold. Conversely, not having clinical levels of hopelessness multiplied the odds of endorsing no clinical level of depressive symptoms 28-fold. Moreover, results differed by levels of depression: (a) among youths with clinical levels of depression, hopelessness was associated with six depressive symptoms; (b) among youths without clinical levels of depression, hopelessness was associated with nine depressive symptoms. We found that hopelessness helps to explain the heterogeneity of depressive presentations. Our finding supports the consideration of hopelessness in the diagnosis (if not treatment and prevention) of depression in children and adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Structural neuroimaging studies of childhood internalizing problems have implicated numerous brain areas; however, findings have been inconsistent. Prior investigations have often studied small samples, used categorical characterizations of psychopathology, and employed methods that were not robust to model overfitting.

Low-income parents are more likely to have a child with disruptive behaviors. Furthermore, these parents are likely to struggle with low expectations about the future, which can interfere with treatment response to even the most effective treatments. The purpose of this study was to explore correlates of low-income parents' expectations, specifically hopelessness and optimism, in families with clinic-referred disruptive young children. Using baseline data from an intervention trial (Jones et al., 2021), we used a multi-informant approach to test whether parenting behaviors, child misbehavior, and parental daily stressors were related to parent hopelessness and optimism. Results based on the Everyday Stress Index indicated that only daily stressors, particularly those related to relationships and responsibilities, were related to parent feelings of hopelessness and optimism. Results were interpreted through transactional and ecological systems theories, particularly the Family Stress Model (Conger & Conger, 2002), as well as a low-income parent's self-efficacy as a caregiver. Clinical implications are discussed.