TEMA: Psichologinės pagalbos galimybės vaikams, turintiems emocijų bei elgesio problemų: dialektinės elgesio terapijos efektyvumo analizė. TIKSLAS: nustatyti dialektinės elgesio terapijos efektyvumą koreguojant 8 – 11 metų vaikų elgesio ir emocijų problemas. TIRIAMIEJI: 54 vaikai, apibūdinami kaip turintys emocijų ir elgesio problemų bei linkę nusižengti taisyklėms ar nusikalsti. 59% imties sudaro berniukai, 41% - mergaitės. Tiriamųjų amžiaus vidurkis 9,6±0,2. METODIKOS: ASEBA klausimyno probleminių teiginių skalės. REZULTAI: vaikų emocijų ir elgesio problemų korekcijai naudota dialektinės elgesio terapijos programa yra efektyvi 9 – 11 metų vaikų grupėje ir įtakoja daugiau elgesio bei dėmesio ir mažiau emocijų problemų raišką. Vaikų lytis ir amžius įtakojo programos efektyvumą. / TOPIC: Effectiveness of Dialectical Behavioral Therapy for Children with Emotional and Conduct Problems GOAL: to evaluate effectiveness of Dialectical behavioral therapy in the sample of 8th – 11th year old children with emotion and conduct problems. PARTICIPANTS: 54 children characterized as having emotional and conduct problems, prone to break rules or offend. 59 percent of the sample are boys, 41 percent are girls. Mean of age in the sample 9,6±0,2. MEASURES: ASEBA Teacher rating form. RESULTS: Dialectical behavioral therapy program was successful in reducing conduct problems in the sample of 9th to 11th year old children. Effect size was larger for conduct problems compared to emotional problems. Age and gender of the children influenced the effectiveness of the program.

This thesis compromise four studies, three regarding psychometrics and norms of parent rating scales, and one study regarding effectiveness of two different interventions. A normative sample consisting of 1443 parents with children aged 10 to 13 years old, was used in the Study I, II and III. In Study IV, 231 self-referred parents with children aged 10-13 years old with externalizing behavior problem (EBP) were randomized to either Family Check-Up (FCU) or iComet. The Strengths and Difficulties Questionnaire (SDQ) used in Study I proved to be a reliable and valid instrument with high internal consistency, clear factor structure and high correlation with other similar instruments. In addition, the results support the online use of SDQ as well as using norms obtained through traditional administration even when the SDQ has been administrated online. The Emotion Regulation Questionnaire (ERQ) investigated in Study II was shown to have adequate reliability and construct validity. The specific use of expressive suppression or cognitive reappraisal as a parental emotion regulation strategy was correlated as expected to the couple’s satisfaction, family warmth, and the employment of adequate discipline strategies. Swedish norms for self-rated ERQs are also presented. Study III investigated the Parental Knowledge and Monitoring Scale (PKMS), which was shown to be a useful instrument for assessing parental knowledge and its sources. Family climate appears to moderate important relationships between parental knowledge and conduct problems with implications for such things as family interventions. Finally, a person-oriented analysis was used in Study IV to subtype the children according to combinations of prosocial behavior and EBP, such as different levels of attention deficit hyperactivity disorder (ADHD) symptoms and/or oppositional defiant disorder (ODD) behaviors. Despite being a heterogeneous group of children with EBP, they were meaningfully grouped into significantly different profiles. Both FCU and iComet resulted in post-treatment measurement within non-clinical range for three of the five profiles. The two profiles that included high levels of ADHD behaviors at baseline assessment continued to have residual symptoms post intervention.

The thesis deals with the possibilities of intervention in children with behavioral problems. The main focus is placed on working with the family (unlike commonly used interventions that focus primarily on working with the child himself or herself). The first part portrays the theoretical background. It describes the mechanisms of family influence on the child in terms of the factors that can increase the risk of behavioral problems, and, vice versa, factors that act protectively and help the child cope with the situation in a functional manner. On this basis, we describe various forms of intervention in the family based on influence of the disclosed risk and resilient factors. The research project aims to respond to the discrepancy between the proven effectiveness of intervention in families and low levels of use (predominance of intervention focused on child itself only). Through qualitative analysis of interviews with professionals research maps possible ways for families to reach the intervention, its benefits and risks, and recommendations for improving the system of this kind of care in the Czech Republic. Keywords: conduct problems, family intervention, therapy

Differential parenting has been shown to be an important correlate and possible cause of positive and negative adjustment of sibling children. However, it is not known whether sibling differences in temperament affect this link between differential harsh parenting and sibling differences in adjustment outcomes. The current study addressed this gap in knowledge. The sample included 92 monozygotic (MZ, 63% female) twin pairs and 137 dizygotic same-sex (DZ, 52% female) twin pairs who had complete temperament survey data collected near the third annual wave in the longitudinal study. Children were 6.09 years old (SD = .69) years old at wave 1. Mothers completed questionnaires, and mother and child were observed interacting during a home visit. Within families, greater sibling differences in conduct problems were statistically predicted by greater differences in harsh parenting exposure between siblings, but not by differences in effortful control. A hypothesized two-way interaction between sibling differences in harsh parenting and differences in effortful control was not significant. Regarding statistical bidirectional “child effects”, greater sibling differences in harsh parenting exposure were statistically predicted by greater sibling differences in conduct problems and greater sibling differences in effortful control. A hypothesized two-way interaction between conduct problems and effortful control was not significant. There was evidence of a bidirectional association between differential harsh parenting and sibling differences in conduct problems. In order to study the proximal family process, it is important to investigate sibling differences using within-family designs. Results can inform parents about how their differential parenting practices may affect child behavioral outcomes, to keep in mind when they parent their children.

Externalizing behavior problems such as noncompliance, tantrums, and aggression constitutes the most frequently cited reason for referral of young children to mental health clinics. The treatment for conduct problems (CP) that possesses the greatest amount of empirical support is referred to as behavioral parent training (BPT). Yet available data suggest that after accounting for treatment failures and dropouts, only about one third of children receiving BPT benefit significantly. More recently, there has been a shift towards the development of early intervention and prevention models for treating children at-risk for developing CP. While many of these programs have been shown to be effective, they fail to address shortcomings of BPT such as the length of treatment and the context of service delivery. Furthermore, the majority of these programs continue to be classified as selective or indicated prevention programs, thereby targeting children once they have already begun showing elevated levels of disruptive behaviors. More recently, a preventative and abbreviated version of BPT, called preventative behavioral parent training (PBPT), has been developed to address the limitations inherent in BPT. A recent evaluation of PBPT has demonstrated its utility in reducing rates of noncompliance and tantruming in children at-risk for developing CP. This study sought to add to previous findings regarding PBPT by evaluating its effectiveness when disseminated as a universal prevention program within a primary care setting. More specifically, this study aimed to evaluate whether PBPT could be utilized to support parents in learning effective strategies for managing their young child's typical misbehaviors, thereby preventing the development of clinical levels of CP and strengthening the practices of all parents. Results demonstrated that PBPT yielded positive outcomes in regards to both child and parent outcome variables. Furthermore, program evaluation data revealed that the PBPT program was socially acceptable and the strategies discussed were both feasible and effective. Taken together, the current study provides preliminary evidence of the positive proximal impact of the PBPT program. Potential clinical implications of these findings and future directions for research are discussed.

There is a particularly robust relation between neighborhood disadvantage and youth conduct problems. Given conduct problems are heterogeneous, it is likely that distinct subgroups of youth who differ in conduct problems and related correlates may be identifiable. The present study identified profiles of youth from a low-income, urban community participating in the Coping Power Program. Profiles were characterized by teacher-reported psychosocial and behavioral functioning assessed at pre-intervention among a sample of 61 fourth-grade students (98% Black/African American; M age = 9.87 ± 0.50; 58.3% female). Auxiliary analyses investigated whether and how these profiles differ on concurrent child-reported conduct problems and contextual (i.e., neighborhood, peer) factors and whether profile membership was associated with post-intervention teacher-reported outcomes. Latent profile analysis identified four profiles: (1) Moderate Conduct Problems (Mod CP; n = 6); (2) Moderate Conduct Problems/Callous-Unemotional Behavior with Moderate Peer Victimization (Mod CP/CU+Mod PV; n = 9); (3) High Conduct Problems/Callous-Unemotional Behavior with Low Prosocial Behavior (High CP/CU+Low Pro; n = 7); and Typically Developing (TD; n = 37). Profiles differed on child-reported outcome expectations for aggressive behavior, such that Mod CP/CU+Mod PV and High CP/CU+Low Pro were more likely to expect aggression to reduce aversive treatment from others. The High CP/CU+Low Pro profile had the most consistent post-intervention improvement across outcomes, though profile responsiveness to the intervention was variable and differed based on how outcomes were operationalized. Findings inform identification of youth from low-income, urban communities who may be at risk for negative outcomes and/or more amenable to preventive interventions for conduct problems. / Psychology

Childhood mental health problems are considered to fall along internalizing and externalizing dimensions; however, this framing does not fully capture the complexity of the relations among these symptoms. Specifically, internalizing problems (Int), conduct problems (CP), and callous/unemotional (CU) behaviors frequently co-occur and may share emotion functioning and contextual correlates that differentially confer risk across these potential symptom profiles. Research is shifting toward testing models of shared vulnerabilities to childhood emotional and behavioral symptoms, but has yet to extensively examine CU behaviors concurrently with these symptoms. The culmination of findings across relevant literature, though sparse, identifies candidate shared child-specific correlates such as emotion function (i.e., recognition, regulation, lability, processing); exposure to community violence; parent emotion socialization practices; and peer processes (e.g., bullying/victimization, social support) as shared correlates of Int, CP, and CU behaviors that may further differentiate profiles that differ in the frequency, type, or severity of symptoms. Such information could facilitate identification of youth at risk for problematic symptoms and outcomes. The current study sought to identify profiles of Int, CP, and CU behaviors in a sample of 104 low-income (69% income < $19,999; all eligible for free school meals) urban youth (M= 9.93 ± 1.22 years old; 50% male; 95% African American). Teachers rated Int, CP, and CU behaviors; and caregivers rated their emotion socialization practices and youth emotion regulation and lability. Youth reported on bullying, peer victimization, social support, and exposure to community violence and completed two lab tasks to assess emotion recognition and processing. A latent profile analysis yielded three teacher-reported profiles: (1) high internalizing, moderate CU, and moderate CP (High-Int/Mod-CU/CP, n = 16; 51.7% male); (2) high generalized anxiety disorder symptoms, CU, and CP (High-GAD/CU/CP, n = 16; 80.9% male); and (3) low problematic behaviors (Low, n = 59; 45.5% male), with the first two profiles rated as having co-occurring presentations of anxiety, depression, and CU behaviors, with different levels of CP. Auxiliary analyses revealed that the High-Int/Mod-CU/CP and High-GAD/CU/CP profiles differed only in levels of recognition of sad facial expressions, whereas the High-GAD/CU/CP and Low profiles differed on witnessing community violence and emotion regulation. The High-GAD/CU/CP profile also reportedly exhibited the greatest engagement in bullying and emotional lability. Current findings add to the growing literature on profiles of youth emotional and behavioral problems that include different constellations with co-occurring CU behaviors among youth in contexts that place them at increased risk for poor functional outcomes. / Psychology

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