abstract: Clinically meaningful emotional and behavioral problems are thought to be present beginning in infancy, and may be reliably assessed in children as young as 12 months old. However, few studies have investigated early correlates of emotional and behavioral problems assessed in infancy. The current study investigates the direct and interactive contributions of early infant and caregiver characteristics thought to play an important role in the ontogeny of behavior problems. Specifically, the study examines: (1) the links between temperamental reactivity across the first year of life and behavior problems at 18 months, (2) whether children high in temperamental reactivity are differentially susceptible to variations in maternal sensitivity, (3) the extent to which child temperamental risk or susceptibility may further be explained by mothers’ experiences of stressful life events (SLEs) during and before pregnancy. Data were collected from 322 Mexican American families during prenatal, 6-, 12-, 18-, and 24-week home interviews, as well as during 12- and 18-month lab interviews. Mother reports of SLEs were obtained between 23-40 weeks gestation; temperamental negativity and surgency at 6 weeks and 12 months; and internalizing and externalizing behaviors at 18 months. Maternal sensitivity during structured mother-infant interaction tasks at the 6-, 12-, 18-, and 24-week visits was assessed by objective observer ratings. Study findings indicated that maternal SLEs before birth were associated with more infant negativity across the first year of life, and that negativity in turn was associated with more internalizing problems at 18 months. Ecological stressors thought to be associated with sociodemographic risk factors such as low-income and ethnic minority status may begin to exert cascades of influence on children’s developmental outcomes even before birth. / Dissertation/Thesis / Doctoral Dissertation Psychology 2016

abstract: The current study delineated the developmental trajectories of early childhood externalizing and internalizing symptoms reported by mothers and fathers, and examined the role of the 18-month observed parenting quality × Respiratory Sinus Arrhythmia (RSA) interaction in predicting these trajectories. Child sex was tested as a covariate and moderator. It was found that children's low baseline RSA or high RSA reactivity , in comparison to high baseline RSA or low RSA reactivity , was more reactive as a function of early parenting quality when predicting the development of early childhood problem symptoms. Differential patterns of the interaction between parenting quality and RSA were detected for mothers' and fathers' reports. Mother-reported models showed a diathesis-stress pattern, whereas the father-reported model showed a vantage-sensitivity pattern, especially for internalizing symptoms. This may imply the potential benefit of fathers' active engagement in children's early development. In addition, the effect of the parenting quality × RSA interaction in predicting the mother-reported models was found to be further moderated by child sex. Specifically, the parenting quality × baseline RSA interaction was significantly predictive of girls' 54-month internalizing, and the parenting quality × RSA reactivity interaction significantly predicted boys' internalizing slope. Girls with low baseline RSA or boys with high RSA reactivity were vulnerable to the less positive parenting, exhibiting high levels of 54-month internalizing symptoms or slow decline in internalizing over time, respectively. Future research directions were discussed in terms of integrating the measures of SNS and PNS in psychopathology study, exploring the mechanisms underlying the sex difference in parenting quality × RSA interaction, and comparing the findings of children's typical and atypical development. / Dissertation/Thesis / Masters Thesis Psychology 2014

Separate externalizing and internalizing pathways to problem drinking have been described. However, internalizing and externalizing are substantially correlated, thus, there is good reason to believe that these two forms of dysfunction behaviors do not operate independently. We tested an integrative developmental model of transactions among internalizing symptomatology, externalizing personality, and psychosocial learning in the prediction of both drinking problems and future internalizing symptoms. To do so, we studied a large sample (n = 1910, 49.9% female) of children over a critical developmental period, from the spring of 5th (last year elementary school) grade through the spring of 9th grade (first year of high school). Using a battery of self-report questionnaires, we assessed demographics, pubertal status, negative urgency, depressive symptoms, positive drinking expectancies, and drinking behavior. Specifically, the present study tested whether internalizing symptomatology (depressive symptoms) in elementary school predicts a classic externalizing pathway ( to problem drinking in middle school, and whether problem drinking in middle school predicts increased depressive symptomatology in highschool. Structural equation modeling yielded significant findings for hypothesized direct and indirect pathways, with overall good model fit (CFI = .94; SRMR = .05; RMSEA = .05, 90% CI .04-.05): elementary school depressive symptomatology predicted middle school drinking problems (mediated by negative urgency and psychosocial learning) and middle school drinking problems predicted increased risk for depressive symptoms in high school, pointing to a reciprocal relationship between internalizing and externalizing dysfunction. The present study incorporated internalizing symptomatology into a traditional externalizing model of drinking risk, and demonstrated a reciprocal relationship between internalizing and externalizing dysfunction during adolescence. These findings are particularly noteworthy when considered in a developmental framework. The present study highlights the need to integrate both internalizing and externalizing forms of dysfunction into models of substance use risk.

This dissertation consists of two studies designed to broaden our understanding of the impact of complex trauma on symptom profiles and outcomes of children in the child welfare system through the lenses of gender, development, and placement permanency. Data for both were obtained using the Child and Adolescent Strengths and Needs Comprehensive Assessment tool (CANS; Lyons, Gawron, & Kisiel, 2005) for youth ages 6 -17 years involved in the child welfare system. In Study 1, I examined symptom profiles of 3,446 youth to determine the ability of gender, age, ethnicity, trauma type, and other adversity variables to predict the following CANS domains: posttraumatic stress symptoms (PTSS), emotional/ behavioral needs, risk behaviors, life domain functioning, and child strengths. Findings supported the hypothesis that males and females would exhibit a similar number and severity of PTSS subsequent to exposure to maltreatment, including complex trauma. Unique gender-specific developmental profiles of trauma exposure and symptomatology emerged. I concluded that the complex and dynamic interactions among gender, age, trauma experience, and psychosocial functioning are more complicated than can be elucidated in main effect or two-way interactions. It is therefore recommended that trauma researchers disaggregate analyses by gender in trauma research because the dynamics of trauma are different for males and females. In Study 2, I employed survival analyses to examine the ability of child characteristics, complex trauma exposure, and placement-related variables to predict placement disruption in a sample of 4,822 youth at high-risk for placement disruption. Older age, female gender, higher levels of externalizing behavior, and more prior placements increased risk for placement disruption, whereas longer time in care and type of out-of-home placement decreased risk for placement disruption in the sample. It is recommended that placement stability be directly targeted for those at higher risk through provision of intensive support to youth and their foster caregivers. Caseworkers should receive training about those subgroups most at-risk for placement disruption. Externalizing behavior and attachment, but not PTSS, mediated the relation between complex trauma and placement disruption. Intervention for youth with a history of complex trauma should focus on both attachment and externalizing behaviors.

Externalizing disorders, including Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiance Disorder (ODD), Conduct Disorder (CD), and Impulse Control Disorder (ICD), are characterized by behavioral disinhibition/disruptive behaviors (King at al., 2004) and have been linked to high rates of substance use (Brady et al., 1998; De Sanctis, et al., 2008; Flory & Lynam, 2003; King et al., 2004). Specifically, Substance Use Disorders (SUDs) are three times higher among adolescents with ADHD and ten times higher for those with CD compared to those without these disorders (Kuperman et al., 2001). Additionally, adolescents with externalizing disorders tend to use substances earlier compared to others (Lillehoj et al., 2005), with many exposed to/regular use of alcohol, nicotine, and marijuana by age 14 (King et al., 2004). Unfortunately, adolescents with comorbid externalizing disorders and SUDs have a poorer prognosis, tending to display more substance use compared to those with SUDs only (Randall et al., 1999). Parental substance abuse disorders have also been related to a higher risk of substance use among adolescents (Hawkins et al., 1992), perhaps due to factors like accessibility and genetic predisposition. Research also suggests high rates of other risky/illegal behaviors for adolescents with externalizing disorders, including an increased number of sexual partners, rates of pregnancy, and sexually transmitted infections among adolescent females with CD (Bardone et al., 1996; 1998). Criminal behavior is more frequent among adolescents with externalizing disorders and comorbid SUDs (Randall et al., 1999). Additional factors like behavioral disinhibition and sensation seeking, typically seen in adolescents with externalizing disorders, contribute to greater engagement in illegal activities (Hawkins et al., 1992). The current study seeks to investigate male adolescents with and without externalizing disorders (i.e., ADHD, ODD, CD, and ICD) by investigating a sample of youth in a residential treatment facility for sexually abusive behaviors (N = 295). Data related to adolescents’ substance use, criminal behavior, risky sexual behaviors, and participant/parental substance abuse history were gathered from archival records. Within the sample, 234 participants were diagnosed with at least one externalizing disorder, including ADHD (n = 209), ODD (n = 91), CD (n = 102), and ICD (n = 50). Chi-square analyses and one-way ANOVAs will be conducted to explore relationships among externalizing disorders, substance use, criminal behavior, and risky sexual behaviors. The results of this study intend to inform the literature by identifying important areas of concern among adolescents with externalizing disorders. Clinical implications from the findings of the current study will help to inform prevention, risk reduction, and therapeutic goals for the treatment of adolescents with externalizing disorders.

Strong Kids is a social-emotional curriculum designed to reduce students' externalizing and internalizing symptoms. Strong Kids has shown promise in elementary school, but this was the first study to evaluate the newly updated version of the intervention in a middle school setting. The curriculum was implemented by two general education teachers with students at-risk for emotional and behavioral disorders. A mixed method design was used to evaluate outcomes with eight middle school students. Overall findings suggest that Strong Kids was effective at improving students' social emotional knowledge and internalizing symptoms; however, there were no significant changes in students' externalizing symptoms. Teachers were able to implement the curriculum with fidelity. Teachers and students also found the curriculum to be predominantly positive. Future studies should include a larger sample size, control group, and follow up data points.

Understanding child behavioral outcomes is important because early behavioral issues can lead to negative outcomes that persist throughout the life course. One characteristic that can affect child behavioral outcomes is parental psychological well-being. While there have been many studies describing the effects of parental psychological well-being on child behavior in the US, the nature of this relationship in non-Western countries has yet to be thoroughly explored. There is also limited research that distinguishes between the effects of both maternal and paternal psychological well-being on child behavioral outcomes. Japan is an interesting area in which to examine this relationship due to unique contextual factors that might affect parental psychological well-being, such as Japanese-specific patterns of maternal and paternal involvement. Utilizing regression analysis, this study examines the relationship between paternal and maternal psychological health and child internalizing and externalizing behavioral outcomes using two complementary longitudinal datasets from Japan (JCPS and JHPS). I find that maternal and not paternal psychological well-being is associated with child internalizing and externalizing behavioral problems. This may be a product of fathers in Japan being less engaged in parenting or the intense relationship mothers are encouraged to develop with their children. Further research on this relationship can help in investigating the universality of Western findings related to paternal and maternal psychological health and child behavior.

Attachment theory is a core theory of child development. The theory proposes a framework to understand how children’s early relationships to their caregiver shape children’s lifelong development. Most attachment research, however, is limited to categorical assessments of infant-mother attachment. This results in a reductionist understanding of children’s development, one that rests on a number of questionable assumptions. From an assessment perspective, categorical measures of attachment assume that all children fit neatly into a fixed number of categories, and that all children within a category present similar attachment behaviors. From a developmental perspective, a focus on infant attachment assumes little change in children’s caregiving environments, and this, despite evidence showing that changes may occur between infancy and the preschool years. Such changes influence child-caregiver attachment relationships. From a caregiver perspective, children’s relationships with their mothers are influential, but they do not span the gamut of children’s early relationships. Fathers, for example, are increasingly involved in child rearing and are influential in children’s development. This dissertation sought to overcome these limitations through the use of the Preschool Attachment Rating Scales (PARS), a novel, continuous measure of child-caregiver preschool attachment. The first study demonstrated the reliability and validity of the PARS as a measure of child-mother and child-father preschool attachment. This study examined the inter-rater reliability, the convergent validity, the construct validity, the predictive validity, and the incremental validity of the PARS. The second study used a longitudinal design to examine the independent and interactive influence of child-mother and child-father attachment in the preschool years on boys’ and girls’ externalizing behaviors in middle childhood. This latter study showed that the prediction of externalizing behavior varied as a function of children’s and parents’ genders, as well as the attachment pattern (e.g., security, avoidance). Taken together, this dissertation shows that a continuous measure of attachment can help uncover the complexity of different attachment patterns, and in turn, provide a more nuanced understanding on how such patterns affect children’s social, emotional, and psychopathological development.

The impacts of childhood stressors are harmful to the emotional and physical well-being of children of all ages. Past research has suggested that children experience increased stress due to change. One subgroup of the United States population that experiences change, is immigrants. Research provides empirical evidence of adolescent immigrant stress but has failed to examine stress experienced by immigrant children at a young age. The present study investigates how immigration status and child immigration generation might impact child stress at a young age using OLS regression. I predict that immigrant children will experience more stress than non-immigrant children and that there will be significant differences in stress between non-immigrant, 1.5 generation immigrant, and 2nd generation immigrant children. Using the 1998 and 2010 cohorts of the Early Childhood Longitudinal Study (ECLS-K 1998 and ECLS-K 2010), I compare non-immigrant and immigrant children in the Kindergarten Wave. Results provide little support for my immigration hypotheses. However, findings suggest that increases in child stress are associated with parent and child health, family structure transitions, and residential movement. Implications of these findings are discussed.

This study examined individual variability in the strength of association between psychophysiological reactivity to trauma cues and clinician-rated PTSD symptoms in a sample of female survivors of sexual and non-sexual assault. PTSD is a heterogeneous disorder, and individual differences in symptom presentation and accompanying comorbidities may be accounted for by internalizing and externalizing latent temperament-based dimensions of psychopathology. The present study proposed that these dimensions may also account for heterogeneity in the association between psychophysiological reactivity and PTSD. Prior research has demonstrated that most individuals with PTSD display elevated psychophysiological reactivity when exposed to trauma reminders, although some do not. As well, research has shown that externalizing pathologies are typically associated with diminished psychophysiological reactivity to aversive cues whereas internalizing pathologies are associated with elevated psychophysiological reactivity. This study therefore employed structural equation modeling to test hypotheses that externalizing and internalizing pathologies would display mitigating and enhancing moderator effects, respectively, on the prediction of PTSD by psychophysiological reactivity. To that end, confirmatory factor analysis first established a viable internalizing and externalizing model based on an array of clinical measures in one participant subgroup (n = 329) and then affirmed the reliability of the model in a second subgroup (n = 245). Structural equation modeling in the latter subgroup, in which PTSD was regressed on Internalizing, Externalizing, and Psychophysiological Reactivity factors as well as Internalizing by Psychophysiological Reactivity and Externalizing by Psychophysiological Reactivity moderator terms, revealed a significant moderator effect for externalizing but not internalizing pathology. However, the nature of the externalizing moderator effect differed from the hypothesized direction, with higher levels of externalizing pathology strengthening the association between PTSD and psychophysiological reactivity rather than weakening it. It therefore appears that variability in the association between PTSD and psychophysiological reactivity may be partially accounted for by individual differences in the externalizing dimension of psychopathology. As well, the psychophysiology of the externalizing dimension may also be marked by heterogeneity, with externalizing pathology being linked with increased rather than decreased psychophysiological reactivity among women who have experienced sexual or non-sexual assault.