Externalizing behavior problems are related to many problematic outcomes for children and adolescents in their home, school, and community settings. Given the ramifications of difficulties related to externalizing behavior problems, the present study examines the relationships among adolescents' externalizing behavior problems, characteristics of adolescents' families, and their perceived neighborhood support in a sample of adolescents who are in the Sixth through Eighth Grades. As part of this study, adolescents were assessed one time in their school setting with a set of brief questionnaires. In particular, adolescents completed measures assessing their levels of externalizing behavior problems, characteristics of their families, their perceptions of neighborhood support and of their teachers, and their ratings of their own acculturation. Results suggest that, although a moderation relationship does not exist between parental warmth, neighborhood support, and the development of externalizing behavior problems, variables such as maternal warmth, overall parental emotional support, and overall neighborhood support are important predictors of the development of externalizing behavior problems. Further regression analyses reveal that, in addition to neighborhood and parental characteristics, adolescents' perceived social acceptance and global self-worth are significant predictors of adolescents' externalizing behavior problems. In conclusion, when identifying adolescents who are at risk for the development of externalizing behavior problems, an ecological conceptualization encompassing culture, community, and home environments can be helpful.

Maternal depression has been found to be a risk factor in the development of child psychopathology (Burke, 2003) and more specifically, in the development of child externalizing disorders (Brennan et al., 2000; Hay et al., 2003; Kim-Cohen et al., 2005). The relation between maternal depression and poor parenting has also been identified in a number of contexts (Lovejoy et al., 2000; Shay & Knutson, 2008), as has the relation between poor parenting and child externalizing disorders (Morrell & Murray, 2003; Pevalin et al., 2003). Because maternal depression confers risk on parenting and child outcome, this study was an attempt to reveal the specifics of how maternal depression relates to the development of child externalizing disorders. The proposed model purports that maternal depression, mediated by trait irritability, which then leads to harsh discipline, will result in the development of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), but not Attention Deficit Hyperactivity Disorder (ADHD). The model also purports that maternal depression, mediated by poor supervision will be associated with care neglect, as found in Knutson et al. (2005), leading to the development of ODD and CD, but not ADHD. Furthermore, it is proposed that child ADHD will not follow either the maternal depression--irritability--poor parenting pattern or maternal depression--supervisory neglect--care neglect pattern. One-hundred thirty four economically disadvantaged mothers who were enrolled in a study of parenting were assessed for depression using both dimensional and categorical measures of current and lifetime depression. Parenting was assessed using a variety of measures which assessed supervisory neglect, care and environmental neglect, and harsh discipline. Maternal irritability not specific to discipline was assessed using the Spielberger Trait Anger Expression Inventory (Spielberger, Johnson, Russell, Crane, Jacobs, & Wordent, 1985). Child externalizing disorders were evaluated based on parent and teacher report as ADHD and a combined ODD/CD construct. As hypothesized, child externalizing disorders were related to maternal depression. The findings of the current study indicate that the relation is not direct and that maternal depression, mediated by trait irritability, leads to poor parenting characterized by inconsistent discipline, and that this poor parenting leads to the development of child ODD and CD. Moreover, whether the index of maternal depression was based on current dimensional data or lifetime history of maternal depression, the results of the analyses supported the hypothesized relation between maternal depression and child ODD/CD. However, an unexpected direct relation between current maternal depression and child ADHD was found, whereas a lifetime history of maternal depression was unrelated to child ADHD. Nonetheless, the relation between maternal depression and child ADHD did not follow the same pattern as the relation between maternal depression and child ODD/CD. Findings suggest that maternal irritability and inconsistent parenting are central to the putative link between maternal depression and child ODD/CD and that depressed mothers should be treated in an effort to reduce the risk for development of child ODD and CD.

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abstract: The present study tested the factor structure of the externalizing disorders (e.g. attention-deficit hyperactivity disorder (ADHD), conduct disorder (SE), and substance experimentation (SE) ) in adolescence. In addition, this study tested the influence of the GABRA2 gene on the factors of the externalizing spectrum. Confirmatory factor analyses were used to test the factor structure of the externalizing spectrum. Specifically, three competing alternate confirmatory factor analytic models were tested: a one-factor model where all disorders loaded onto a single externalizing factor, a two-factor model where CD and SE loaded onto one factor and ADHD loaded onto another, and a three-factor model, where all three disorders loaded onto separate factors. Structural equation modeling was used to test the effect of a GABRA2 SNP, rs279858, on the factors of the externalizing spectrum. Analyses revealed that a three-factor model of externalizing disorders with correlated factors fit the data best. Additionally, GABRA2 had a significant effect on the SE factor in adolescence, but not on the CD or ADHD factors. These findings demonstrate that the externalizing disorders in adolescence share commonalities but also have separate sources of systematic variance. Furthermore, biological mechanisms may act as a unique etiological factor in the development of adolescent substance experimentation. / Dissertation/Thesis / M.A. Psychology 2012

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Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: Externalizing disorders such as attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) have a high prevalence rate in both children of alcoholics and in those with prenatal alcohol exposure (PAE). These disorders are also predictors of alcohol dependence (alcdep), heritable, and share an underlying genetic liability with alcdep. Furthermore, a mother who drinks while pregnant is likely to be alcohol dependent (AD), and vice-versa. This study incorporated these factors into one model, including as well as a measure of broad genetic risk for ADHD and alcdep to test for the contributions of these effects simultaneously. An independent sample was used to confirm the results for PAE and broad genetic risk. The hypothesis is that PAE will increase the risk to ADHD but not to CD or ODD. Methods: Each of these factors was evaluated independently to test if that effect on its own, significantly contributed to each disorder. Another model included several demographic covariates, to determine which of these environmental effects also contributed to the disorder. The final model for each disorder included environmental effects along with the primary effects of interest. Results: PAE resulted in increased risk for the inattentive (INATT) sub-type of ADHD and conduct disorder (CD) in the discovery sample and for the hyperactive-impulsive (HYPIMP), INATT and CD in the replication sample. PAE and the PAE*maternal alcohol dependence interaction increased the risk for ADHD and INATT. A broad genetic risk for ADHD was associated with all disorders except HYPIMP in the replication sample. Conclusion: This study further supports the trending evidence of a unique etiology of ADHD in those with PAE, and more specifically, that INATT and HYPIMP are affected according to two different mechanisms of action, independent of a genetic contribution due to either ADHD or alcohol dependence, both of which also were associated with a risk for INATT. The contribution of PAE to INATT and CD were the only consistent results across all definitions of alcohol exposure and in both datasets, indicating that PAE is a veritable risk for INATT and CD.

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.

This research study compared perceptions of family functioning among preadolescent children with behavior difficulties and their primary caregivers. Participants consisted of 29 caregiver-child dyads as well as each child's classroom teacher. Eligibility for the study was based on the child's placement within a self-contained Emotionally Handicapped (EH) or Severely Emotionally Disturbed (SED) classroom in one of three elementary schools within two west coast Florida counties. Data collection included teacher rating scales pertaining to the severity of each child's behavior and the presence of Callus Unemotional (CU) traits in addition to caregiver and child interviews tapping perceptions of family functioning. Results indicated that caregivers consistently viewed their families as more adaptive and cohesive than did children with a disruptive behavior disorder. These findings are consistent with previous research showing a similar pattern among older adolescents with a disruptive behavior disorder. No relationship was not found between the child's perception of family functioning and CU traits, although it was noted that there was considerable restriction of range on CU traits. Overall, the results of this study contributes to the existing literature by demonstrating that preadolescents, like their older counterparts, also view their families as less adaptive and cohesive than do their caregivers. Limitations and directions for future research are discussed.

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