An accumulating evidence-base indicates that internalizing mental health disorders in adulthood are causally associated with cardiovascular diseases (CVD) and type-2 diabetes (T2DM). It is plausible, however, that the relationship between mental and cardiometabolic ill-health becomes established long before adulthood, and that externalizing problems (the other central domain of common psychopathology) are also involved. These questions, as well as questions on the mechanisms that underlie the relationships, have been insufficiently investigated. The overarching goal of this dissertation was to expand current knowledge on how common mental health problems increase cardiometabolic risk over the life course. First, the prospective association between childhood internalizing (emotional problems) and externalizing problems (hyperactivity and conduct problems) with CVD and T2DM risk in adolescence was assessed in data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N=7,730). Results showed that hyperactivity problems were associated with insulin resistance (high HOMA-IR); that hyperactivity and conduct problems were each associated with high triglyceride levels; and that emotional problems were inversely associated with high triglyceride levels. These results suggest that childhood externalizing problems are an early life risk factor for CVD and T2DM and that childhood internalizing problems are not a risk factor or, that risk in these children does not become apparent until after adolescence. Second, the mechanisms underlying the prospective association of childhood hyperactivity and conduct problems with high levels of triglycerides in adolescence were investigated using causal mediation methods. Results showed that despite being associated with hyperactivity and with conduct problems, body mass index and lifestyle health behaviors including sleep, diet, physical activity, alcohol, and smoking, together these variables, as measured, mediated only 19.6 % and 19.3% of the associations of hyperactivity and conduct problems with triglycerides, respectively. These results would suggest that mechanisms other than body adiposity and unhealthy behaviors are also involved and that those mechanisms have a larger role in mediating these relationships. Alternatively, It is possible that the observed small role of health behaviors is due to error in measurement and therefore improving measurements for health behaviors should be a central focus of future work. Third and last, a systematic review of the literature on the relationship between childhood externalizing problems with CVD and T2DM risk was conducted. Studies were graded for propensity to bias. Evidence was summarized and assessed for consistency. Results strongly supported positive associations of externalizing problems with insulin resistance, T2DM, and with increased blood lipids among children and adolescents. Evidence suggested that associations are at least partly independent of body adiposity. Evidence provided mix support for the associations with T2DM and blood lipids in adults and with other outcomes in children or adults. Studies in children tended to be cross-sectional and to use valid and reliable assessment methods, whereas studies of adults tended to be prospective and to rely on less-valid, less reliable assessment methods. These results warrant more research, specifically prospective studies that track children into young adulthood, that employ well-validated measures of externalizing behaviors, that rely on repeated assessments of T2DM and CVD risk throughout follow-up, and that investigate mechanisms other than body adiposity and health behaviors. Overall, this dissertation has found that childhood externalizing problems are prospectively associated with elevated CVD and T2DM risk, specifically with elevated risk of increased levels of blood lipids and insulin resistance. Unlike studies in adults, this dissertation does not support a role of internalizing problems as risk factors. Among children with externalizing problems, risk becomes evident before adolescence and appears to be largely driven by pathways independent of unhealthy behaviors and body adiposity. Implications of this research’s findings for health practice were proposed. This dissertation identified several gaps and methodological shortcoming in the extant literature. Recommendations were made for future research, including fundamental next questions to investigate, and study designs and methodologies that are best suited to tackle those questions.

People use language to communicate their needs and intentions, to express emotions, and to form relationships. It seems likely that a disruption in children's language development would have a negative impact on their social development. There is extensive research that shows that school age children with delayed language are "at risk" for increased maladaptive behaviors (Cantwell and Baker, 1977). Whether this is also true for children in the earliest stages of language development is not yet known. The questions this study sought to answer were: 1) Is there a significant difference in the severity and frequency of maladaptive behaviors seen in language delayed children, children who were "late talkers," or children with normal language? and 2) Is there a significant difference among the three subject groups in terms of which behaviors parents are the most concerned about·?

Collectively known as Behavioral Skills Training (BST), instruction, modeling, rehearsal, and feedback procedures are often used in parent training programs. A nonconcurrent multiple baseline, single-subject component analysis of BST procedures was conducted with 12 parents of children aged 2-4 years in their homes. Written instructions, video modeling, and rehearsal-feedback training conditions were counterbalanced and randomly assigned to each parent. The frequency and quality of parent praise were measured during structured free-play and cleanup observations. BST 6 procedures produced comparable results in praise frequency and quality. For all parents, the cleanup scenario was associated with higher praise frequency than the play scenario. Common trends observed in the data and limitations of the study are discussed, along with directions for future component analysis research on BST procedures.

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This study investigates the level of social competency and presence of behavioral problems associated with young sexually abused children ages 4 to 8, as compared to those among a comparable sample of nonabused young children. Thirty-two parents or guardians, 16 in each group, completed the Achenbach Child Behavior Checklist for each child. Characteristics of the abuse were addressed on an additional questionnaire. Data was collected on 12 female and 4 male children in each group. The results indicated that the amount and severity of behavior problems was greater and social competency levels were lower among the sexually abused children than that of the nonabused sample. However, sexually abused children were perceived to exhibit significantly higher levels of each problem than nonabused children with the exception of the problem identified as somatic complaints. Nonsignificant results were found when comparisons were made of the behavior problem level and characteristics of the abuse. These findings are consistent with previous research and further support the existence of problem behaviors among young sexually abused children. Suggestions for future research in this area and the clinical utility of the current findings are discussed.

This study examines selected variables as they relate to the performance of sixth-grade learning disabled (LD) and behaviorally-emotionally handicapped (BEH) students on minimum competency tests administered by the North Carolina public schools. The sample consisted of 313 LD and 79 BEH subjects who attended the 1988 Basic Education Program Summer School in 38 selected school districts. Data were collected describing the independent variables including students’ race, sex, handicapping condition, parent education level, and school and teacher characteristics including instructional time, class size, teacher training, and teacher certification. The dependent variables for the study included language, reading, and mathematics performance scores on the Minimum Skills Diagnostic Tests (MSDT). Data were analyzed by utilizing a multiple regression model to describe the relationships between selected demographic and school variables and language, math, and reading gain scores on the MSDT and by utilizing dependent t tests for differences between the means for pre- and post-test performances. Although gains were made by LD and BEH students on the MSDT, it was concluded that the student and school variables used in the study were not predictive of achievement. / Ed. D.

Chan Wai-Lok. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 46-58). / Abstracts in English and Chinese ; questionnaire also in Chinese. / Abstract --- p.i / 擇要 --- p.ii / Acknowledgement --- p.iii / Table of Contents --- p.iv / List of Tables --- p.vi / List of Figures --- p.vii / List of Appendices --- p.viii / Chapter Chapter 1: --- Introduction --- p.1 / Parenting Style --- p.1 / Effects of Parenting Style on Misbehavior --- p.3 / Effects of Parenting Style on Academic Performance --- p.4 / Paradox in Chinese --- p.5 / Summary on Parenting Style --- p.9 / Teaching Style --- p.10 / Effects of Teaching Style on Misbehavior --- p.12 / Effects of Teaching Style on Academic Performance --- p.13 / Teaching Style in Chinese --- p.14 / Summary on Teaching Style --- p.15 / Interaction Effects of Parenting and Teaching Styles --- p.15 / Parental Influences and Teacher Influences on Children and Adolescence --- p.17 / Summary --- p.18 / Chapter Chapter 2: --- Method --- p.20 / Participants --- p.20 / Measures --- p.20 / Parenting Style --- p.20 / Teaching Style --- p.21 / School Misbehavior --- p.22 / Academic Performance --- p.22 / Procedures --- p.23 / Chapter Chapter 3: --- Results --- p.24 / Time 1 Analysis --- p.24 / Means & Correlation --- p.24 / Hierarchical Regression Analysis --- p.25 / Across Time Analysis --- p.27 / Correlation --- p.27 / Direct Effect Analysis --- p.28 / Indirect Effect Analysis --- p.30 / Chapter Chapter 4: --- Discussion --- p.34 / References --- p.46