This study examined the link between interparental violence and children's functioning. The goal of the study was to examine an indirect pathway of the effect of interparental violence on children's internalizing and externalizing problems. The data for the study was drawn from The Women and Family Project and included 359 women and one of their children between the ages of 5 and 12-years-old. Sixty-four of these women resided in a battered women's shelter, 100 of these women resided in the community but had a history of interparental violence, and 195 of these women were recruited as a comparison sample. Interparental violence, maternal parenting practices, maternal depression, and children's internalizing and externalizing problems were assessed via interviews with mothers and their children. An indirect pathway hypothesis of the effects of interparental violence which posits that interparental violence leads to maternal depression, maternal depression leads to maternal use of maladaptive parenting practices, and maternal maladaptive parenting practices lead to children's internalizing and externalizing problems was tested using structural equation modeling. This new model of the indirect effects of interparental violence was supported by the results of the structural equation models when tested on the sample as a whole as well as separately for the battered and nonbattered sample. A second indirect pathway, though, was more strongly supported. This second model indicates that interparental violence affects children through maternal depression, which is directly related to children's internalizing and externalizing problems. The results of the present study support the importance of indirect pathways of the effects of interparental violence on children.

The internalizing and externalizing dimensions of psychopathology have been shown to effectively identify groups that are at higher risk for experiencing certain forms of psychopathology. Many studies have shown that chronic physical health conditions are a risk factor for psychological distress, yet there has been very little research examining the association between chronic physical health conditions and dimensional models of psychopathology to date. In the present study we examined the factor structure of internalizing and externalizing symptoms in a sample of adults with postural orthostatic tachycardia syndrome (POTS; n =172) and in a sample of adults without any chronic illness diagnoses (n = 199). Confirmatory factor analyses suggested that psychological distress in individuals with POTS can be effectively characterized by an internalizing dimension composed of distress and fear subcomponents as well as an externalizing dimension. Tests of measurement invariance allowed for the examination of latent means, which showed that individuals with POTS tend to have higher scores on the internalizing dimension and lower scores on the externalizing dimension than healthy controls. Regression analyses suggested that within the sample of people with POTS, those who were more accepting of their illness and had higher health related quality of life tended to have lower scores on the internalizing dimension. Findings suggest that individuals with POTS are at heightened risk for experiencing internalizing symptoms of psychopathology. A dimensional conceptualization of psychopathology seems like an effective way to identify symptoms of psychopathology that are separate from symptoms of autonomic nervous system dysfunction.

Childhood maltreatment predicts mental health problems and stress responses. To design better intervention/prevention programs, it is important to explore mechanisms that may mediate those relationships. Some evidence indicates that emotion regulation strategies (suppression and reappraisal) may play this role. Using self-report, observational, and biological measures and stress manipulation in female and male college students (Study 1: N=267; Study 2: U.S.= 264; Korean=211; Study 3: N=211), I tested the following hypotheses: Study (1) habitual suppression and reappraisal strategies will mediate the relation between childhood maltreatment and perceived stress; Study (2) parental emotional neglect will be positively associated with habitual suppression and internalizing problems, and negatively associated with habitual reappraisal, in both U.S. and Korean participants; Study (3) childhood maltreatment will be associated with heightened physio-emotional responses to the Trier Social Stress Test, mediated by spontaneous suppression and reappraisal. In Study 1, partially supporting my hypotheses, habitual suppression and reappraisal mediated the relationship between self-reported maternal/paternal emotional neglect and perceived stress, though in females only; habitual suppression also mediated the relationship between maternal psychological maltreatment and perceived stress in females. In Study 2, structural equation modeling revealed that, as hypothesized, in both countries parental emotional neglect was positively associated with internalizing problems and negatively associated with habitual reappraisal; habitual reappraisal was negatively associated and habitual suppression was positively associated with internalizing problems. The positive association between parental emotional neglect and suppression was significant only in U.S. participants. In Study 3, partially supporting hypotheses, childhood maltreatment was associated with lower spontaneous reappraisal, higher negative affect at stress-test baseline, and higher behavioral expression during recovery; spontaneous suppression and reappraisal were associated with reduced emotional responsivity. Contrary to hypothesis, no mediating roles for spontaneous suppression and reappraisal were found. Together, results showed that habitual use of some emotion regulation strategies can mediate the relation between childhood maltreatment and later perceived stress (at least in females) and internalizing problems; habitual suppression mediates the association between parental emotional neglect and internalizing problems in U.S. young adults; and childhood maltreatment is related to emotional and behavioral responses to stress and effectiveness of spontaneous reappraisal strategy use during stress. / 2022-02-28T00:00:00Z

Strong Teens is an evidence-based social and emotional learning (SEL) curriculum designed to target internalizing disorders by promoting emotional resilience and social competence. In this study, Strong Teens was implemented among 36 adolescent girls during group therapy in a residential treatment center (RTC). A non-equivalent, quasi-experimental wait-list control group design was used. The curriculum was evaluated by tracking the girls' social and emotional knowledge, internalizing symptoms, and resilience from the perspectives of the girls, group therapists, and a supervisor who was blind to the study. Although the results indicated that exposure to Strong Teens was not effective in increasing the social and emotional knowledge of the girls, statistically significant reductions in internalizing symptoms and statistically significant gains in resilience were reported. Treatment fidelity checklists were filled out during 31% of the lessons where it was observed that the average lesson time was 30.11 minutes and 62% of the lessons' components implemented with integrity. In addition, group therapists completed a social validity questionnaire after the completion of the lessons in which they agreed with the goals and procedures of the curriculum, were neutral with the outcomes, and generally reported that the curriculum helped the girls facilitate better awareness of linking thoughts, feelings, and behaviors as well as helping them better understand empathy and improved peer interactions. They also indicated that the curriculum was "too basic" and wished it would have had more tailored specifics for their population. It is recommended that future research with this population investigate which SEL topics are most suitable, identify the most favorable lesson time, and explore student perspectives and experiences with Strong Teens.

Many adults suffering from mental health problems often report that the onset of these concerns began in adolescence, highlighting the importance of identifying and treating mental health concerns from an early age. In high schools, some students are identified as having externalizing or internalizing disorders. The majority of these students, especially those with internalizing symptoms, go untreated. One potential reason may be that limited school resources are used to correct behavior problems, leaving those with internalizing disorders to silently suffer, which often exacerbates the issues. Recent research suggests many individuals have high levels of resilience which can be taught, and which positively contributes to mental health. Social emotional learning (SEL) is one approach to teaching resilience. In this study we implemented an SEL program called Strong Teens at the high school level. The high school identified students with internalizing symptoms and provided them with this curriculum, intended to reduce those symptoms. We used a time series design to evaluate changes in internalizing symptoms (e.g., depression, anxiety, and withdrawal) and resilience. Results indicated that with the implementation of the Strong Teens curriculum, student levels of internalizing symptoms decreased from pretest to posttest, according to self-report. Teacher reports did not indicate any significant change in internalizing symptoms or resilience. This study supports the findings o fthe Strong Teens curriculum as a generalizable program which significantly reduces internalizing symptoms.

Internalizing disorders cause serious psychological problems for many adolescents. The effects can be both debilitating and long lasting. However, assessment of internalizing disorders has been plagued by limited measurement strategies. Historically, individual measures were developed to assess the narrow-band symptoms that are subsumed under the broad construct of internalizing disorders (e.g., depression, anxiety, somatic complaints, and social withdrawal). Recently, the Internalizing Symptom Scale for Adolescents has been created. The Internalizing Symptom Scale for Adolescents is a short screening measure that includes newer models of affect such as the tripartite model of affect. Additionally, there has been limited research on the relationship between self-concept and internalizing disorders. Although the inverse relationship between depression and self-concept is well documented, the relationship between self-concept and other internalizing syndromes is essentially unknown. The present study addressed the underlying factor structure of the Internalizing Symptom Scale for Adolescents. A factor analysis using principal axis extraction with varimax rotation was conducted. A two-factor solution was identified as superior to any other factor solution considered. The two factors accounted for 34.2% of the total variance in the Internalizing Symptom Scale for Adolescents scores and were identified as Factor 1, Negative Affect/General Distress and Factor 2, Positive Affect. The two-factor solution of the Internalizing Symptom Scale for Adolescents provided some support for Watson and Clark's tripartite model of affectivity. The present study also considered the relationship between the Internalizing Symptom Scale for Adolescents and the Multidimensional Self-Concept Scale. Bivariate correlations were run to evaluate the relationship between internalizing symptoms and self-concept. The correlations ranged from moderate to large (-.42 to -.78) and were inversely related as expected. Multiple regression analyses were conducted to determine if the Multidimensional Self-Concept Scale subscales could predict internalizing symptoms. The combined predictors accounted for 62% of the variance in the Internalizing Symptom Scale for Adolescents. These findings indicate that self-concept is a robust predictor for internalizing disorders. The study provides evidence for the use of the Internalizing Symptom Scale for Adolescents a s a pscyhometrically sound measure for assessing internalizing disorders in adolescents. Implications of this study for clinical practice and directions for future research are discussed.

The purpose of this study was to examine the difference of self-reported emotional problems between low levels and high levels of victimization. Participants included 214 fourth and fifth grade students from a southcentral county in Kentucky. Students answered demographic questions and completed a series of surveys including the Personal Experiences Checklist and the Strengths and Difficulties Questionnaire. The study was completed via computer-based questionnaire and focused on victimization within the last month. Results show that students who reported higher levels of victimization reported higher levels of emotional problems when compared to students who reported lower levels of victimization. The current study focused on short-term effects of bullying behavior as compared to the more traditional assessment of long-term outcomes. The study focused on a younger population (i.e., late elementary) than the majority of previous research. The findings of the study support the need for higher ratios of mental health professionals in school systems. With continued research into bullying and its prevalence, more comprehensive and effective bullying prevention programs can be developed and implemented.

The current dissertation consists of three interrelated studies examining the relationship between sleep functioning and adolescent adjustment. Although links between sleep patterns and internalizing problems and externalizing or problem behaviors in children and adolescents have been established in literature, several gaps remain in this research. This dissertation addressed these by: (a) testing sleep problems, quantity, and chronotype in childhood as predictors of internalizing problems in adolescence (Study 1), (b) testing sleep problems, quantity, and chronotype in childhood as predictors of problem behaviors in adolescence (Study 2), and (c) testing sleep problems and quantity as mediators of the chronotype-adjustment link (Study 3). Latent Growth Modeling (LGM) and Half-longitudinal Path Analysis were used to carry out these studies using a large sample of children part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Findings from Study 1 and 2 showed that greater sleep problems in early childhood and their slower decrease during childhood predicted higher levels of internalizing problems and problem behaviors in early adolescence. Furthermore, lower sleep quantity in early childhood predicted higher internalizing problems and problem behaviors in early adolescence and a greater increase in problem behaviors in adolescence. Lastly, greater eveningness in early childhood predicted greater increases in problem behaviors during adolescence. Results of Study 3 provided evidence that evening chronotype longitudinally predicted less favorable sleep patterns, including greater sleep problems and lower sleep quantity. However, only sleep problems significantly predicted measures of adjustment, particularly internalizing problems; no effects of sleep quantity on adjustment were found.

This study examines the relationship between parental personal mastery, parents' depressive symptoms and children's internalizing symptoms and externalizing behaviors. Respondents in this study included 282 four- year old children randomly sampled from classrooms in public sponsored pre-k programs and their parents who participated in the National Center for Early Development and Learning (NCEDL) study of pre-k quality. Personal mastery was measured using Pearlin and Schoole's (1978) Personal Mastery Scale and depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Internalizing symptoms and externalizing behaviors were measured using the Hightower Teacher-Child Rating Scale. It was expected that children of parents who displayed depressive symptoms and low personal mastery would exhibit a higher level of internalizing and externalizing problems than their peers. No support was found for a relation between parental depression and child outcomes. However, children of parents reporting high parental mastery exhibited fewer behavioral problems than their peers. This study underscores the importance of parental beliefs and suggests the value of including modules on personal mastery in programs to train parents to deal with child behavior problems. / acase@tulane.edu

Using data gathered during in-depth interviews as the primary method of analysis, the current study explored the transition planning process and the factors that helped youth with internalizing disorders decide to pursue and enroll in college. More specifically, the purposes of the current study were to: (1) explore the resources and supports available to students with internalizing disorders both within and outside of the high school setting as they prepare for the transition to postsecondary education and (2) explore student perceptions of the impact of the transition planning process. Eight college students from the Midwestern United States who received special education services and had a diagnosed internalizing disorder in high school participated in the study. An analysis of the interviews was conducted using the constant comparative method as a guide. The data analysis process involved creating codes, developing broader categories for codes, comparing newer interview data to prior interview data, and continuing to revise findings until a point was reached where additional coding no longer led to new conclusions. Results of the current study suggest that participants received many of the transition planning components considered to be best practice within the transition planning literature; however, their experiences highlight the need for plans to be tailored in order to address concerns related to the daily impact of their symptoms of anxiety and/or depression. Although no participants reported a seamless transition to college, they did identify several school-based services and outside supports that helped facilitate the process. These services included individualized transition plans, access to mental health services in and out of school, access to informal emotional support from school staff, and sometimes relying on family members as an additional resource throughout the process. Even when they were able to access these components during transition planning, participants noted that their internalizing symptoms continued to negatively affect their functioning as young adults. In addition, lack of access to quality mental health care in young adulthood emerged as a salient concern for participants.