Despite research that indicates that internationally adopted children are at greater risk for poor developmental outcomes than their non-adopted peers (Bimmel, Juffer, IJzendoorn, Bakermans-Kranenburg, 2003; Juffer, & van IJzendoorn, 2005), girls adopted from China into Western culture tend to thrive, exhibiting high self-esteem, low behavior problems (i.e., both externalizing and internalizing), and excelling academically (Rojewski, Shapiro, & Shapiro, 2000; Tan & Jordan-Arthur, 2012). However, few studies have examined whether this trend continues into adolescence, as well as to what factors lead to these positive outcomes. The purpose of this study was to investigate predictors of mental health outcomes among internationally adopted adolescent Chinese girls, particularly factors that predicted levels of internalizing pathology (e.g., depression and anxiety) in adolescence. To fulfill this purpose, a secondary data analysis (N = 167) of information collected as part of a longitudinal study of U.S. international adoptions of Chinese children (2005-present) was completed using a hierarchical regression approach. Overall, these variables (e.g., age at adoption, pre-adoption adversity, family stress, parenting style, adolescent self-esteem, and academic competence) predicted 35% of the variance in internalizing behavior outcomes. The positive adjustment that has been seen in childhood continued to adolescence in this study, with 88% of the adolescent girls reporting Total Internalizing T-scores of less than 60 (i.e., in the normal range) on the Youth Self-Report form on the Child Behavior Checklist (Achenbach & Rescorla, 2001b). Authoritative parenting style and self-esteem showed the strongest relations to internalizing behaviors. Implications of the study for practice and discussion of future research based on these findings are explored.

Students with internalizing behaviors are often overlooked in terms of receiving interventions that could change academic outcomes and prevent problems that could have serious implications, including social withdrawal, social isolation, and suicidal ideation. Recent research has found the use of social emotional learning (SEL), school-wide positive behavior support (SWPBS), and social skill instruction, to be effective in treating students with both internalizing and externalizing behavior problems. The use of peers has also shown promise in helping students with behavior problems. In this study, a multiple baseline across participants' design was used across two playgrounds to evaluate a buddy bench intervention, which utilized peers to help socially withdrawn students increase social engagement and peer interactions and decrease social isolation. All students (N = 448) in grades 1st through 6th were observed during the pre-lunch recess period. Results revealed that from baseline to intervention phases there was a decrease of between 19% (on the 4th to 6th grade playground) and 24% (on the 1st to 3rd grade playground) in the number of students engaged in solitary behavior on the playground. The majority of students reported positive attitudes towards the intervention. Teachers reported mixed feelings about the social validity of the Buddy Bench. Limitations and implications are discussed.

Schools need accurate and efficient ways to identify youth with mental health problems, in part to provide services to such students whose mental health concerns pose barriers to learning. The present study involved an investigation of the accuracy of one method--relying on educators (teachers, a team of school-based mental health professionals, and a school nurse) to identify early adolescents who self-report elevated levels of anxiety or depression. With respect to teachers as screening agents, the possible variability in rates of accurate identification as a function of number of teachers involved in the process (i.e., pooling nominations from multiple subject area teachers for a single student rather than from a single subject area teacher) was examined. The present study also included an examination of the demographic and psychological features of students who are more likely to be missed (i.e., self-report elevated symptoms but are not detected) or misidentified (i.e., self-reported symptoms in the typical range but were incorrectly identified as symptomatic) by educators. Participants included 233 middle school students in grades 7 to 8, 19 teachers, and 6 school-based mental health professionals. Approximately 15.5% and 12% of student participants twice-reported at-risk levels of anxiety and depression, respectively. At-risk was defined as T-scores more than one standard deviation from the norm group mean on psychometrically sound narrowband measures of anxiety and depression. Teachers correctly identified 58.33% of these anxious students and 32.14% of the students with elevated depression, but misidentified 34.52% of non-symptomatic students for anxiety and 23.41% for depression. The school-based mental health staff was largely less accurate than the teachers. The team of school-based mental health professionals accurately identified 12.50% of students for anxiety and 26.32% for depression, and falsely identified 10.31% for anxiety and 25.49% for depression. The school nurse correctly identified 14.81% of students for anxiety and 14.29% for depression, and misidentified 16.26% for anxiety and 17.83% for depression. Taken together, the use of educator nominations in identification of internalizing middle school students appears most defensible when relying on teacher judgments to identify youth with elevated anxiety. The combined group of core subject area teachers (language arts, math, and social studies) was more accurate than teachers from a single subject area, suggesting that teacher nominations should be elicited from multiple groups of core subject area teachers, particularly math and language arts. Rather than nominating students themselves, school-based mental health professionals may be better situated to deliver professional development to teachers regarding the identification of anxiety and depression. Additionally, although several demographic (i.e., gender, race/ethnicity, socioeconomic status) and psychological features (i.e., symptom severity, symptom type; also socially desirable responding and life satisfaction) were examined for students who were missed and misidentified, few differences emerged between the pairs of groups with similar self-reported levels of symptoms. Exceptions included that students who were misidentified reported higher levels of depressive symptoms (albeit still in the typical range) and less satisfaction with their lives than students who were not nominated by teachers. Thus, teachers may detect some mild mood or quality of life differences among students that do not align with students' self-report of symptoms. The practical implications of all study findings, as well as directions for future research, are discussed

This study aims to find out the relationship among marital communication patterns, parental attitudes, internalizing and externalizing behavior problems of children. To elaborate, it is aimed to figure out whether marital communication patterns predict parental attitudes, and children internalizing and externalizing behavior problems. Furthermore, it is purposed to investigate the relationship between parental attitudes and children adjustment. Finally, mediator role of parental attitudes between marital communication patterns and children adjustment was investigated. The participants of this study consist of 189 parents of preschool children. In order to measure the variables and characteristics of participants, Demographic Information Form, Communication Patterns Questionnaire (CPQ), Parenting Styles and Dimensions Questionnaire (PSDQ), and Strengths and Difficulties Questionnaire (SDQ) are used. The results of the study revealed that higher levels of destructive communication pattern is significantly associated with higher levels of authoritarian parenting attitudes whereas higher levels of constructive communication pattern is related to lower levels of permissive parenting style. Moreover, there is positive significant relationship was found between mother reported constructive communication pattern and authoritative style. Furthermore, it was shown that mother reported authoritarian and authoritative parenting attitudes are linked to emotional problems of children. Another finding of the current study revealed that constructive communication pattern is related to prosocial behavior of children. Besides inattention problems of children was found to be associated with aggressive communication pattern and mother reported permissive parenting style. However, no significant mediation effect was found. The significance, limitations, and clinical implications were discussed in the light of related literature.

The purpose of this study was to investigate how levels of stress among caregivers beginning a behavioral parent training program are related to caregiver and child variables. Research questions were answered using archival data collected from 474 caregivers who participated in HOT DOCS, a behavioral parent training program, between January 2009 through July 2010. The three objectives of the study were to (a) examine caregivers' perceived stress in relation to caregiver demographic variables (i.e., gender, marital status, level of education); (b) examine caregivers' perceived stress in relation to child demographic variables (i.e., levels of externalizing and internalizing behavior and presence or absence of a diagnosis); and (c) determine how levels of caregiver stress were related to number of parent training sessions completed. Results showed that female caregivers beginning a behavioral parent training program have higher levels of perceived stress than their male counterparts. Additionally, caregivers with a higher level of education reported less stress than caregivers with less education. No differences were found among those of different marital statuses. With regard to child variables, parents' perceptions of their child's externalizing behavior, as measured by the Child Behavior Checklist (CBCL) Externalizing score, were a significant predictor of caregiver perceived stress, but internalizing behavior (also as measured by the CBCL) and presence/absence of a diagnosis were not. Perceived stress upon entering the behavioral parent training was not a significant predictor of number of sessions completed. Implications of the study for parent training for caregivers raising young children with challenging behaviors are discussed.

Although there have been many studies investigating international adoptees' outcomes in relation to their pre-adoption experiences, there is a paucity of research investigating the influence of post-adoption experiences. Guided by the proximity of the family to the child in Bronfenbrenner's (1979) ecological systems theory of human development, this study addressed a gap in the literature by investigating the interrelationships among family-related variables (e.g., stress in family environment, parenting behavior) and 648 internationally adopted Chinese girls' behavior problems. Moderate, positive relationships were found between family stress and both internalizing (r = .43, p < .001) and externalizing (r = .59, p < .001) behavior problems. Modest, inverse relationships were found between authoritative parenting and both internalizing (r = -.08, p < .01) and externalizing (r = -.15, p < .001) behavior problems. Additionally, modest to moderate, positive relationships were found between authoritarian and permissive parenting and internalizing (r = .18, p < .001; r = .19, p < .001, respectively) and externalizing (r = .39, p < .001; r = .34, p < .001, respectively) behavior problems. Finally, authoritarian and permissive parenting behaviors were partial mediators between family stress and both internalizing (R2 = .08, p < .001; R2 = .08, p < .001, respectively) and externalizing (R2 = .20, p < .001; R2 = .16, p < .001, respectively) behavior problems while authoritative parenting was not a mediator to either type of behavior problem. The implications of these findings and suggestions for future research are discussed.

Die Arbeit untersucht die physiologische und psychologische Stressreaktion von Kindern und Jugendlichen mit internalisierenden Störungen im Vergleich zu gesunden Kontrollkindern (n = 55 pro Gruppe, Alter 8-14 J). Es wurde ein standardisierter Stressor, der Trier Social Stress Test for Children (TSST-C; Buske-Kirschbaum et al., 1997) eingesetzt und die Stressreaktion der Probanden mehrdimensional erfasst. So wurde vor und nach Stresstest insgesamt zu 9 Messzeitpunkten die physiologische Stressreaktion anhand des Stresshormons Cortisol gemessen sowie die aktuelle subjektive Aufregung erfragt. Die kognitive Stressreaktion wurde unmittelbar nach dem Stresstest anhand einer subjektiven Leistungseinschätzung sowie eine Stunde nach dem Stressor anhand eines Fragebogens zu negativen Kognitionen erfasst. Es zeigte sich, dass die Kinder der internalisierenden Gruppe eine signifikant geringere physiologische (blunted reaction) sowie eine signifikant höhere kognitive Stressreaktion aufweisen als die Kinder der Kontrollgruppe. Darüber hinaus zeigte sich eine Unterschied in den subjektiven Aufregungswerten nach dem Stresstest, mit einer höheren und länger andauernden Aufregung in der internalisierenden Gruppe. Im Rahmen von mehreren explorativen Fragestellungen wurde der Zusammenhang zwischen den verschiedenen Aspekten der Stressreaktion untersucht. Stärken und Schwächen der Arbeit sowie klinische Implikationen der gefundenen Ergebnisse werden diskutiert.

Since Bowlby (1958, cited in Bowlby, 1969) originally introduced the theory of attachment it has been written about extensively and a vast amount of research has contributed to the development of the theory. In more recent years research has focused on the possible link between attachment and psychopathology. The major aim of the present meta-analysis was to contribute to this research effort by establishing the magnitude of the effect size for the relationship between attachment security and internalizing psychopathology; and attachment security and externalizing psychopathology, in children and adolescents. Four separate meta-analyses were conducted investigating internalizing and externalizing problems in cross-sectional and prospective studies. A comprehensive literature search was conducted to identify relevant studies for inclusion in the analysis. Identified studies were assessed for eligibility according to stringent inclusion and exclusion criteria. A total of 23 studies contributing 45 effect size correlations, involving 3793 different participants were considered eligible for inclusion. Relevant information was extracted and coded from the studies before the analyses were conducted. For cross-sectional studies the mean effect size correlation for attachment security and internalizing psychopathology was r = -0.24 (k = 14; p &lt;0.01; 95% CI = -0.31, -0.17). For attachment security and externalizing psychopathology the mean effect size was r = -0.28 (k = 16; p &lt;0.01; 95% CI = -0.34, -0.21). In terms of prospective studies the mean effect size correlation for attachment security and internalizing psychopathology was r = -0.17 (k = 8; p = 0.01; 95% CI = -0.28, -0.04); and for externalizing psychopathology it was r = -0.09 (k = 7; p = 0.02; 95% CI = -0.16, -0.01). When attachment security and psychopathology were measured concurrently, there was evidence of a negative association for both internalizing and externalizing psychopathology. Although the magnitude of effect was smaller for prospective studies evidence was also found for the predictive validity of a lower level of attachment security in the development of both internalizing and externalizing psychopathology. Theoretical explanations for these findings are presented and the research and clinical implications are discussed in terms of the limitations of the study.

Three empirical studies comprising this dissertation were carried out to provide a more comprehensive understanding of concurrent measures of both predictors and outcomes of young adolescents' sibling interactions. The participants included older siblings (M age = 14.3), younger siblings (M age = 11.6), and their mothers from approximately 450 families who completed web-based surveys.Study one examined correlates of overt and relational aggression between young adolescent siblings. Family environment emerged as an important factor in explaining internalizing problems as well as overt/relational aggression for both younger and older siblings. Findings also provided partial support for the positive linkages between young adolescents' aggression and their own and siblings' internalizing problems above and beyond family and maternal variables. The main purpose of the study two was to investigate self-criticism as a potential mediating factor in the link between mother-child relationships and aggression or perceptions of social competence. Maternal self-criticism strongly corresponded to the quality of relationships with children, and an intergenerational similarity of self-criticism, particularly for older children, was found. Mother-child relationships and adolescent self-criticism were significantly related to aggression and perceptions of social competence. In addition, the link between mother-child relationships and aggression or social competence is mediated, in part, by self-criticism in adolescents. Using social control theory and attachment theory as guides, study three examined how qualities of young adolescents' social relationships (i.e., mother, sibling, and friend), and dynamic interactions among characteristics of those relationships, are associated with school involvement and delinquency. Results were largely consistent with tenets of social control theory and attachment theory. Young adolescents' social relationships were associated with their adjustment in ways that are protective or beneficial. Furthermore, these social affordances worked additively and in compensatory ways to promote positive adjustment. Positive relationship qualities tended to amplify other relational influences promoting successful development, and these findings were invariant across gender.While optimal mother-child relationships are central in nurturing the child's capacity to develop warm and harmonious sibling relationships in both a direct and an indirect manner, there is a considerable contribution of siblings to adjustment and socialization above and beyond the effects of mother-child relationships.

Childhood emotional maltreatment is associated with damaging consequences, although relatively little is known about the mechanisms underlying its effects. This dissertation investigated the concurrent influences of adult attachment and mindfulness on internalizing symptoms and emotional processing in young adults with and without a history of emotional maltreatment. Study 1 revealed that a sequential mediation model, with adult attachment orientations as first-step mediators and mindfulness as a second-step mediator, fit the data better than a simultaneous mediation model. In addition, moderation analyses revealed that high self-reported levels of mindfulness protected against the development of internalizing symptoms, even in at-risk individuals. Study 2 replicated these findings in a new sample, while also extending the results beyond a self-report outcome, using behavioural measures of emotional processing. Emotional maltreatment, adult attachment, and mindfulness predicted the amount of perceptual information required to correctly identify fearful faces and the amount of interference demonstrated in response to positive and negative emotional words. Cumulatively, these findings suggest that childhood emotional maltreatment can disrupt attachment relationships and encumber the development of mindfulness, contributing to internalizing symptoms and the biased processing of emotional information. However, alternative outcomes are possible, given the presence of high levels of mindfulness and secure attachment representations. This has implications for clarifying developmental theories and evaluating clinical interventions that may mitigate the negative effects of childhood emotional maltreatment.