Parenting Predictors of Early Conduct Problems in Urban, High-Risk Boys

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<ul><li><p>Parenting Predictors of Early Conduct Problemsin Urban, High-Risk Boys</p><p>GAIL A. WASSERMAN, PH.D., LAURIE S. MILLER, PH.D., ELIZABETH PINNER, M.A.,</p><p>AND BEATRIZ JARAMILLO, D.P.H.</p><p>ABSTRACT</p><p>Objective: As part of a larger, prospective study, the authors examined concurrent and prospective relations among</p><p>parenting and child antisocial behavior in inner-city boys at high risk for delinquent behavior. Method: One hundred</p><p>twenty-six younger brothers (aged 6 to 10 years) of convicted delinquents in New York City and their parents were</p><p>assessed; 15 months later 112 boys were reassessed. Demographics, parenting, and child diagnosis were examined</p><p>as they relate to child externalizing behavior problems. Hierarchical multiple regression analyses predicted changes in</p><p>Externalizing scores from year I parenting. Results: At years I and II, 22% and 27% of boys, respectively, scored above</p><p>the clinical cutoff for Externalizing. Controlling for earlier Externalizing, each of three domains of parenting still made</p><p>significant independent contributions to later Externalizing scores, explaining 17% of the variance. Altogether this model</p><p>explained 51% of the variance in year II Externalizing scores. Conclusions: Data support a cumulative risk model,</p><p>whereby each of several adverse parenting factors further compounds the likelihood of child conduct problems. J. Am.</p><p>Acad. Child Ado/esc. Psychiatry, 1996,35(9):1227-1236. Key Words: conduct problems, parenting, antisocial behavior,</p><p>family factors.</p><p>Recent formulations of the development of childhoodconduct problems have described two distinct develop-mental patterns (e.g., Moffitt, 1993): early-onset life-persistent and adolescent-limited. Early starters displaybehavior problems prior to age 10 years, are frequentlyphysically aggressive, and tend to have disturbed peerrelations. Compared with those with the adolescent-limited pattern, early starters are more likely to havepersistent conduct problems, to develop antisocial per-sonality disorder in adulthood (American PsychiatricAssociation, 1994), and to be impaired in multiplefunctional domains. Given the high risk for negativeoutcome in such children, understanding the precursorsof early-onset conduct problems is of great importance.</p><p>Accepted March 28, 1996.From the Department ofChild Psychiatry, Columbia University/New York</p><p>State Psychiatric Institute, New York.</p><p>This research was supported by a grant from the Lowenstein Foundation to</p><p>the Lowenstein Center for the Study and Prevention ofDisruptive Disorders(Gail A. Wasserman, Principal Investigator).</p><p>Reprint requeststo Dr. Wasserman, Columbia University, NYSPI Unit 78,722 West 168th Street, New York, NY 10032.</p><p>0890-8567/96/3509-1227$03.00/01996 by the American Academyof Child and Adolescent Psychiatry.</p><p>Transactional models of early-onset conduct prob-lems suggest that the juxtaposition of a difficult child(e.g., impulsive, irritable) with an adversefamily context(e.g., incompetent parenting) initiates risk for a persis-tent pattern of oppositional and aggressive behavior(e.g., Cicchetti and Richters, 1993; Conduct ProblemsPrevention Research Group, 1992; Moffitt, 1993).While skillful parenting may overcome early childhooddifficulties, family environments characterized by nega-tive interactions will likely maintain or worsen childbehavior problems.</p><p>The relation between family environment and child-hood conduct problems has been demonstrated pre-viously (e.g., Henggeler, 1989; Loeber and Dishion,1983; Loeber and Stoutharner-Loeber, 1986; Snyderand Patterson, 1987). For example, families of childrenwith conduct problems are characterized by inconsistentdisciplinary practices and unintentional parent rein-forcement (McCord, 1979; Patterson and Stouthamer-Loeber, 1984). Such family environmental factors haveparticular influence on juvenile antisocial behavior (Ly-ons et aI., 1995; McGuffin and Gottesman, 1985).</p><p>Three specific parenting practices emerge from theexisting literature as important for the onset of early</p><p>]. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 35:9, SEPTEMBER 1996 1227</p></li><li><p>WASSERMAN ET AL.</p><p>conduct problems (see Loeber and Stourhamer-Loeber,1986, for a review). One such important aspect is"parent-child conflict," which encompasses harsh pun-ishment, fighting and arguing between parent andchild, and overt dislike of the child by the parent.Relations between parents and children with conductproblems are often characterized by harsh physicalpunishment (Andrew, 1981; Eron et al., 1991).</p><p>A second important domain is "monitoring," whichinvolves knowing where, how, and with whom thechild spends time. Children with conduct problemstend to be more poorly monitored (Farrington, 1983;Patterson et al., 1992).</p><p>"Positive involvement" is a third domain that in-cludes support for socially competent behavior (Pat-terson et al., 1992), emotional support, and expressionsof interest in the child. While involvement providedin the home is important for academic achievement(Bradley et al., 1989; Luster and Dubow, 1992; Richterand Grieve, 1991), recent studies have demonstratedthat a cognitively stimulating and emotionally support-ive home environment also predicts decreased antisocialbehavior (e.g., Dubow and Ippolito, 1994).</p><p>While very few studies have examined the relativeimportance of different aspects of family functioningover time, one recent study (Reiss et al., 1995) under-scores the contribution of each of these components toantisocial behavior. Unfortunately, that study examinedneither the relative contribution of these componentsto antisocial behavior nor the prospective associationsbetween parenting and child outcome.</p><p>In another series of prospective studies, poor moni-toring and inept discipline made significant independ-ent contributions, of equal magnitude, to children'santisocial behavior (Forgatch, 1991; Patterson et al.,1992). Similarly, Sampson and Laub (1993) demon-strated that erratic and harsh discipline, low supervision,and weak parent-child attachment each predicted self-parent-teacher-reported delinquency in older children.</p><p>Following a sample of children at elevated risk forearly-onset conduct problems facilitates the study ofemerging conduct problems. Investigations that mea-sure parenting and child behavior concurrently are lessinformative since components of parenting are as likelyto be reactions to child conduct problems as they areto be contributors to child misbehavior. A prospectiveinvestigation of a high-risk cohort, beginning beforethe onset of serious behavioral disturb-ance, would</p><p>better elucidate the specific contributors to child behav-ior problems.</p><p>To expand our understanding of the multiple familyinfluences on early-onset child conduct problems, weexamined a sample of boys at high risk for antisocialbehavior because of family history, gender, and urbanresidence. Urban residence (Garbarino et al., 1992;Tolan and Henry, 1994; Walter et al., 1995), malegender (American Psychiatric Association, 1994), andhaving a sibling with a history of delinquency (Joneset al., 1980; Patterson, 1984; Rowe and Herstand,1986; Rowe et al., 1992; Twito and Stewart, 1982)are well-documented risk factors for antisocial behavior.We examined the prospective associations among pa-rental involvement, monitoring, and parent-child con-flict, as they relate to later child conduct problems.</p><p>METHOD</p><p>Subjects</p><p>Subjects were 126 youths at high risk for conduct problemsand their families. Risk status was defined by urban residence,male gender, and the presence of a sibling (half or full) with arecent juvenile court conviction. We first screened the court recordsof every male delinquent (N = 1,614) found guilty in Manhattanor Bronx Family Court from November 1991 until October 1993.Cases dismissed in court or for which the juvenile was found "notguilty" are "sealed" by law, and therefore they were not examined.Families of female delinquents adjudicated during that time framewere not included because of their lower frequency (n = 110).</p><p>New York City Family Court probation reports were screenedto identify families of delinquents with a younger brother 6 to 10years old who resided in Manhattan, Brooklyn, or the Bronx, NewYork. Information on gender, age, and residence of the delinquent'ssiblings was taken from the probation report. Probation reportswere unavailable for 272 cases. Of the 1,342 with reports, 1,163were ineligible because (1) there was no younger brother in thetargeted age range (n = 1,055); (2) the family resided outside thedesignated area (n = 81); or (3) the younger sibling had a substantialphysical or mental disability (n = 4), was in foster care (n = 16),or did not reside with the delinquent (n = 7) at the time of arrest.</p><p>Of 179 eligible families, 28 were unreachable and 42 refused.In families with more than one age-appropriate son, all were askedto participate. One hundred nine families with 126 eligible boysconsented. Eligible families (n = 179) did not differ from ineligibleones (n = 1,163) on the age of delinquent youth, erhnicity, boroughin which the delinquent committed the crime, and severity ofcriminal charge; participating (n = 109) and eligible, nonparticipat-ing families (n = 70) did not differ on these measures. Onaverage, 7.1 months elapsed between the delinquent's arrest andour home interview.</p><p>The delinquent older brother was, on average, 14.8 years old(ranging from 10 to 17 years), and the biological mother was theprimary caregiver in 98 of the 109 participating families. In theremaining families, the primary caregivers were the biologicalfathersin two, the grandmother in eight, and the adoptive mother in</p><p>1228 ]. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 35:9, SEPTEMBER 1996</p></li><li><p>one. When the biological mother was not the primary caregiver,the primary caregiver was interviewed about the biological mother,as well as about herself or himself. Below, "moth er" refers tobiological mothers, and "caregiver" or "parent" refers to theprimary caregiver.</p><p>Procedures</p><p>Study procedures were approved by the New York State Psychiat-ric Institute/Columbia University Institutional Review Board. Eligi-ble families were sent a letter describing the study. Families whodid not wish to be contacted were asked to return a "do notcontact" postcard. Families not declining further contact weretelephoned or visited at home 2 weeks later. Study procedureswere explained, consent was obtained, and a home interview wasscheduled. Interviewers were college graduates with prior experienceconducting standardized interviews with children and families, whowere familiar with the communities in which study families resided.</p><p>During the 3- to 4-hour year I home interview, caregiversreported on their own functioning, parenting practices, and theirchildren's functioning, including psychiatric diagnostic status . Ob-servations were made of the quality of parenting. Latino familieswere interviewed by bilingual staff, and questions were read aloudfor parents not proficient in reading. Information about parentingpractices was collected from children by direct interview.</p><p>Approximately 15 months later, 112 boys in 98 families weresuccessfully reassessed (child behavior and diagnostic information)in a clinic visit. This article reports on demographic characteristics,parenting, behavioral, and diagnostic information collected at yearsI and II.</p><p>Instruments and Measures</p><p>Instruments unavailable in Spanish were translated to Spanishand back-translated into English to ensure accuracy and readability.</p><p>Demographic Information. Demographic information includedchild's age, family composition, parental education, ethniciry, andoccupational status (Stevens and Cho, 1985).</p><p>Parenting Practices. Three instruments assessed parenting: theHome Observation for Measurement of the Environment (HOME)scale, the Conflict Tactics Scale (CTS) , and components of thePittsburgh Youth Study Survey (PYSS).</p><p>HOME. The elementary-age version of the HOME (Caldwelland Bradley, 1984) indexed the quality of the home environment.The semistructured instrument combines observational and inter-view information on aspects of the home, such as parental warmthand acceptance toward the child and physical punishment. Items arescored as present/absent. The instrument has excellent psychometricproperties (Bradley et al., 1989) . While the entire instrument wasadministered, the subscales tapping Emotional Climate, EmotionalResponsiviry, and Encouragement of Maturity were selected on ana priori basis for this report because they are based largely onobservations of the emotional quality of the parent-child relation-ship. These were summed into a single scale, referred to below asEmotional Support.</p><p>CTS. We adapted the CTS (Straus , 1979 ; Straus et al., 1980 )to measure the extent to which parents used conflict during disputeswith their children. The CTS was originally developed for assessingconflict between adult domestic partners and was standardized ona large, stratified sample (Straus et al., 1980) . The CTS generatesfour subscales: Reasoning, Verbal Aggression, Violence, and LethalViolence. The Verbal Aggression and Violence subscales werecombined into a single scale, which we termed "Fighting." We</p><p>PREDICTORS OF CONDUCT PROBLEMS</p><p>did not consider the other twO scales in this report because LethalViolence was extremely rare, and Reason ing has not been foundto be associated with child behavior problems.</p><p>PYSS. Caregivers and children were asked questions from thePYSS (Loeber er al., 1991b), including measures of Punishment,Rejection, Monitoring, and Communication. Components of thissurvey have been associated with antisocial behavior in youngchildren (Loeber et al., 1991 b).</p><p>Constructs. Selected scales from the above instruments were usedto create three parenting constructs: Involvement, Parent-ChildConflict, and Monitoring. Table 1 presents the components ofthese constructs, their psychometric properties, and sample items .</p><p>For each construct, two informants provided information: parentand observer (Involvement), or parent and child (Parent-ChildConflict and Monitoring). For two child report measures, Punish-ment and Monitoring, data were unavailable for eight childrenwho did not understand the questions. The average age of excludedchildren was 7.5, but 8.9 for included children, suggesting thattheir age made comprehension difficult.</p><p>ChildSymptomatic Behavior. Parents completed the Child Behav-ior Checklist (CBCL/4-18) (Achenb ach, 1991), a 113-item check-list that has adequate reliability and stability (e.g., Achenbach,1991). It generates eight subscales, a Total scale, and two broad-band scales, Externalizing and Internalizing. The Externalizing scaleis the primary outcome measure in the present study.</p><p>Caregivers were also administered the D iagnostic InterviewSchedule for Children (DISC-P, 2.3) (National Institute of MentalHealth, 1995; Shaffer et al., 1996). This structu red interview isthe most extensively tested of all the child and adolescent diagnosticint erviews. Test-retest and in...</p></li></ul>

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