Child behavior problems, injury-related family burden, and parent psychological distress were assessed longitudinally over the first year post injury in 40 children with severe traumatic brain injury (TBI), 52 with moderate TBI, and 55 with orthopedic injuries not involving brain insult. Parents rated children's preinjury behavior soon after injury. Postinjury child behavior and family outcomes were assessed at 6- and 12-month follow-ups. Findings from path analysis revealed both direct and indirect effects of TBI on child behavior and family outcomes, as well as cross-lagged child-family associations. Higher parent distress at 6 months predicted more child behavior problems at 12 months, controlling for earlier behavior problems; and more behavior problems at 6 months predicted poorer family outcomes at 12 months, controlling for earlier family outcomes. Support for bidirectional influences is tentative given that limited sample size precluded use of structural equation modeling. The findings nevertheless provide impetus for considering the influences of person-environment interactions on outcomes of TBI. (JINS, 2001, 7, 755–767.)

Life course and current family factors associated with individual differences in parent–child relationships were investigated in a sample of 467 children from 192 families, including stepfather, single-parent, stepmother, and complex stepfamilies; informants were fathers, mothers, and children. Both positive and negative dimensions of father–child and mother–child relationships were linked to earlier life course experiences of parent and of partner, to current family factors, and to the quality of partner's relationship with the child. The pattern of associations between the adults' life course experiences meant that children were at risk for a “double dose” of less affectionate relationships in families in which parents had experienced early adversities. The significance of biological relatedness, family setting, and child–partner relationships was highlighted.

Previous research has shown that children receiving substitute parental care tend to have high rates of emotional/behavioural disturbance, but uncertainty remains on the extent to which this derives from genetic risk, adverse experiences before receiving substitute care, or from risks associated with substitute care experiences. In order to examine the effects of institutional rearing (as a specific form of substitute care), two groups of primary school children reared in substitute care from before the age of 12 months were compared: 19 children in residential group (institutional) care and 19 in continuous stable foster family care (matched for age and gender). The two groups were similar in coming from biological families with high rates of psychopathology and social malfunctioning, but differed with respect to pattern of rearing. Both groups were compared with classroom controls, using teacher questionnaires, systematic classroom observations, and standardised cognitive testing. Parental questionnaires were also obtained for the two substitute care groups. As found previously, the combined substitute care groups differed from controls in showing a high level of hyperactivity/inattention. The observational measures showed a similar effect, indicating that the elevated rate was not attributable to rater bias. The teacher questionnaire and observational measures showed, however, that the increased level of hyperactivity/inattention was substantially higher in the institutional group than the foster family group. Parental questionnaire ratings showed the same contrast between the groups, except that the main difference was on unsociability and emotional disturbance rather than hyperactivity/inattention. It is concluded that, against a background of genetic and early environmental risk, institutional rearing predisposes to a pattern of hyperactivity/inattention.

Sweden has now around 38,000 individuals who have been adopted from other countries. Most often they are transracially adopted and have a different appearance from their new parents—“visible” adoptions. This study was made to explore the mental health of a teenager/young adult group that arrived with their families in the southernmost county of Sweden between 1970 and 1977. They were placed through the largest Swedish adoption agency at that time. One hundred and forty-seven families and their 211 adopted children, who were 13 years of age or older at the time of the investigation, were interviewed in their homes. CBCL, SCL-90, a self-esteem questionnaire, and two family relations inventories were also completed. Compared to nonadopted Swedish young persons of the same ages, who had been investigated with the same inventories in earlier epidemiological studies, the adoptees had as good mental health. The adoptees also reported good self-esteem. The pre-adoption conditions were more important than the age of arrival in itself for the risk of later maladaptation. Family relations, various aspects of identity, and peer relations explained much of the variance of mental health and self-esteem. Those who were most engaged in questions about their identity and felt mostly non-Swedish had more behaviour problems. The association, however, between the factor “Identity” and the mental health variables approached zero for the older subjects (18–27 years of age). The majority (about 90%) of the adoptees felt mostly Swedish. Seventy per cent didn't feel any connection to their country of origin.

Data gathered over the course of a longitudinal study of a birth cohort of over 900 New Zealand children were used to examine factors associated with the formation of affiliations with delinquent or substance using peers in adolescence (15 years). The findings of this study include:

(1) Adolescent peer affiliations were associated with a wide range of prospectively measured social, family, parental, and individual factors. This analysis indicated that those children most at risk of forming deviant peer affiliations were those from socially disadvantaged backgrounds, dysfunctional families, who showed early onset conduct problems and other difficulties.

(2) Regression analysis suggested that specific factors that were associated with increased risks of later deviant peer affiliations included family socioeconomic status, parental conflict, mother/child interaction, childhood sexual abuse, parental alcoholism, parental criminal offending, parental illicit drug use, parental smoking, early conduct problems, early anxiety/withdrawal, and early smoking experimentation.

It is concluded that peer affiliations in adolescence are shaped by a complex social, family, and individual process that includes social stratification, family functioning, and individual behavioural predispositions.

The relationships between maternal age (at birth) and educational and psychosocial outcomes at age 18 were examined in a birth cohort of 1025 New Zealand children. This analysis indicated the presence of consistent tendencies for increasing maternal age to be associated with declining risks of educational underachievement, juvenile crime, substance misuse, and mental health problems. Children with teenage mothers had risks of later adverse outcomes that were 1.5 to 8.9 times higher than the risks for offspring of mothers aged over 30. Subsequent analyses revealed that the associations between maternal age and later educational and psychosocial outcomes were largely, but not wholly, explained by associations between maternal age and the child-rearing practices and home environments experienced by children. In general, increasing maternal age tended to be associated with more nurturant, supportive, and stable home environments. In turn, these linkages between maternal and childhood environment explained most of the association between maternal age and later outcomes. The theoretical and applied implications of these results are considered.

This paper examines the effects of living in a stepfamily during childhood and adolescence on a range of psychosocial outcomes at age 18 years. Data collected during an 18-year longitudinal study were used to examine a sample of 907 children with respect to: exposure to living in a stepfamily during the period from age 6 to 16 years; measures of psychosocial outcomes including mental health, antisocial behaviour, substance use, restricted life opportunities, and sexual risk-taking at age 18 years; and measures of prospectively collected confounding factors. The analyses revealed that children exposed to living in a stepfamily for the first time between ages 6–16 years had elevated risks of a range of psychosocial outcomes at 18 years. These included elevated risks of: (1) juvenile offending; (2) nicotine dependence; (3) abuse or dependence on illicit substances; (4) leaving school without qualifications; (5) early onset of sexual activity; and (6) multiple sexual partners. However, these risks were reduced substantially when psychosocial outcomes were adjusted for the confounding effects of antecedent factors such as: family socioeconomic characteristics; family history of instability, adversity, and conflict; mother's age, religiosity, and smoking; child gender; and preexisting child conduct and attentional problems. After adjustment, the odds ratios between exposure to a stepfamily and adolescent outcomes were nonsignificant. Additional analysis revealed that there were no significant differences in outcomes for boys and girls exposed to stepfamilies. It was concluded that although young people exposed to living in a stepfamily had increased risks of poor psychosocial outcomes, much of this association appeared to be spurious, and arose from confounding social, contextual, and individual factors that were present prior to the formation of the stepfamily.

Abnormal psychosocial factors, assessed both clinically and by raters blind to clinical presentation, were examined in 21 hyperkinetic and 26 conduct disordered children. Blind raters found the frequency of psychosocial adversities to be similar in the two disorders. By contrast the clinical rater, who did know the diagnosis of patients, rated adverse psychosocial situations as much lower in hyperkinetic children than in children with conduct disorder. Logistic regression showed, particularly in the category of abnormal intrafamilial relationships (Lack of warmth in parent child relationship, Hostility or scapegoating of the child, Intrafamilial discord among adults), effects of the interaction between rater and knowledge of diagnosis. Clinical raters should be aware of abnormal psychosocial situations in hyperkinetic children and assess possible adverse effects on parents and children. Researchers should be aware of a possible bias in research interviews.

Associations between the extent of conduct problems at age 8 years and later life opportunity outcomes at age 18 years were examined in a birth cohort of New Zealand children studied prospectively to age 18 years. Conduct problems at age 8 were assessed using a combination of parent and teacher reports of conduct disordered and oppositional behaviours. Two measures of life opportunities were assessed at age 18: (a) whether the young person had left school by age 18 without educational qualifications; (b) whether the young person had experienced a period of unemployment of 3 months or longer following school leaving. The analysis suggested the following conclusions: (1) There were clear and significant (p<.0001) tendencies for increasing levels of conduct problems at age 8 to be associated with increasing risks of leaving school without qualifications and of unemployment by age 18. (2) A substantial component of these associations was explained by a series of confounding social, family, and individual factors (notably child intelligence, early attentional problems, and family sociodemographic disadvantage) that were associated with both early conduct problems and later life opportunities. (3) Further analysis suggested that linkages between early conduct problems and later educational underattainment and unemployment (after adjustment for confounders) were mediated by a series of adolescent behavioural processes including patterns of peer affiliations, substance use, truancy, and problems with school authority.

This paper reports the results of a high-risk study of children under age 18 of parents who served as probands in a family study of comorbidity of substance abuse and anxiety disorders. There was a strong degree of specificity of familial aggregation of both the anxiety disorders and substance disorders. Rates of conduct disorder and depression were elevated among offspring of all affected parents. Inclusion of co-parent disorders in the evaluation of familial transmission in the present study strengthened the findings regarding the specificity of transmission of the anxiety disorders and the links between both parental substance abuse and antisocial personality with child conduct disorder.

The associations of the mutual mother–child, father–child, and mother–father relationship and various patterns of family relations with child psychopathology were investigated in a sample of 137 families referred to outpatient mental health services. Assessment of the relative association of the different family dyads showed that both the mother–child and the mother–father relationship were related to child problem behaviour. However, whereas the mother–child relationship was consistently more related to externalising behaviour, the mother–father relationship was particularly related to internalising behaviour. Our findings gave clear support for the cumulative risk model: having more negatively qualified relationships was associated with more problem behaviour. Furthermore, our results suggested a protective influence of the parent–child relationship: having one or two positive parent–child relationships was associated with less problem behaviour. No support was found for the cross-generational coalition hypothesis. Implications for future research are discussed.

This study was an investigation of the relationship between family variables and the perceived quality of parental involvement following parental notification of an adolescent's decision to have an abortion. Demographics, family religiosity, and family functioning variables were examined. Pregnant adolescent clients from seven abortion clinics in three states completed a survey assessing their perception of the quality of parental involvement and the family variables. Only family functioning variables were significantly related to the perceived quality of parental involvement. Family adaptability (the family's ability to change its power structure, role relationships, and relationship rules in response to situational and developmental stress) was the most predictive. Adolescents from adaptable families had a more positive experience with parental involvement than adolescents from less adaptable families.

Severe retardation in a child surely has an effect on all family members. Studies of nondisabled siblings in these families have indicated both emotional risks and perceived benefits. Little is known about how out-of-home placement of the child with retardation affects the siblings. Adolescent siblings of children with retardation living at home (N=25) or in residential placement (N=20) were contrasted with siblings of children without retardation (N=28), on measures obtained from their mothers and themselves. Despite their different situations, these siblings were highly similar on measures of psychological adjustment, self-esteem, and family environment. Sibling relationships, however, were less intense, with less warmth but also lower conflict, in families where the child lived out of the home. Most siblings of children with retardation reported positive personal growth experiences while also expressing realistic concerns about the future. Siblings of children with retardation had beliefs and attitudes about placement that were highly consistent with the child's current living situation.

Human interest in and concern about inheritance is very far from new. It is reasonable to assume that ideas about physical resemblances and behavioural characteristics running in families are as old as concepts of family and kinship. We can be rather more certain that from the dawn of agriculture selective breeding has been used to change the characteristics of plant crops and domesticated animals. Indeed, selective breeding may well be viewed as the first step required to create agriculture. However, a knowledge of genetics is not required to apply selective breeding to animals or plants (or humans). All that is needed is the assumption that parental characteristics are likely to be passed to offspring. Then one can breed from superior stock, or those which have desired characteristics, and avoid breeding from inferior stock.

This study aims to identify (1) a core disruptive behavior disorder (DBD) postulated to presage a substance use disorder, and (2) the relative importance of parental DBD phenotypes, and familial and nonfamilial environmental factors in the determination of DBD in male children. DBD symptom counts and measures of familial and nonfamilial environmentals were collected from intact families ascertained through the presence (SA+) or absence (SA−) of substance dependence in fathers. Multivariate analyses revealed that both behavioral symptoms and environmental measures were significant discriminators of the families. In SA+ families, the child's score DBD was best predicted by magnitudes of parental dyssocial behaviors and by familial environmental factors. However, in SA− families only familial environmental factors were significant predictors of the child's DBD. These findings suggest that in addition to independent actions of familial transmissible and nonfamilial factors, strong genotype-environment interactions may determine DBD in children and that may contribute to the liability for a substance use disorder.

Abbreviations: ADD: attention-deficit/hyperactivity disorder; ASPD: antisocial personality disorder; CD: conduct disorder; DBD: disruptive behavior disorder; K-SADS-E; author to supply; NCI: Neighborhood Cohesion Index; ODD; oppositional defiant disorder; PSUD: psychoactive substance dependence disorder; SA: substance dependence (+=present, −=absent); SCID: Structured Clinical Interview for DSM-III-R; SUD; substance use disorders.

Although a role for family and parent factors in the development of behavioral problems in childhood is often acknowledged, the roles of specific parental characteristics in relation to specific child actions need further elucidation. We studied parental “Big Five” personality traits and psychiatric diagnoses in relation to their children's antisocial diagnoses and naturalistically observed antisocial behaviors, in boys with and without the diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD). First, regardless of comorbid antisocial diagnosis, boys with ADHD, more often than comparison boys, had mothers with a major depressive episode and/or marked anxiety symptoms in the past year, and fathers with a childhood history of ADHD. Second, compared to the nondiagnosed group, boys with comorbid ADHD+Oppositional Defiant or Conduct Disorder (ODD/CD) had fathers with lower Agreeableness, higher Neuroticism, and more likelihood of having Generalized Anxiety Disorder. Third, regarding linkages between parental characteristics and child externalizing behaviors, higher rates of child overt antisocial behaviors observed in a naturalistic summer program were associated primarily with maternal characteristics, including higher Neuroticism, lower Conscientiousness, presence of Major Depression, and absence of Generalized Anxiety Disorder. The association of maternal Neuroticism with child aggression was larger in the ADHD than in the comparison group. In contrast, higher rates of observed child covert antisocial behaviors were associated solely with paternal characteristics, including history of substance abuse and higher Openness. Results provide external validation in parent data for a distinction between overt and covert antisocial behaviors and support inclusion of parent personality traits in family studies. The interaction of maternal Neuroticism and child ADHD in predicting child aggression is interpreted in regard to a conceptualization of child by parent “fit.”

Abbreviations: ADHD: Attention-Deficit Hyperactivity Disorder; CBCL: Child Behavior Checklist; CD: Conduct Disorder; DBD: Disruptive Behaviors Checklist; DIS-3-R: Diagnostic Interview Schedule for DSM-III-R; MMPI: Minnesota Multiphasic Personality Inventory; NEO-FFI: Neuroticism, Extraversion, Openness Five Factor Inventory; ODD: Oppositional Defiant Disorder; WURS: Wender Utah Rating Scale.

Research conducted primarily over the past 5–8 years on the psychosocial effects of pediatric chronic physical disorders on children and their families is reviewed. A large body of studies show that both children and their mothers, as groups, are at increased risk for psychosocial adjustment problems compared to peers, but that there is considerable individual variation in outcome. Since the last review on this topic (Eiser, 1990a), many studies have been conducted to identify risk and resistance factors associated with differences in adjustment among these children and their mothers. Improvements are noted in the theoretical basis for this work, programmatic nature of some of the research, and efforts at producing clinically relevant information. Evaluations of interventions, however, are lagging. Critical issues and future directions regarding developmental approaches, theory, method, measurement, and intervention are discussed.