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Significant numbers of children have diagnosable mental health problems, but only a small proportion of them receive appropriate services. Stigma has been associated with help-seeking for adult mental health problems and for Caucasian parents. The current study aims to understand factors, including stigma, associated with African American parents' help-seeking behavior related to perceived child behavior problems. Participants were a community sample of African American parents and/or legal guardians of children ages 3-8 years recruited from an urban primary care setting ( N = 101). Variables included child behavior, stigma (self, friends/family, and public), object of stigma (parent or child), obstacles for engagement, intention to attend parenting classes, and demographics. Self-stigma was the strongest predictor of help-seeking among African American parents. The impact of self-stigma on parents' ratings of the likelihood of attending parenting classes increased when parents considered a situation in which their child's behavior was concerning to them. Findings support the need to consider parent stigma in the design of care models to ensure that children receive needed preventative and treatment services for behavioral/mental health problems in African American families. [ABSTRACT FROM AUTHOR]

Behavioral parent training is an efficacious treatment for children with externalizing behavior problems, but many parents refuse to attend treatment and/or terminate prematurely. The Obstacles to Engagement Scale (OES) assesses the impact of personal and intervention-based obstacles on attending parent training. The published factor structure of the OES has an unstable, two-item subscale and has not been confirmed. We ran exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and, consistent with literature, hypothesized that factors would differ across different demographic groups. An EFA was conducted on 192 parents of 2-8 year old children presenting to primary care pediatric clinics, with a CFA on a similar sample. CFA failed to support a stable factor structure for the full sample. An EFA on 129 parents with at least a college degree revealed a 3-factor solution: Health and legal barriers, Belief in utility and effectiveness, and Personal barriers. This structure was confirmed with a CFA on 53 parents. Consistent with our hypothesis, this model did not fit for parents with less than a college education. Findings of differences based on amount of education of parents supports the need for additional research on the factor structure and predictive validity of the OES for parents with more or less education. Research should continue to examine educational differences in willingness to attend and belief in efficacy of psychological treatments. Interventions to improve attendance at empirically supported treatments need to be customized based on education of parents. Larger samples will be needed to assess the factor structure for other relevant groups. [ABSTRACT FROM AUTHOR]

Literature suggests advantages for co-locating behavioral health care in primary care. We compared the impact of location of services on attendance at behavioral health appointments when access to care was assured for externalizing behavior problems with referral as usual. Two primary care pediatric practices had an evidence-based parenting program co-located in the practice for parents of children aged 2-12 years and two practices had the program available using an enhanced-referral procedure for locations external to the practices. The program was available at the regional children's hospital (referral as usual). During an 8-month period, the rate of attendance at first appointments was significantly higher in the co-located than the enhanced referral condition (.38 and .12 % of patient visits, respectively; χ = 13.32; p < .0003; OR = 3.10; 95 % CI: 1.63, 5.89). These outcomes, while low, were better than the near 0 rate of attendance to referral as usual. Availability of behavioral health services in both conditions increased rates of attended appointments. However, the low rates of attendance indicate increasing availability of services, alone, is not sufficient to decrease the unmet need of children with behavioral problems. Factors other than availability must be addressed in order to improve outcomes for children. [ABSTRACT FROM AUTHOR]

While most primary care pediatricians acknowledge the importance of identifying child behavior problems, fewer than 2% of children with a diagnosable psychological disorder are referred for mental health care in any given year. The present study examined the potential role of parental characteristics (parental affect, parenting style, and parenting self-efficacy) in pediatrician identification of child behavior problems, and determined whether these relationships differed across practices. Parents of 831 children between 2 and 16 years completed questionnaires regarding demographic information, their child's behavior, their affect, their parenting style, and their parenting self-efficacy. Pediatricians completed a brief questionnaire following visits in four community-based primary care practices in the Midwest. Logistic regressions controlling for child behavior and demographic predictors of pediatrician identification found that an authoritarian parenting style, in which parents yell or strongly negatively react to problem behavior, was negatively associated with likelihood of identification in the overall sample. However, the variables that were predictive of pediatrician identification differed depending on the specific practice. Parental characteristics can aid in understanding which children are likely to be identified by their pediatrician as having behavioral problems. The finding that practices differed on which variables were associated with pediatrician identification suggests the need to potentially individualize interventions to certain physicians and practices to improve identification of child behavior problems in primary care. [ABSTRACT FROM AUTHOR]

Parenting behaviors have received ample support as a mediator of the relationship between maternal affect and child behavior problems. The majority of these research efforts were based on a uni-dimensional conceptualization of maternal mood, even though decades of theory and research suggest that mood is multidimensional. We examined the mediating role of parenting behaviors on positive affect (PA) and negative affect (NA) and reports of child behavior problems. Evidence for mediation was demonstrated for both PA and NA for children in early to middle childhood. Consistent with the positive psychology movement, our results suggest that maternal PA plays an important role in parents’ utilization of effective parenting behaviors. Implications for clinical intervention and future research are discussed. [ABSTRACT FROM AUTHOR]

We used confirmatory factor analysis (CFA) to investigate the factor structure of several models of Arnold et al.’s Parenting Scale [Arnold et al. (1993). Psychological Assessment, 5, 137–144] across children from various age groups and races. Participants were parents of children (ages 2–16 years) presenting to four community-based pediatric practices for routine care. Parents completed questionnaires pertaining to various aspects of parenting and child behavior problems. Results indicated that a two-factor revision proposed by Reitman et al. [(2001). Journal of Clinical Child Psychology, 30, 514–524] represented the data well and better than the original three-factor structure and other two-factor models. Results from multigroup CFA analyses indicated that this factor structure did not vary across child sex, child age, and parental race. Results of validity analyses indicated that scores on both factors were related to reports of children’s behavior and parental affect and cognitions. This study was the first to use multigroup CFA procedures to demonstrate that relationships between individual items and factors of the Parenting Scale are similar for parents of children across various age groups. [ABSTRACT FROM AUTHOR]

The present investigation focused upon the impact of gender and various ‘powerful’ and ‘less powerful’ linguistic features on the communication of unfamiliar male and female college students. Same-sex and mixed-sex dyads were recorded as they engaged in discussions regarding suggestions for a bogus freshman orientation booklet. Although few gender differences were found, the result of a factor analysis yielded three factors: questions, suggestions, and process variables. These factors are consistent with a power perspective in the use of various linguistic features. However, the present findings suggest that gender and power alone cannot explain differences in communication styles. Rather, the results suggest the need to consider other aspects of the speaker to explain differences that occur in the use of language. [ABSTRACT FROM AUTHOR]