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Black South Africans are disproportionately affected by HIV compared with White counterparts. In their unique social context, South African families affected by HIV are vulnerable to adverse psychosocial effects. U.S.-based and emerging South African research suggests mothers living with HIV may experience compromised parenting. In the United States, mother-child relationship quality has been associated with internalizing (anxiety, depression) and externalizing (delinquency, acting out) child behaviors. This study adds to South African research with emphasis on the role of the mother-child relationship among HIV-affected South Africans from multiple communities. Structural equation modeling examined relationships between maternal health and child adjustment, operating through mother-child relationship. The best-fitting model suggested maternal health influences youth externalizing behaviors through the mother-child relationship, but that maternal health is directly related to child internalizing problems. Findings support and extend previous results. Further research would benefit from investigating ways the unique South African context influences these variables and their interactions.

The TRACK-II program is a multi-site, community-based randomized controlled trial evaluating an intervention to assist mothers living with HIV (MLH) in disclosing their HIV status to their young children. Many participants—both mothers and children—reported significant depression and/or suicidal ideation, a phenomenon that presented ethical challenges. This article focuses on participants at one site (Atlanta). Through the vignette of “Jordan,” we describe ethical challenges that may arise when faced with the responsibility of maximizing participants’ safety while maintaining the boundaries of the researcher role. Guided by community psychology values, our team has taken measures within our role as researchers to empower and protect children and mothers endorsing suicidal ideation. For example, we have relied on relationships with community-based organizations and AIDS service organizations to connect HIV-affected families to mental health services. Further, we have expanded our system of documentation in order to follow up adequately with families at risk, and we track family resources in order to promote a strengths-based framework. We have solicited families’ feedback about their supports and needs in order to understand how we may best serve them by connecting them to the resources they report needing most and empowering them to care for themselves.

This study examined South African early adolescent youth (aged 10-14 years) and their female caregivers ( N = 99 dyads) participating in an HIV prevention intervention over a period of 8 months. We examined youth perceptions of neighborhood cohesion, safety, and collective monitoring as they related to concurrent and longitudinal associations with youth (externalizing behavior and hope about the future) and family (parent-youth relationship quality, parental involvement, and parental responsiveness to sex communication) functioning while controlling for baseline characteristics. Neighborhood perceptions were significantly associated ( p < .05) with short- and longer term outcomes. Gender differences suggested a greater protective association of perceived neighborhood conditions with changes in functioning for boys versus girls. Unexpected associations were also observed, including short-term associations suggesting a link between better neighborhood quality and poorer family functioning. We account for the culture of this South African community when contextualizing our findings and conclude with recommendations for interventions targeting neighborhood contexts.

Black South African youth are disproportionately affected by HIV, and risky sexual behaviors increase youths' vulnerability to infection. U.S.-based research has highlighted several contextual influences on sexual risk, but these processes have not been examined in a South African context. In a convenience sample of Black South African caregivers and their 10-14-year-old youth (Mage = 11.7, SD = 1.4; 52.5% female), we examined the relation between parenting and youth sexual risk within the context of community-level processes, including neighborhood quality and maternal social support. Hypotheses were evaluated using structural equation modeling. Results revealed that better neighborhood quality and more social support predicted positive parenting, which in turn predicted less youth sexual risk. There was a significant indirect effect from neighborhood quality to youth sexual risk via parenting. Results highlight the importance of the community context in parenting and youth sexual risk in this understudied sample. HIV prevention-interventions should be informed by these contextual factors.

Mothers living with HIV (MLWH) experience stressors inherent to parenting, often within a context characterized by poverty, stigma, and/or limited social support. Our study assessed the relationship between parenting stress and child perceptions of family functioning in families with MLWH who have healthy school-age children. MLWH and their children ( N = 102 pairs) completed measures addressing parenting stress and perceptions of family functioning (i.e., parent–child communication, family routines, and family cohesion). We used covariance structural modeling to evaluate the relationship between these factors, with results showing greater maternal parenting stress associated with poorer family functioning outcomes (reported by both the child and the mother). Findings offer support for the parenting stress–family functioning relationship by providing the child perspective along with the maternal perspective, and point to the need for interventions aimed at minimizing the impact of maternal parenting stress on family functioning.

Much of the research on child sexual abuse focuses on negative outcomes. This brief report explores a potentially protective parenting behavior among black South African female caregivers with and without a child sexual abuse history. Using cross-sectional baseline data, we hypothesized that caregiver child sexual abuse history would be positively associated with caregiver-youth sex communication and this relationship would be strongest for girls. Youth whose caregiver experienced child sexual abuse were more likely to report communicating with their caregiver about sex than youth whose caregivers did not experience child sexual abuse; however, this relation did not hold for caregiver reported communication. Child sexual abuse survivors' ability and decision to discuss sex with their youth has the potential to protect youth from sexual risk and demonstrates resilience among a group rarely acknowledged for positive parenting practices.

Our study seeks to untangle systemic influences on specific family dynamics understudied in a non-Western context. Specifically, we examine the associations between caregivers’ perceptions of neighborhood cohesion, neighborhood safety, and social support, and one aspect of parenting relevant to the South African community from which data were drawn, caregiver–youth communication about sex. Multivariate regression models demonstrate interactive relationships among our variables of interest (p ≤ .05). For caregiver–youth dyads (N = 99), living in a neighborhood caregivers perceived to be relatively cohesive or safe was associated with differential relationships (i.e., conditional effects; p ≤ .07) between caregiver social support and youth report of communication about sex. Our findings indicate that neighborhood and social-level influences on parenting are not universal. Moreover, cross-cultural adaptations of family-based behavioral interventions to prevent HIV should consider the role of caregiver social support within diverse neighborhood contexts.

The purpose of this study was to examine a model of the relationships between parenting deficits and skills, along with child outcomes, in a sample of mothers living with HIV (MLH) and their 6 to 14 year old children. Sixty-two MLH (61% Latina, 26% black, 3% white, & 10% multiracial) and their well children (age 6 - 14) were recruited from the greater Los Angeles, California, region to participate in an intervention (IMAGE: Improving Mothers' parenting Abilities, Growth, and Effectiveness) designed to assist MLH with parenting and self-care skills. Constructs examined included parenting deficits, parenting skills, and child outcomes. Covariance structural modeling was used for the analyses. Covariance structural modeling confirmed the hypothesized set of construct associations. As predicted, fewer parenting deficits were associated with better parenting skills, which, in turn, were associated with better child outcomes. This study delineated further the parenting issues with which MLH struggle, providing information on the interventions needed for this population. MLH who have little confidence they can enact parenting skills and limited knowledge of basic parenting practices appear to be less likely to provide family routines consistently, monitor their children, or to engender family cohesion or a close parent-child relationship. Such parenting skills were found to be associated with child functioning.

Caregiver–youth communication about sex protects youth against HIV/AIDS, and caregivers who believe that sex knowledge is important are more likely to talk to their youth about sex. However, caregivers who experience barriers to communication about sex may not talk to their youth about sex even if the caregiver believes that sex education is important. The Theory of Planned Behaviour predicts that an actor has perceived control is necessary for behavioural change. This study therefore hypothesised that caregivers’ perceived control moderates the relationship between caregiver attitudes about youth sex knowledge and caregiver–youth communication about sex. Results from a sample of 99 female South African caregivers of adolescent (10–14 year old) youth supported our hypothesis, indicating that caregiver attitudes about providing youth with sex knowledge positively predict communication about sex only when caregivers have perceived control. This finding illustrates the importance of perceived control in predicting caregiver–youth communication, and therefore has implications for family-based interventions aimed at improving caregiver–youth communication about sex.Keywords: HIV, family, caregivers, perceived control, parental attitudes, parent–child communicationAfrican Journal of AIDS Research 2014, 13(1): 31–36

One group often overlooked by HIV prevention efforts is adolescent children of mothers living with HIV (MLH). Despite their potential vulnerability, very few evidence-based prevention programs exist for this population in the United States (U.S.) and elsewhere. The current study introduces a parent-based program adapted for families affected by HIV for the purpose of preventing adolescent HIV infection. Following a structured process of adaptation, 12 African American MLH-adolescent dyads were recruited from HIV clinics and non-governmental organizations in a southeastern U.S. city to participate in a feasibility pilot evaluation of the adapted program (Moms Stopping It Now! [Ms. Now]). The intervention consisted of group and individual sessions implemented in a university setting and at participants' homes, respectively. We determined feasibility through assessing participant acceptability and signs of intervention efficacy. Quantitative and qualitative process data revealed high levels of acceptability, as participants were largely satisfied and engaged with Ms. Now, and were willing to attend most sessions. In addition, positive intervention effects approaching medium to large effect sizes were observed for some protective parenting outcomes, including increases in parent-child relationship quality, parental monitoring, maternal HIV disclosure self-efficacy, and communication about maternal HIV infection. Other outcomes, namely communication about sex topics, did not show positive shifts due to ceiling effects and may be indicative of the pre-existing strengths these MLH possess. Ms. Now's approach and further refinement is discussed in the context of strengthening families affected by HIV. Moreover, we recommend that policy aimed at program development consider jointly targeting these populations (MLH and adolescents) due to the unique benefits of family intervention.

An estimated 33 million people were living with HIV in 2007 (UNAIDS, 2008). Women account for half of all people living with HIV, and this percentage has remained stable for the past several years. Thus, women are one of the groups now at the forefront of HIV, and are most often the primary caregivers in families (Weiner, Battles, & Heilman, 1998). An HIV diagnosis impacts not only mothers as individuals, but also affects how they care for their families (Schmidt & Goggin, 2002). Many mothers choose not to tell their young children about their HIV-positive status. However, not disclosing can negatively impact mothers’ physical and psychological functioning. For example, mothers living with HIV (MLHs) who had not disclosed reported sometimes skipping medications because they are afraid their children will observe them and suspect something is wrong, and were more likely to miss medical appointments (Mellins et al., 2002; Murphy, Steers, & Dello Stritto, 2001). Another study found disclosure related to improved well-being, particularly when the first-disclosure experience was positive, which may lessen fear of future disclosure (Chaudoir & Quinn, 2010). Many MLH report that they choose not to disclose for fear of burdening their children (e.g., Palin et al., 2009). However, nondisclosure is no guarantee of positive child outcomes. One study found that adolescents who are not informed about their mothers’ HIV status can be left with feelings of resentment, and broken trust and anger because they were unable to address their parent’s illness openly, express their feelings, ask questions, and receive direct answers (Wood, Chase, & Aggleton, 2006). Among younger children whose mothers have chosen not to disclose, research indicates elevated levels of anxiety (Forsyth, Damour, Nagler, & Adnopoz, 1996; Murphy, Kaufman, & Swendeman, 1998), perhaps due to guilt they feel for a disordered family environment whose source they cannot identify. Children who found out their mothers’ serostatus report they knew something was wrong but felt unable to ask about the cause (Nagler, Adnopoz, & Forsyth, 1995). Women who had known their diagnoses longer were more likely to have children who were aware of their illness (Kirshenbaum & Nevid, 2002), For MLH who do disclose to their young children, two findings have been fairly consistent: They are less likely to disclose to younger children and more likely to disclose to female children (e.g., Armistead, Tannenbaum, Forehand, Morse, & Morse, 2001; for a full review of factors affecting MLH disclosure, see Murphy, 2008). MLHs who have disclosed report significantly lower levels of depression than mothers who have not disclosed (Wiener et al., 1998), less use of concealment to manage HIV-related stigma, stronger social support (Letteney, 2006), and stronger family cohesion. However, disclosure may cause short-term stress among mothers and children. For example, parents reported their children reacted to their HIV disclosure with depression (39%), and anxiety (11%), although parents reported improved adjustment over time for the majority of children (Nostlinger, Bartoli, Gordillo, Roberfroid, & Colebunders, 2006). This is consistent with findings by Murphy, Roberts, and Hoffman (2006), where most children were upset immediately following disclosure, but the majority adjusted over time. Whether maternal HIV disclosure may vary by race/ethnicity has been investigated in a number of studies. For example, Tompkins, Henker, Whalen, Axelrod, & Comer (1999) reported children of White and African American mothers were more likely to be aware of the mother's HIV status than were children of Latina women, but suggest this difference may be accounted for, at least in part, by the younger age of the Latino children. Corona et al. (2006) reported more English speaking compared to Spanish speaking parents disclosed their HIV status to their child; however, after controlling for factors including age of child and level of social isolation, language was no longer associated with disclosure. In a sample of predominantly African American and Latina HIV positive women, disclosers and non-disclosers were similar in most sociodemographic characteristics including race, marital status, religion and employment (Letteney & LaPorte, 2004). Other studies have not found ethnicity and/or acculturation to be related to serostatus disclosure (Lettney, 2006; Murphy et al., 2001; Rice, Comulada, Green, Arnold, & Rotheram-Borus, 2009). The Parents And children Coping Together (PACT) study was designed to longitudinally assess MLHs and their well children age 6 -- 11 years of age. Throughout the course of the study (now in its 13th year), the UCLA research team has investigated maternal disclosure (Murphy, Marelich, & Hoffman, 2002; Murphy et al., 2001). Mothers who disclosed reported higher levels of social support in their lives than non-disclosing mothers. Children of disclosing mothers displayed lower levels of aggressiveness (by mothers report), and lower levels of negative self-esteem (by child report), compared to children of non-disclosing mothers. Across the course of the PACT study, a number of MLH disclosed to their children. An analysis of depression and anxiety scores for the children who were unaware of their mothers serostatus at baseline and who were disclosed to at any of the follow-up points was conducted (Murphy, 2008). Children showed significant improvement on the mental health variables at the assessment following disclosure (which gave them time to adjust potentially if they were immediately distressed by the disclosure). They had significantly fewer depression symptoms and showed a trend for lower anxiety. To obtain more information about the process and content of maternal disclosure, the PACT research team conducted in-depth, qualitative interviews with mothers (N = 47) and children (N = 41). Overall, 51% of the children had no immediate reaction to their mothers HIV disclosure. The other 49% of the children expressed an emotional reaction. Anxiety was the most common reaction, with children expressing concern about their mother's health and how long she would live. Most of these reactions were short term, however, a few children (N = 7) displayed acting out behavior over time. Thus, most of the children adjusted, but a small percentage had maladaptive reactions that were sustained. The majority of the mothers who disclosed (77%) explicitly told their children not to tell other people (Murphy, Roberts, & Hoffman, 2002). The children understood this, as they were aware of the stigma associated with HIV/AIDS. Very few of the MLHs identified "safe people" with whom their child could talk. Children sworn to secrecy have been shown to demonstrate more externalizing problems and poorer social competence (Tompkins, 2007). Finally, the majority of PACT MLH had no regrets about disclosing (Murphy, Roberts, & Hoffman, 2003). However, many were sorry they had not planned for the event, but, rather, blurted out the news during an emotional time. Mothers deemed it crucial to have a plan for what to say when disclosing. They reported hoping for education to provide them with skills and information so that they would be better able to share appropriately with their children, indicating a need for assistance at this critical time. The Teaching, Raising And Communicating with Kids (TRACK) pilot intervention was developed based on the quantitative and qualitative disclosure studies conducted during Murphy's PACT study. Derlega et al.’s (2004) Model of HIV-Disclosure provided a conceptual framework for studying self-disclosure decisions and outcomes, which for TRACK was applied to the family context. The first factor in the model is the social environment in which the MLH and child live; the second factor focuses on individual, temporal, and relational contexts. These factors affect the endorsement of reasons for and against disclosure, which then leads to disclosure outcomes for both the mother and child. Consistent with family system theory (e.g., Alexander, Sexton, & Robbins, 2002), the intervention targets the relationship context, including intrafamilial communication and parenting skills, specifically as they apply to disclosure. By significantly improving parent skills and self-efficacy in these areas, the intervention was expected to increase steps toward disclosure and disclosure itself, as well as positively affect outcomes associated with disclosure (i.e., mother and child functioning). Thus, for all of the intervention MLHs, we anticipated improving relationship context variables (Figure 1, middle box) and the disclosure outcomes for those mothers who chose to disclose. This small pilot study focuses on the changes in the relationship context variables and the disclosure outcomes (Figure 1, last box) from the model. The specific aims of the intervention were to: (1) enhance family communication and parenting skills specific to disclosure; (2) increase readiness to disclose HIV serostatus, and increase disclosure itself (primary outcome); (3) improve MLH mental-health indicators over time (it was anticipated that MLH anxiety and depression scores might be poorer immediately following disclosure but that these would decrease over time); (4) improve child mental health indicators over time (it was anticipated that child depression, anxiety, and self-concept may actually be poorer around the time of disclosure, but would improve over time); and (5) improve the parent-child relationship and family functioning. Figure 1 Conceptual Diagram of Proposed Intervention Effects for Maternal HIV Disclosure (Based on Integrative Disclosure Theory; Derlega, Winstead, Greene, Serovich, & Elwood, 2004)

Predictors of change in the number of sexual topics parents discussed and responsiveness during sex communication with their preadolescent after participating in a five-session sexual risk reduction intervention for parents were examined. Data were from 339 African American parents of preadolescents enrolled in the intervention arm of a randomized-controlled trial of the Parents’ Matter! Program (PMP). Four categories of predictors of success were examined: time and resource constraints, personal characteristics, the parent-child relationship, and parent perceptions of child readiness for sex communication. There were only sporadic associations between success and time and resource constraints for either outcome. Parent perception of child readiness for sex communication was positively associated with discussions of sex topics (b = 1.11, confidence interval [CI]: 0.24-1.97) and parental responsiveness (b = .68, CI:0.22-1.15). Although parents face time and resource constraints, most attended at least four sessions, and demographics such as income had limited effects on program success. In 2006, persons aged 13-29 accounted for the largest number of new HIV infections (Centers for Disease Control and Prevention [CDC], 2008). In addition, an estimated one out of four adolescent girls between the ages of 14 and 19 in the United States is infected with at least one of the most common sexually transmitted infections, or STIs (human papillomavirus [HPV], chlamydia, herpes simplex virus, and trichomo

South Africa has one of the highest HIV-infection rates in the world, yet few studies have examined disclosure of maternal HIV status and its influence on children. This study provides descriptive information about HIV disclosure among South African mothers and explores whether family context variables interact with maternal HIV disclosure to affect children's functioning. A total of 103 mothers, who self-identified as living with HIV and who were the primary caregivers of a child between the ages of 11 and 16, were interviewed. A total of 44% of mothers had disclosed, and those who had most typically perceived children's reactions to disclosure to be sadness and worry. Widows and married mothers were more likely than single mothers to disclose their HIV status. Disclosure to children significantly predicted externalizing, but not internalizing, behaviors. Family variables had direct but not interactive effects on child functioning. This study highlights the complexity of disclosure-related decisions and the importance of addressing the family context.

Research has established that both exposure to community violence and family functioning are predictive of various forms of psychological distress in adolescents. This study examined whether predictors in this area interact in such a way that the relation of community violence exposure to psychological distress in serious male juvenile offenders is moderated by caregiver-adult support and caregiver control. A heterogeneous sample of 116 male incarcerated adolescents (aged 12-18) was administered measures evaluating exposure to community violence, caregiver-adult support and control, and different forms of psychological distress. As expected, a significant caregiver-adult support by violence exposure interaction was found for alcohol/drug use and depression/anxiety. The implications of the findings for understanding and treating serious male juvenile offenders are discussed.

The purpose of the current study was to examine communication about sexual topics between preadolescents and their mothers and fathers. Participants were 135 African-American mothers, fathers, and their 9- to 12-year-old offspring. Each member of the triad completed a 10-item measure of communication about risk factors for sexual activity, sexual communication, and sexual risk prevention. A majority of parents and their preadolescents reported communication had occurred about most topics. Mothers and fathers were equally likely to communicate with sons whereas mothers were more likely to communicate with daughters than were fathers. Based on the study results, preadolescence may be the optimal time for parents to provide sexual risk prevention messages to their children before sexual behaviors are initiated.

The purpose of this study was to determine whether parental variables predict abstinence above and beyond the influence of peer variables in a sample of African American adolescent females (n = 568). In order to determine predictors of abstinence, hierarchical logistic regressions were conducted for the entire sample, the younger adolescent girls, and the older adolescent girls. Results indicated that for the total sample and older adolescents, both parental sexual attitudes and parent-adolescent relationship quality predicted abstinence after accounting for the variance associated with peer variables. For the younger girls, perceived parental attitudes were the only significant predictor. These findings suggest that adolescent sexual risk reduction interventions may benefit from including parents, stressing the importance of articulating parental sexual attitudes, and highlighting the significance of the parent-adolescent relationship.

This prospective study examined the association between perceived neighborhood violence and maternal monitoring and the moderating role of 2 sources of social support (coparents and friends/neighbors) among low-income African American single mothers. Mothers' ratings of neighborhood violence were associated with monitoring both concurrently and longitudinally; however, this association was qualified by each source of social support. When neighborhood violence is perceived as being high by mothers, high levels of social support from coparents and from friends and neighbors are associated with more maternal monitoring. The findings point to the importance of understanding the social context in which African American single mothers live when developing and implementing parenting prevention and intervention programs targeting high-risk families.

African-American female adolescents living in urban areas are at increased risk for adverse adjustment outcomes. The present study accomplished two goals. First, the quality of the parent-adolescent relationship across age groups was examined for differences among younger (i.e., 12'14) versus mid-range (i.e., 15'16) versus older (i.e., 17'18) adolescents. Second, self-esteem was examined as a possible mediator of the relationship between the quality of the parent-adolescent relationship and adolescent psychological functioning in a sample of 608 African-American urban adolescent females. With regard to developmental shifts in the quality of the parent-adolescent relationship, midrange adolescents reported a significantly poorer relationship with their mother than older adolescents. Results also indicated that self-esteem partially mediated the relationship between parent-child relationship and adolescent psychological functioning. Mental health professionals can broaden their interventions that aim to improve adolescent psychological functioning by either focusing on the quality of the parent-adolescent relationship or adolescent self-esteem.

In an effort to expand the parental conflict literature beyond 2-parent and divorced families, this study examined the following questions: Is coparental conflict between single mothers and the individuals who assist them in raising their children associated with child adjustment, and do parenting skills mediate or moderate this association? The sample consisted of 238 African American mothers and their 7- to 11-year-old children. Data were collected at 2 time points separated by approximately 15 months. Results indicated that coparental conflict was associated with child adjustment both concurrently and longitudinally, and that this association was partially mediated, but not moderated, by parenting skills.

This study examined the unique and interactive roles of mother and teacher depressive symptoms in child adjustment in 277 African American single mother-headed families, as well as whether the associations differed depending on the age and gender of the child. Findings revealed a significant association between maternal depressive symptoms and child depressive symptoms in girls, but not boys. Moreover, the combination of higher levels of both mother and teacher depressive symptoms was associated with the highest level of child depressive symptoms and, for younger children, externalizing symptoms. The importance of considering the multiple social contexts in which children interact is discussed. Key Words: child depressive symptoms, child externalizing problems, maternal depressive symptoms, teacher depressive symptoms. Much has been written about the influence of maternal depression or depressive symptoms on the adjustment and development of children and adolescents. Several reviews of the literature leave little question that these children are at greater risk for a range of psychosocial adjustment difficulties (Cummings, DeArth-Pendley, Du Rocher Schudlich, & Smith, 2001; Forehand, McCombs, & Brody, 1987; Goodman & Gotlib, 1999; Kaslow, Deering, & Racusin, 1994). Children of mothers who are depressed or who manifest depressive symptoms are at greater risk for both internalizing and externalizing difficulties, as well as greater difficulties in peer relationships. Notably, the primary focus of this work has been married White families. Given the changing face of American families, the generalizability of this work to minority and disadvantaged families is questionable at best. Although there has been some speculation that maternal depressive symptoms may account for less variance in socially disadvantaged families as a result of the high levels of chronic stress they confront (e.g., Goodman & Brumley, 1990), research to date suggests otherwise. For example, research with divorced White families has demonstrated a link between maternal depressive symptoms and adverse child outcomes in motherheaded families (Forehand, McCombs Thomas, Wierson, Brody, & Fauber, 1990; Thomas & Forehand, 1993). More recently and directly relevant, Petterson and Albers (2001) found some evidence to suggest that maternal depressive symptoms are related more strongly to the adjustment of preschoolers living in disadvantaged families versus advantaged families, and that there is no evidence to support that the relationship is stronger in advantaged families. In an earlier study by our research group, we provided evidence supporting a similar model of family transmission of depressive symptoms for both White, middle class, intact families and African American, innercity, predominantly mother-headed families (Jones, Forehand, & Neary, 2001). Unfortunately, the assessment of child adjustment was confined to depressive symptoms in the Jones et al. study. Consistent with the view of developmental psychopathologists who argue the need to study a broad and developmentally appropriate range of outcomes of children at risk (Cicchetti, 1984; Goodman & Gotlib, 1999; Rutter & Garmezy, 1983), the preliminary purpose of this study was to extend our research on the adverse consequences associated with maternal depressive symptoms in single mother-headed African American families by examining two domains of child adjustment: externalizing problems and depressive symptoms. Some of our recent research, although not focusing specifically on maternal depressive symptoms, suggests that different domains of child adjustment may be differentially sensitive to such maternal symptoms (Jones, Forehand, Brody, & Armistead, 2002). Furthermore, relative to our earlier work (Jones et al., 2001), we enlarged our sample with the intent of making it more representative by including families living in both metropolitan and nonmetropolitan areas. …

A total of 63 males and 54 females from the southeastern United States who averaged 20 years of age (range=14–27) answered a questionnaire concerned with coming-out milestones, disclosure, and self-esteem for gay, lesbian, and bisexual youths. The mean ages for first awareness of same-sex attraction (11 years), first same-sex sexual contact (16 years), and first disclosure of their sexual identity (17 years) were similar to other recent young samples. The order of these milestones varied among subgroups of gays, lesbians, and bisexuals, and proportions who were out to one or both parents differed for bisexuals and African Americans. The findings suggest diverse individual trajectories as opposed to an invariant sequence of coming-out experiences and highlight the need for greater attention to individual differences in sexual orientation identity development.

Three models of risk were examined for 277 African American children from single-mother-headed homes: cumulative, additive, and indirect models. Risk factors were mother-reported community risks, inadequate income, maternal depressive symptoms, and inadequate parenting. Child-reported internalizing and externalizing difficulties served as dependent measures of adjustment. Whereas the cumulative risk model identified a subset of children within this group as at-risk for adjustment difficulties, only more proximal family variables (maternal depressive symptoms and inadequate parenting) accounted for unique variance in child outcomes (additive risk model). However, the more distal risk factors—community risk and inadequate income—were linked to both internalizing and externalizing difficulties through the proximal family variables (indirect effects model).

This study addressed two questions about single-parent African American families: Are parenting strategies associated with perceived risks in the environmental context? and Does the association between parenting and child adjustment depend on the context in which parenting occurs? Families (N = 277) resided in 2 communities that differed in violence-related risk: one rural (low risk) and one urban (high risk). Mother-reported monitoring and warm, supportive mother-child relationships and child-reported internalizing problems, externalizing problems, and social competence were examined. Mothers monitored their children more in the urban than the rural community. The warmth and supportive nature of the mother-child relationship did not differ across contexts. A warm, supportive mother-child relationship was associated with fewer internalizing and externalizing child behaviors in both contexts. Monitoring was associated with fewer problem behaviors only in the urban community.

The unique contributions that parenting processes (high levels of monitoring with a supportive, involved mother-child relationship) and classroom processes (high levels of organization, rule clarity, and student involvement) make to children's self-regulation and adjustment were examined with a sample of 277 single-parent African American families. A multi-informant design involving mothers, teachers, and 7- to 15-year-old children was used. Structural equation modeling indicated that parenting and classroom processes contributed uniquely to children's adjustment through the children's development of self-regulation. Additional analyses suggested that classroom processes can serve a protective-stabilizing function when parenting processes are compromised, and vice versa. Further research is needed to examine processes in both family and school contexts that promote child competence and resilience.

The purposes of this study were to compare, across 4 years, the psychosocial adjustment of noninfected children (ages 6 to 11 at first assessment) whose mothers are and are not HIV-infected, examine differential changes of the two groups of children across the 4 years, and examine the role of parenting on the child's adjustment. Children of HIV-infected mothers reported more depressive symptoms across the four assessments than children whose mothers were not infected. Evidence for differential change of child psychosocial adjustment across assessments for the two groups did not emerge. Parenting variables, particularly the mother-child relationship, were related to child adjustment in both groups. Many of the findings suggest that mothers and children often provide unique perspectives. Prevention and intervention implications are considered.

This study examined the role of family variables in child resiliency within a sample of African-American, inner-city children whose mothers are HIV-infected. Variables from three dimensions of the family were included: family structural variables, maternal variables, and mother-child (parenting) variables. The participants were 82 children between the ages of 6 and 11 and their HIV-infected mothers. Correlational analyses indicated that resiliency was associated only with three parenting variables: parent-child relationship, parental monitoring, and parental structure in the home. Hierarchical regression analyses indicated a multiplicative relationship between parental monitoring and parent-child relationship and between parental monitoring and parental structure in the home, suggesting that parenting variables potentiate each other. Clinical implications of the findings are considered.

Purpose: To identify factors related to human immunodeficiency virus (HIV) antibody testing among gay, lesbian, and bisexual youth. Methods: Self-reported demographics, risk behaviors, variables related to the Health Belief Model, and HIV testing data were collected at a conference for gay youth, as well as at the Gay and Lesbian Community Center in a Southeastern metropolitan area ( n = 117). Results: About one third of participating youth who reported engaging in anal and vaginal sex had done so without a condom. In addition, one in four youth reported at least one other HIV risk factor. Of youth engaging in sexual risk behaviors, one third had not been tested for HIV antibodies. Furthermore, 61% of the youth reported some type of drug use, and only 57% of those using drugs had been tested. To determine factors associated with HIV testing, a hierarchical logistic regression was conducted. A binary variable of HIV testing was regressed first on demographic variables, second on risk factors, and third on variables derived from the Health Belief Model. Results of the logistic regression revealed that unprotected anal sex and the Health Belief Model variables predicted having been tested for HIV. The final model explained 42% of the variance in HIV testing. Conclusions: Gay, lesbian, and bisexual youth are at high risk for HIV infection and are often untested for HIV antibodies.

In this study we assessed understanding of HIV/AIDS in 83 6- through 1 I-year-old children from families in which the mother was infected with HIV and 148 same-age children from families in which the mother was self-reported as not infected with HIV. The children were from economically disadvantaged, urban, African American neighborhoods where individuals are considered to be at high risk for contracting HIV. Between-group differences in the level of understanding of HIVIAIDS, as well as the endorsement of misconceptions about HIVIAIDS, were examined. Additionally, child-related predictors of understanding of HIVIAIDS were investigated, including the child's age, sex, understanding of illness in general, and cognitive competence. The average level of understanding across groups was substantially lower than that reported in previous studies with demographically different samples. Although no differences in understanding of HIVIAIDS emerged between the 2 groups, differences did emerge for 10- and 11-year-ol...

The role of religious activity in the psychosocial adjustment of 205 inner-city African-American women, one-half of whom are HIV infected, was examined. Those who were HIV infected reported praying more but viewed prayer as less effective in coping with a chronic illness. Frequency of prayer predicted optimism about the future, whereas religious activity was not related to current depressive symptoms.

Children of HIV-infected mothers have more psychosocial adjustment difficulties than do those of noninfected mothers. In this study, child psychosocial adjustment in children of HIV-infected women is examined across the three stages of HIV-infected: asymptomatic, symptomatic and AIDS. Participants were 99 HIV-infected women and 148 noninfected women. Children were not identified as being HIV infected. Mother and child reports of behavioral difficulties are compared, and competing hypotheses about mother report of child behavior difficulties are tested. Results indicate an ascending linear trend for child report of internalizing and externalizing difficulties from the noninfected stage through increasingly severe stages of HIV-infection. According to mother report, child externalizing and internalizing difficulties are nonlinear, as mothers report an increase through the infected symptomatic stage, then a decrease in the AIDS stage. Implications for assessment, prevention and intervention in families with maternal HIV infection are discussed.

Parenting behavior and its association with child psychosocial adjustment were examined in inner-city African American families. Participants included 86 HIV-infected women and their noninfected children and 148 HIV-seronegative women and their noninfected children. Interview data were collected concerning maternal physical health, parenting behaviors, and child psychosocial adjustment. The results indicated that mother-child relationship quality and monitoring were important parenting factors for adaptive child psychosocial functioning. HIV-infected mothers reported poorer mother-child relationship quality and less monitoring of their children's activities than did noninfected mothers, suggesting that maternal HIV infection may disrupt effective parenting. Directions for future research and clinical implications are discussed.

Aspects of functioning in families of 137 hemophilic men who, in 50% of cases, were also HIV seropositive were examined in terms of psychological and physical functioning and economic pressure. Results indicated that HIV-seropositive status, but not severity of hemophilia, was associated with poorer psychological and physical functioning of the husband, a poorer mother-child relationship, less support from outside the family for both spouses, and greater economic pressure on the family.

This study examined whether adolescent adjustment problems which previously have been attributed to parental divorce exist prior to the divorce. Three groups (to-be-divorced, remain intact, and already divorced) were examined across four domains of adolescent functioning reported by multiple informants. The results indicated that adolescents from the to-be-divorced group functioned similarly to those who would remain in intact families but better than those in the already divorced group, suggesting that differences can be attributed to parental divorce and its accompanying disruption of family processes. Two of these processes, interparental conflict and parenting, were examined and failed to receive support.

Sixty-nine families (father, mother, and one child) in which the father had hemophilia, approximately half of whom were HIV positive, were assessed in an examination of the relationship between parental chronic illness, family functioning, child coping strategies, and child adjustment. Latent variable path analyses with partial least-squares estimation procedures (PLS) were used to test a model of the relationship between parental chronic illness, family process variables, child coping strategies, and child internalizing behavior problems. The severity of the father's illness predicted family process variables, which predicted the coping style of the child. The use of more avoidant coping strategies was associated with more internalizing problems.

The present investigation examines the impact of family, self, and peer systems, evaluated during early adolescence, on the development of interpersonal competence in young adulthood. The participants were 110 Caucasian individuals, their mothers, and one of their teachers. At the first assessment, the participants ranged in age from 11.5 to 15.1 years old. Approximately six years later, the participants completed a second evaluation involving assessment of interpersonal competence. Increased interparental conflict and parental divorce predicted decreased self-esteem. Decreased self-esteem predicted poorer peer-adolescent relationships, which, in turn, forecasted poorer adult interpersonal competence. The results suggest that living in a distressed family leads to diminished self-esteem which can influence the quality of peer relationships and place an adolescent on a trejectory toward difficulties in interpersonal competence during adulthood.

Unique and interactive internalizing and externalizing behavior problems in adolescence were examined in relationship to drug and alcohol use in young adulthood. Results indicated that higher externalizing scores in adolescence predicted more alcohol use in young adulthood for both males and females and also predicted more marijuana and hard drug use for males. Lower internalizing scores were found to predict more marijuana and hard drug use in young adulthood for boys, but not for girls.

Although physical illness among adults is prevalent, few studies exist which examine the relationship between parental illness and child functioning. We reviewed the existing studies and tentatively conclude that an association does exist. We also delineated variables that have been identified as qualifiers of this relationship, outlined dimensions of physical illness which may be important in the relationship, and discussed possible mechanisms for the association between physical illness and child functioning. The need for more research and the consideration of parental physical illness within a broader family context is emphasized.

We delineate critical parenting issues faced by mothers who are HIV seroposttive. These issues, which must be considered within the environmental context in which most of these women live, include major life decisions (pregnancy, disclosure, future planning) and daily life challenges (day-to-day parenting, managing other burdens). Research is virtually nonexistent and, as most parenting issues faced by mothers who are seroposttive are unique, “it is not possible to draw upon work with other parents for direction and solution. Research on the parenting issues faced by these women is needed to guide interventions and policy.

One hundred and three subjects and their mothers were assessed at three points during adolescence and young adulthood in a longitudinal examination of the predictive and mediational relationships between family variables and substance abuse. Latent variable path analysis with partial least-squares estimation procedures (LVPLS) was utilized to test a theoretical model including constructs of family structure, family environment (maternal depressive mood and interparental conflict), mother/adolescent dynamics (mother/adolescent supportive relationship and maternal control), and substance abuse (problematic alcohol use and marijunana/hard drug use). Higher levels of interparental conflict were consistently related to poorer quality of the mother/adolescent relationship and stricter maternal control. As hypothesized, family environment variables mediated the impact of family structure, and mother/adolescent dynamics variables mediated the impact of the family environment. Results revealed notable differences between the trajectories for males and females, as well as between different types of substance abuse. Implications for substance abuse prevention efforts are discussed.

We examine efficacy of the Parents Matter! Program (PMP), a program to teach African-American parents of preadolescents sexual communication and HIV-prevention skills, through a multicenter, randomized control trial. A total of 1115 parent-child participants were randomized to one of three intervention arms (enhanced, brief, control). Percentages and 95% confidence intervals compare parents' perception of child readiness to learn about sexual issues, communication effectiveness, and dyad concordance from baseline to 12 months postintervention. Wilcoxon rank sum tests compare the changes in scores measuring communication content in HIV/AIDS, abstinence, and condom use. Compared to control, parents in the enhanced arm increased perception of child readiness to learn about sex (16% vs. 29%; p < .001), and a greater proportion of parent-child dyads reported concordant responses on communication topics: HIV/AIDS (15%, 95% CI = 8-21%; p < .001), abstinence (13%, 95% CI = 7-20%; p < .001), condoms (15%, 95% CI = 9-22%; p < .001). Increases in communication scores in HIV/AIDS, abstinence, and condom use were greater in the enhanced arm than control (p < 0.01). We conclude that the enhanced PMP can help parents educate children about HIV and prepare children to avoid sexual risk.

Parental HIV infection has been associated with negative outcomes for children, and parenting skills appear to be one mechanism operating in that association. The present study focuses on the relations between maternal stress, parenting, and child functioning among families where the mother is living with HIV. Sixty-nine mothers with at least one child between six and 12 years old completed questionnaires at the baseline assessment of an intervention designed to facilitate maternal disclosure of HIV status. Respondents were assessed using multiple measures of stress/anxiety, parenting skills, and child outcomes, including the Parenting Stress Index, the RAND Mental Health Inventory, the Family Routines Questionnaire, and the Child Behavior Checklist. Covariance structural modeling was used to assess the variable relationships, with latent constructs created for maternal anxiety/stress, parenting skills, and child problem behaviors (both direct and indirect effects were evaluated, with a model-based bootstrap used to verify model stability). Results demonstrated that maternal stress was negatively associated with a broad range of parenting skills, and that parenting skills were negatively associated with child problem behaviors. Mothers living with HIV who are anxious about their own health and functioning, and who were more stressed in their parental role, were more likely to exhibit poorer parenting skills - specifically to engage children less frequently in family routines (e.g., eating meals together, having a bedtime routine), poorer parent-child communication, and poorer and less consistent parenting discipline. Not uncommonly, mothers living with HIV experience a range of stressors above and beyond those related to their illness (e.g., poverty, residence in high risk and low resource communities, discrimination). Results demonstrate the need for interventions designed to decrease maternal stress and enhance parenting skills for families affected by HIV.

The purpose of this study was to examine whether retention of kindergarten and first-grade children is associated with long-term beneficial effects. Thirty-one children who had been retained were compared to 31 children who had similar grades but had never been retained. The dependent measures were grade point average in the second through fifth grades and four teacher-assessed areas of functioning in the fourth and fifth grade: social competence, cognitive competence, externalizing problems, and internalizing problems. The results indicated that retention was not associated with long-term beneficial effects but rather, especially for White children, appeared to be associated with poorer academic and social functioning. Implications and limitations of the study are discussed.

We examined the role of attention deficit hyperactivity disorder (ADHD) in juvenile delinquency. Forty-two incarcerated male delinquents participated. Thirty of these youths met the criterion for conduct disorder (CD), only while 12 met the criterion for CD and ADHD. The results indicated that the latter group were arrested at an earlier age and had more total arrests than those in the former group; however, they did not have more criminal charges against them. The role of intellectual and academic skills in these findings was considered. It appears that ADHD has an important additive influence on the development and persistence of juvenile delinquency. Implications for the behavior therapist are discussed.

Examined whether the presence of a sibling may buffer young adolescents from adverse influences of parental divorce. Subjects were 79 adolescents from intact families, 77 from divorced families, their mothers, and their social studies teachers. Independent variables included adolescent gender, parental marital status, and sibling group (i.e., no siblings, one older sibling only, or one younger sibling only). Dependent measures were externalizing behaviors as reported by the adolescent's teacher and internalizing behaviors as reported by the teacher and the adolescent. Results indicated a significant interaction between marital status and sibling group; specifically, adolescents with no siblings from divorced families were reported by teachers as demonstrating more externalizing problems than all other groups.

This study examined the association between cumulative family stressors (divorce, interparental conflict, maternal depression) and adolescent functioning as well as the protective role of the parent-adolescent relationship as perceived by the adolescent when family stressors are present. Two hundred and thirty-one adolescents, their mothers, and their social studies teachers served as the subjects. Results indicated that, as family stressors increased, adolescent functioning deteriorated. Furthermore, a positive parent-adolescent relationship as perceived by the adolescent was associated with less deterioration in all areas of functioning. The role of the relationship in protecting the adolescent supported both a stress buffering model and a main effect model.

The purpose of the current study was to examine the agreement across three informants (youth, teacher, caretaker) when rating behaviors of incarcerated juvenile delinquents. Furthermore, the agreement between a dimensional approach (Child Behavior Checklist) and a categorical approach (DSM-III-R) of assessing behavior was examined. Fifty-two delinquent youth were assessed with a structured interview. In addition, the youth, teacher, and caretaker completed the Child Behavior Checklist (CBCL). The results indicated significant correlations across the teacher and caretaker for externalizing types of problems. The youth report form of the CBCL did not correspond to either adult informant. However, the ratings by the teacher and caretaker were related to externalizing types of problems, primarily hyperactivity/inattention, derived from the structured interview with the delinquent. The results suggest that, in the psychological assessment of incarcerated juvenile delinquents, agreement across informants is dependent on multiple factors, including type of behavior assessed and the approach utilized in assessment.

The concept of cross-informant consistency has long been a topic of interest for those involved in assessment of behavior problems in adolescence. The purpose of the present study was to replicate and expand the existing literature by including four informants (mother, father, teacher, and adolescent self-report) and examining correlations among them as well as differences between reporters on an absolute level of both internalizing and externalizing problems. Fifty-two young adolescents (ranging in age from 11 to 15 years) and their mothers, fathers, and social studies teachers participated in the study. The Conduct Disorder subscale, Socialized Aggression subscale, and Anxiety/Withdrawal subscale of the Revised Behavior Problem Checklist were used. Results indicated that teachers showed little agreement with other informants on conduct problems (teachers reporting fewer problems), while parents and adolescents showed significant agreement. Informants showed no agreement on the measure of covert problems (socialized aggression), and all reports showed agreement on internalizing problems (although teachers continued to report fewer problems). Implications for assessment of young adolescents are discussed.

Parent-adolescent conflict is viewed as a common dimension of the family during the teenage years. The purpose of the present study was to determine whether mothers and fathers of young adolescents differ in their report of conflict with their adolescent, level of stress, and parenting competence. Furthermore, the role of age and gender of the young adolescents was examined. One hundred and twenty-two adolescents and their parents participated in the study. All families were intact. The families were divided into groups according to the adolescent's age and gender. Analyses of variance with three factors (adolescent's age, adolescent's gender, mothers versus fathers) were performed. Mothers and fathers did not differ on personal (depression) or marital adjustment and on perceived parenting competency. In contrast, in terms of parent-adolescent conflict, mothers reported a less positive relationship, a greater number of conflicts, and more intense discussions of conflicts with their adolescents. Gender and age of the adolescent were not important contributors to the analyses. The results suggest that, in terms of the variables examined in this study, conflict in the parent-adolescent relationship is the primary difference between mothers and fathers.

Labor statistics show that mothers of adolescents are more likely to work than are those of children in any other age group, and, therefore, represent an important sample to address. The present study had two purposes. First, the effects of maternal employment on adolescent functioning were examined in a sample of 63 young adolescents. Results showed that maternal employment was not related to any of the areas assessed, suggesting that maternal employment may not have a harmful effect on adolescent adjustment. Second, the relationship of prestige ratings of either maternal or paternal employment to adolescent functioning was examined ia a sample of 96 young adolescents. Maternal prestige ratings were not significantly related to any dependent measures, yet prestige ratings of paternal employment were significantly related to at least one measure in most areas of adolescent functioning. Multiple regression analyses demonstrated that only the paternal rating served to predict adolescent functioning, particularly for male adolescents.