Search

Background: As e-cigarette use rises among U.S. adolescents, the need to understand its risk factors becomes increasingly urgent. If the risk profile of adolescents who exclusively use e-cigarettes differs from those who use traditional tobacco products and dual users, prevention and intervention efforts would need to target such differences. Methods: In a sample of 708 adolescents, this study compared individual, peer, and family risk factors that are classically associated with greater substance use between exclusive e-cigarette users and traditional tobacco product users. Results: Exclusive e-cigarette users and traditional tobacco product users share many risk factors when compared to non-users. Additional analyses compared exclusive e-cigarette users to exclusive traditional tobacco users and dual users, with some differences emerging. Lower friend (OR = 0.28, 99% CI [0.12, 0.67]) and peer e-cigarette use (OR = 0.26, 99% CI [0.13, 0.52]), and greater friend cigarette smoking (OR = 2.17, 99% CI [1.23, 3.83]) predicted higher odds of being an exclusive traditional tobacco user compared to an exclusive e-cigarette user. Lower SES (OR = 0.67, 99% CI [0.51, 0.90]), and greater friend (OR = 2.68, 99% CI [1.56, 4.59]) and peer cigarette smoking (OR = 1.91, 99% CI [1.17, 3.13]) predicted greater odds of being a dual user compared to an exclusive e-cigarette user. Conclusion: Although some differences exist between exclusive e-cigarette users and traditional tobacco users, their risk profiles are generally the same. Prevention and intervention efforts that target traditional tobacco product could guide efforts to target e-cigarette use and dual use. Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1899236.

We examined child and family risk factors that were associated with the development of individual differences in externalizing problems across the toddler years. Our central hypothesis was that toddlers with more aggressive and disruptive older siblings would be at elevated risk for heightened levels of externalizing behavior. We tested this hypothesis in the context of other theoretically relevant risk factors: toddlers' inhibitory and internalized control, experiences of coercive parental discipline, and gender. Participants were 167 toddlers, their older siblings, and parents in a longitudinal study following younger siblings across the first 3 years of life. Mothers and fathers contributed ratings of externalizing symptoms between 1 and 18 months across the transition to siblinghood for older siblings and 18 to 36 months for younger siblings. Toddlers' inhibitory and internalized control were assessed using behavioral and parent report measures, and parents completed questionnaires concerning their use of coercive discipline. Individual differences in toddler externalizing symptoms were highly stable between 18 and 36 months of age for a sample of second-born children with older siblings, even though there was evidence of significant decline in externalizing symptoms from 18 to 36 months. As predicted, toddlers with elevated levels of externalizing symptoms tended to have older siblings with higher externalizing difficulties across the first 18 months of the younger sibling's life. Thus, these findings highlighted the need for further research on older siblings' contributions to the behavioral development of their toddler-age younger siblings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Problematic family functioning places young adolescents at risk for internalizing behaviors. However, not all adolescents who experience family risk develop internalizing behaviors during early adolescence. Informed by a cumulative risk perspective, the current study examined whether associations between cumulative family risk, as well as particular family risk domains, and youth internalizing behaviors are moderated by youth parasympathetic reactivity. Participants include 68 young adolescents in 6th grade. Youth were 56% female, 41% African American, and 54% European American. For young adolescents who experienced higher change in respiratory sinus arrhythmia during a challenge/stressor task, greater cumulative family risk, exposure to more family risk domains, and several particular risk factors (maternal psychological well-being, marital/family system risk), were associated with higher levels of internalizing behaviors. The findings from this study demonstrate that the extent to which both particular family risk factors and cumulative family risk place youth at increased risk for internalizing behaviors depends on youth's parasympathetic functioning.

To determine the usefulness of cumulative and additive risk models in predicting the healthy-related quality of life (HRQOL) of caregivers of youth with chronic gastrointestinal conditions. 203 caregivers (82.8% mothers; 77.3% white) of youth (M = 11.27 years; 44.3% female; 78.8% White) completed self-report questionnaires focused on potential environmental, child health, and family risk factors that could impact caregiver HRQOL. Cumulative risk models, evaluating overall combined risk level, as well as an additive risk model, exploring individual risk variables, were evaluated. Higher levels of cumulative risk were associated with poorer caregiver HRQOL after controlling for child and caregiver sex. A linear cumulative risk model was a better fit than a quadratic cumulative risk model for predicting caregiver HRQOL, while an additive model identified child HRQOL, child pain interference and family functioning as the most individually impactful risk variables. This study illustrates the usefulness of both additive and cumulative risk approaches in identifying caregivers at risk for poor HRQOL. Provision of appropriate referrals and interventions based on the caregiver’s risk factors can help protect caregiver quality of life and, in turn, benefit the care children with chronic conditions receive at home.

Background In most Western countries, the individual, social, and family characteristics associated with students’ dropout in the general population are well documented. Yet, there is a lack of large-scale studies to establish whether these characteristics have the same influence for students with an immigrant background. Aims The first aim of this study was to assess the differences between first-, second-, and third-generation-plus students in terms of the individual, social, and family factors associated with school dropout. Next, we examined the differential associations between these individual, social, and family factors and high school dropout as a function of students’ immigration status. Sample Participants were 2291 students (54.7% with an immigrant background) from ten low-SES schools in Montreal (Quebec, Canada). Method Individual, social, and family predictors were self-reported by students in secondary one (mean age = 12.34 years), while school dropout status was obtained five or 6 years after students were expected to graduate. Results Results of logistic regressions with multiple group latent class models showed that first- and second-generation students faced more economic adversity than third-generation-plus students and that they differed from each other and with their native peers in terms of individual, social, and family risk factors. Moreover, 40% of the risk factors considered in this study were differentially associated with first-, second-, and third-generation-plus students’ failure to graduate from high school. Conclusion These results provide insights on immigrant and non-immigrant inner cities’ students experiences related to school dropout. The implications of these findings are discussed.

The current study examined trajectories of maternal and paternal depression in the year following the birth of an infant sibling, and relations with family risk factors and firstborn children's internalizing and externalizing behavior problems. Latent class growth analysis was conducted on 231 families in a longitudinal investigation (prebirth and 1, 4, 8, and 12 months postbirth) and revealed four classes of families: both mother and father low in depressive symptoms (40.7%); mother high–father low (25.1%); father high–mother low (24.7%), and both mother and father high (9.5%). Families with both mothers and fathers high on depressive symptoms were higher on marital negativity, parenting stress, and children's internalizing and externalizing problems, and lower on marital positivity and parental efficacy than other classes. Children, parents, and marital relationships were more problematic in families with fathers higher on depressive symptoms than in families in which mothers were higher, indicating the significant role of paternal support for firstborn children undergoing the transition to siblinghood. Maternal and paternal depression covaried with an accumulation of family risks over time, no doubt increasing the likelihood of children's problematic adjustment after the birth of their infant sibling.

Gender differences in the relationship between parent drinking and adolescent drinking are poorly understood. As parental alcohol use is a primary early exposure to alcohol for adolescents, it is important to understand how consequences may differ for adolescent males and females.The aim of this paper was to examine gender differences in the relationship between mother's and father's heavy episodic drinking, and its combination, and adolescent drinking.The sample included 2,800 14-15 year olds (48.9% female) living in two-parent households from the Longitudinal Study of Australian Children. The adolescent outcome measure was having had an alcoholic drink in the past year. Mothers and fathers self-reported their frequency of heavy episodic drinking. Covariates included parents' education, smoking, non-English-speaking background, and symptoms of psychological distress. Logistic regression was used to examine the hypotheses.After adjustment for covariates, both mothers' and fathers' heavy episodic drinking significantly increased the likelihood of adolescent drinking. Moreover, fathers' heavy drinking was more strongly related to adolescent drinking for girls. However, there were no gender differences in the relationship between mothers' drinking and adolescent drinking, and the combination of mothers' and fathers' drinking was not more risky than heavy drinking in either parent alone.Parent heavy episodic drinking is a risk factor for adolescent drinking, after controlling for potential confounding variables. Results suggest that girls may be especially vulnerable to parent heavy drinking in early adolescence. This variation should be considered in the design and evaluation of family-based interventions to prevent adolescent drinking.

Not only are childhood onset offenders at high risk of becoming serious persistent offenders, they are also at high risk of becoming victimized themselves. Furthermore, studies in the general population suggest that a combined perpetrator–victim group can be distinguished from a perpetrator-only and a victim-only group on individual and family risk factors. The current study investigated the co-occurrence of offending and victimization among first-time arrestees and the 2-year predictive value of previously found clusters of dynamic risk factors of offending. Childhood first-time arrestees ( N = 308; Mage= 10.3, SD = 1.45) were clustered into three groups based on dynamic risk factors of offending in the individual, peer, school, and family domains: a pervasive high, an externalizing intermediate, and a low problem group. Police records and self-report data on re-offending and victimization of these children were collected over a 2-year follow-up period. Compared with the low problem group, the prevalence of re-offending was higher in both the externalizing intermediate group and the pervasive high group. The pervasive high group was most likely to display co-occurring future antisocial behavior and victimization. These findings emphasize that attention should be paid to victimization in addition to future antisocial behavior, especially if additional internalizing and family problems are present. Furthermore, the differences in re-offending and victimization between subgroups of childhood onset offenders stress the need for specific interventions tailored to the risk profile of a child.

Objective: ADHD is frequently detected in boys though there is no established cause. One possibility is that genes predisposing to ADHD have sexually dimorphic effects. With an aim to find out the reason for this male biasness, contribution of 14 functional polymorphisms was investigated in ADHD subjects. Method: Genomic DNA of probands, their parents, and ethnically matched controls was subjected to analysis of single-nucleotide polymorphisms and variable number of tandem repeats (VNTRs). Results: Case–control analysis revealed significant higher occurrence of DAT1 intron 8 VNTR “5R” allele ( p = .028), DBH rs1108580 “A” allele ( p = .027), and MAOA-u VNTR-rs6323 3R-T haplotype ( p = .007) in male probands. Family-based analysis showed significant preferential transmission of Dopamine receptor D4 exon 3 VNTR-rs1800955 7R-T haplotype from parents to male probands ( p = .008). Interaction between DBH gene variants and low enzymatic activity was also noticed, especially in male probands. Conclusion: Data obtained may partly answer the male biasness of ADHD.

Recent theory and empirical research suggest that child neglect is a heterogeneous phenomenon characterized by various types. This study examined family risk factors associated with five neglect types including failure to provide physical needs, lack of supervision, emotional neglect, moral–legal neglect, and educational neglect in 390 substantiated cases of neglect in four U.S. Army communities. Family factors associated with elevated risk of each neglect type relative to other types were identified using multivariate regression. Relatively distinct sets of family risk factors were differentially associated with the neglect types. Family mental health problems and larger family size were associated with risk of failure to provide physical needs, childcare problems and larger family size were associated with risk of supervisory neglect, and family disagreements were associated with risk of emotional neglect. None of the family factors were associated with elevated risk of moral–legal or educational neglect. Results can inform the development of indicated and relapse prevention strategies for families affected by different neglect types.

Introduction Our purpose was to examine associations between maternal caregiving and child indicators of toxic stress among multiethnic, urban families with children of early school age. Method We conducted an exploratory cross-sectional analysis of 54 maternal–child dyads. Mothers reported on parenting behaviors and parental reflective functioning (PRF). Child indicators of toxic stress included hair/salivary biomarkers, anthropometric characteristics, and maternally reported health and behavior. Results Hostile/coercive parenting behaviors were associated with child externalizing behavioral problems (r = 0.43, p = .001, but lower interleukin (IL) 6 levels (r = 0.31, p = .03). High PRF was associated with fewer child emergency department visits (ρ = –0.43, p = .009), whereas impaired PRF was associated with more behavioral problems (ρ = 0.52, p Discussion PRF and supportive parenting behaviors may protect against toxic stress among vulnerable families, but additional research is needed to better understand these relationships. Resources are available to help clinicians screen for family risk factors and model responsive caregiving in pediatric settings.

The results of prevalence and prognostic significance of occupational, housing and family risk factors for myocardial infarction are presented. The significance of the analyzed risk factors for predicting development of myocardial infarction is established. The myocardial infarction (MI) have to do with global social and medical evidential problems. The MI morbidity results in significant economic and social damage. The loss of the gross domestic product as a result of MI mortality in able-bodied age prevails in the structure of economic damage in the Russian Federation and makes up to more than 49 billion rubles per year. In MI patients such risk factors as tense psychological relationships at work, duration of workday more than 8 hours are highly spread. This is especially true for tensed psychological relationships at work, which are 5.6 times more likely to be detected in patients with MI as compared with other groups of patients. The study demonstrated considerable prevalence and significant role of particular professional, housing and family risk factors in the MI development. It is proved that physical overloads, unsatisfactory housing conditions and lack of one's own housing are of highest prevalence and prognostic significance. The study data permits to prognosticate possibility of MI development and to implement preventive and curative measures prior to onset of disease resulting in decreasing of MI morbidity, various complications and mortality.

Controversy exists about the role of parent psychopathology in persistence and severity of attention deficit hyperactivity disorder (ADHD) symptoms in their children. Here we aimed to analyse the potential association between the severity of ADHD symptoms in children and the presence of psychiatric and ADHD symptoms in their biological parents. Seventy-three triads of children and their parents who were in active treatment for their diagnosed ADHD were evaluated in our Child and Adolescent Mental Health Centers. The mental health of the parents was also assessed. The general psychopathology of the parents was evaluated using the Symptom Checklist-90-R (SCL-90-R), and symptoms of hyperactivity were examined using the Adult ADHD Self-Report Scale (ASRS v.1.1). The severity of symptoms in children was assessed using the ADHD Rating Scale-IV (ADHD-RS-IV). Variables that could have affected the clinical development of ADHD such as sex, evolution time, age, academic level and the presence of comorbidities were controlled. The severity of the symptoms in children with ADHD was significantly related to the psychiatric history of their mother, the younger age of the child and the presence of a comorbid conduct disorder in the child. We discussed the importance of screening for parental psychopathology in clinical practice.

Because alcohol use typically is initiated during adolescence and young adulthood and may have long-term consequences, the Monitoring the Future (MTF) study annually assesses various measures of alcohol use among 8th-, 10th-, and 12th-grade students. These analyses have found that although alcohol use among these age groups overall has been declining since 1975, levels remain high. Thus, in 2011 about one-quarter of 8th graders, one-half of 10th graders, and almost two-thirds of 12th graders reported drinking alcohol in the month preceding the interview. Binge drinking (i.e., consumption of five or more drinks in a row) was also prevalent. Specific rates of drinking, binge drinking, and getting drunk varied among different student subgroups based on gender and race/ethnicity. The MTF study has also identified numerous factors that influence the risk of alcohol use among adolescents, including parents and peers, school and work, religiosity and community attachment, exercise and sports participation, externalizing behavior and other drug use, risk taking and sensation seeking, well-being, and drinking attitudes and reasons for alcohol use. Drinking during adolescence can have long-term effects on a person's life trajectory. Therefore, these findings have broad implications for prevention and intervention efforts with this population.

Children from low-income households tend to exhibit higher levels of conduct problems and emotional problems, yet the pathways linking economic disadvantage to children's behavioral functioning are not well understood. This study uses data from the Early Steps Multisite (ESM) project (N = 731) to investigate associations between family income in early childhood and children's conduct problems and emotional problems in middle childhood. The study explores whether the associations from income to child conduct problems and emotional problems operate through maternal depressive symptoms and 3 family risk factors in early childhood-harsh parenting, parenting hassles, and chaos in the home environment. Results of a sequential mediation model revealed significant indirect effects of family income on children's conduct problems operating through maternal depressive symptoms and parenting hassles and indirect effects of family income on children's emotional problems operating through maternal depressive symptoms, chaos in the home environment, and parenting hassles. Implications of these findings for understanding processes through which income influences child functioning are discussed.

Objective Efforts to promote early brain and child development (EBCD) include initiatives to support healthy parent–child relationships, tools to identify family social-emotional risk factors, and referrals to community programs to address family risk factors. We sought to examine if pediatricians perceive barriers to implementing these activities, and if they utilize resources to address those barriers. Methods Data were analyzed from 304 nontrainee pediatricians who practice general pediatrics and completed a 2013 American Academy of Pediatrics Periodic Survey. Sample weights were used to decrease nonresponse bias. Bivariate comparisons and multivariable regression analyses were conducted. Results At least half of the pediatricians agreed that barriers to promoting EBCD include: a lack of tools to promote healthy parent–child relationships, a lack of tools to assess the family environment for social-emotional risk factors, and a lack of local resources to address family risks. Endorsing a lack of tools to assess the family environment as a barrier was associated with using fewer screening tools and community resources. Endorsing a lack of local resources as a barrier was associated with using fewer community resources and fewer initiatives to promote parent–child relationships. Interest in pediatric mental health was associated with using more initiatives to promote healthy parent–child relationships, screening tools, and community resources. Conclusions Although the majority of pediatricians perceive barriers to promoting EBCD, few are routinely using available resources to address these barriers. Addressing pediatricians' perceived barriers and encouraging interest in pediatric mental health may increase resource utilization and enhance efforts to promote EBCD.

Deviance proneness models propose a multilevel interplay in which transactions among genetic, individual, and family risk factors place children at increased risk for substance use. We examined bidirectional transactions between impulsivity and family conflict from middle childhood to adolescence and their contributions to substance use in adolescence and emerging adulthood (n = 380). Moreover, we examined children's, mothers’, and fathers’ polygenic risk scores for behavioral undercontrol, and mothers’ and fathers’ interparental conflict and substance disorder diagnoses as predictors of these transactions. The results support a developmental cascade model in which children's polygenic risk scores predicted greater impulsivity in middle childhood. Impulsivity in middle childhood predicted greater family conflict in late childhood, which in turn predicted greater impulsivity in late adolescence. Adolescent impulsivity subsequently predicted greater substance use in emerging adulthood. Results are discussed with respect to evocative genotype–environment correlations within developmental cascades and applications to prevention efforts.

This secondary data analysis examined the association of Head Start children's entry age and enrollment duration on children's dental, vision, and hearing health based on data from 60 local Head Start classrooms. Children were divided into three groups: One group of children entered Head Start at age three and maintained enrollment for one year (Group 1). The second group of children entered Head Start at age four and stayed one year (Group 2). The third group of children entered at age three and stayed in Head Start for two years (Group 3). Compared with Group 3, Group 1 had fewer dental problems and Group 2 had less identified hearing problems. Children's gender, ethnicity, and program characteristics and family risk factors were associated with health problems.

Mental health problems among adolescents are prevalent and are associated with important difficulties for a normal development during this period and later in life. Understanding better the risk factors associated with mental health problems may help to design and implement more effective preventive interventions. Several personal and family risk factors have been identified in their relationship to mental health; however, much less is known about the influence of school-related factors. One of these school factors is school belonging or the psychological sense of school membership. This is a well-known protective factor to develop good academic commitment, but it has been scarcely studied in its relationship to mental health. We explored this association in a sample of early adolescents and found that students who reported having a high level of school membership had lower mental health problems, even after controlling for several personal and family factors.

The objective of the study was to evaluate whether mental health problems identified through screens administered in first grade are related to poorer academic achievement test scores in the fourth grade. The government of Chile uses brief teacher- and parent-completed measures [Teacher Observation of Classroom Adaptation-Revised (TOCA-RR) and Pediatric Symptom Checklist (PSC-Cl)] to screen for mental health problems in about one-fifth of the country's elementary schools. In fourth grade, students take the national achievement tests (SIMCE) of language, mathematics and science. This study examined whether mental health problems identified through either or both screens predicted achievement test scores after controlling for student and family risk factors. A total of 17,252 students had complete first grade teacher forms and these were matched with fourth grade SIMCE data for 11,185 students, 7,903 of whom also had complete parent form data from the first grade. Students at risk on either the TOCA-RR or the PSC-Cl or both performed significantly worse on all SIMCE subtests. Even after controlling for covariates and adjusting for missing data, students with mental health problems on one screen in first grade had fourth grade achievement scores that were 14-18 points (~1/3 SD) lower than students screened as not at risk. Students at risk on both screens had scores that were on average 33 points lower than students at risk on either screen. Mental health problems in first grade were one of the strongest predictors of lower achievement test scores 3 years later, supporting the premise that for children mental health matters in the real world.

Electrophysiological measures of brain function are effective tools to understand neurocognitive phenomena and sensitive indicators of pathophysiological processes associated with various clinical conditions, including alcoholism. Individuals with alcohol use disorder (AUD) and their high-risk offspring have consistently shown dysfunction in several electrophysiological measures in resting state (i.e., electroencephalogram) and during cognitive tasks (i.e., event-related potentials and event-related oscillations). Researchers have recently developed sophisticated signal-processing techniques to characterize different aspects of brain dynamics, which can aid in identifying the neural mechanisms underlying alcoholism and other related complex disorders. These quantitative measures of brain function also have been successfully used as endophenotypes to identify and help understand genes associated with AUD and related disorders. Translational research also is examining how brain electrophysiological measures potentially can be applied to diagnosis, prevention, and treatment.

There is growing concern about elevated blood pressure (BP) in children. The evidence for familial aggregation of childhood BP is substantial. Twin studies have shown that a large part of the familial aggregation of childhood BP is due to genes. The first part of this review provides the latest progress in gene finding for childhood BP, focusing on the combined effects of multiple loci identified from the genome-wide association studies on adult BP. We further review the evidence on the contribution of the genetic components of other family risk factors to the familial aggregation of childhood BP including obesity, birth weight, sleep quality, sodium intake, parental smoking, and socioeconomic status. At the end, we emphasize the promise of using genomic-relatedness-matrix restricted maximum likelihood (GREML) analysis, a method that uses genome-wide data from unrelated individuals, in answering a number of unsolved questions in the familial aggregation of childhood BP.

This paper describes the use of seclusion in a child and adolescent inpatient unit, including precipitating events, management strategies, details of seclusion episodes and individual and family risk factors. Inpatient ward documentation of seclusion episodes, demographic data and measures of individual psychopathology and impairment, parent mental health, life events and family functioning were used to compare secluded, non-secluded and outpatient groups. Secluded individuals had elevated psychopathology compared with non-secluded inpatients and outpatients. Their families reported poorer parental mental health and family functioning and more recent stressful life events. The results indicate that seclusion is most common among high-risk inpatients.

Research on family risk factors for addictive behaviors in young people has not paid a great deal of attention to parents' knowledge of their children's addictive behaviors and of the family risk factors that affect such behaviors. The aim of this work is to compare knowledge about these two aspects in two groups of parents that differ regarding their children's declared drug use. The research was carried out with a sample of 309 schoolchildren and their families, divided into two groups: one of 154 families with children defined as non-Drug Users and another of 155 families with children defined as Drug Users. The results show that parents with children who consume drugs tend to strongly underestimate their children's use. Moreover, they overestimate the control they exercise over them and appear to be more familiarized with the use of drugs, if we compare them with parents of non-Drug Users. It is suggested that these results may be relevant for the planning of strategies that increase motivation in families with drug-risk children to participate in prevention programs.

A dual coercion model of family processes associated with the development of antisocial and depressive behavior during adolescence was assessed, using an at-risk sample of families and children. Consistent with the model, involvement in family coercion during childhood and adolescence increased both boys' and girls' risk for antisocial behavior in adolescence and girls' risk for depressive behavior. Coercive family processes served as a link between older and younger siblings' antisocial behavior. Childhood exposure to maternal depression predicted boys' and girls' depressive behavior 10 years later, but this association was not mediated by coercion. The data suggest that family risk factors and processes for antisocial development are similar for boys and girls but pathways to depression may be gender specific.

We determined risk factors for influenza hospital admission in children aged We linked all singleton live births in Scotland from 2007 to 2015 to hospital administrative data and influenza laboratory reports. Cox proportional hazard models were used to identify birth and family risk factors for influenza admissions. There were 1115 influenza admissions among 424 048 children. 85.1% of admitted children were born at term and were not in a high-risk group. Presence of an older sibling was strongly associated with increased risk of influenza admission, particularly for children aged versus first-born child was 2.02 (95% CI 1.52–2.69). Maternal age Targeting vaccination programmes to high-risk children will not prevent the vast majority of influenza admissions. Parents of children aged

It is widely believed that the family plays an etiologically significant role in somatization. Although research indicates many high symptom reporters come from dysfunctional homes, very little is known about the more specific aspects of daily family functioning that may heighten the risk of physical symptomatology at different developmental levels. Accordingly, we report findings on the relationship between ten dimensions of family-of-origin environment and physical health complaints in 933 children, adolescents, and young adults in junior high, high, and undergraduate school (grades 6-16). Results indicated that certain aspects of family life may combine to heighten the risk of somatic complaints for youth at different developmental levels. The implications of these findings are discussed and directions for future research are noted.

This retrospective study examined differences among three groups of urban males in the prevalence of various family risk factors occurring before age 11 and their independent contributions to subsequent deviance. The groups included: narcotic addicts; never-addicted peer controls who were associates of the addicts at age 11; and never-addicted community controls not associated with the addicts. Sixty-four percent of the addicts, compared to slightly under 40% of both control groups, reportedly experienced one or more family risk factors involving deviant behavior among family members and family disruption before age 11. While community controls differed from addicts on both family deviance and disruption in family structure, peer controls differed from addicts only on disruption of family structure. For the total sample, both family deviance and family disruption experienced before age 11 were significantly associated with crime severity level at age 11. Implications of these findings for future substance abuse research and intervention are discussed.

Objective: Although previous reports have found no birth-order influence on ADHD risk, the authors hypothesize that being the firstborn is a risk factor for developing ADHD. Method: They selected all of the currently treated ADHD outpatients (n = 748) from our database. Families with adopted sons, nonnuclear families, and families with only one child and with sons (affected or unaffected) younger than 6 or older than 18 years were excluded. A total of 181 families with 213 ADHD sons met the inclusion criteria. We used all siblings without a clinical diagnosis of ADHD and who had no contact with our service as our unaffected controls (n = 173). Results: The bivariate analysis showed that ADHD was associated with birth order and that firstborn children had nearly twice the ADHD risk of children with other birth orders. Conclusion: birth order can be an ADHD risk factor in clinical samples.

Due to the increased prevalence of psychosomatic presentations and the difficulty of managing such patients, this article summarizes the latest findings for identifying individual and family risk factors, and new trends in the evaluation and management of pediatric patients with psychosomatic illness.Up to 50% of patients in pediatric care will complain of medically unexplained symptoms with significant functional and emotional impairment. Such patients place heavy burdens on the healthcare system (frequent utilization of health resources and hospitalizations, specialist consultations, unnecessary investigations, and treatments). Somatoform disorders in pediatric care are associated with risks for psychiatric co-morbidity (anxiety and depressive disorders), family conflict, parent-perceived ill health, and school problems/absenteeism.Gaining expertise in addressing pediatric psychosomatic illness can make a great difference in patients' life and in physicians' professional satisfaction. Effective treatment approaches involve a multidisciplinary approach to consolidate care and facilitate communication, target the patient/family's understanding of the mind-body relationship and their acceptance of the bio-psycho-social formulation and treatment, and utilize functional rehabilitation and cognitive behavioral therapy for the individual and family and management guidance for schools.

The associations between the quality of teacher-student interactions and first grade academic and adaptive behavior outcomes were examined in a study of 106 Portuguese students in 64 first grade classrooms. Students' vocabulary, print concepts, math, and adaptive skills were assessed both at the end of preschool and in first grade. Classrooms were observed in the spring of first grade. After taking into account family risk factors and preschool skills, the quality of teacher-student interactions, particularly in terms of classroom organization, was positively associated with students' first grade vocabulary and print concepts. In addition, classroom quality predicted number identification outcomes differently depending on student skills prior to school entry. Students with lower preschool math skills seemed to benefit from higher quality teacher-student interactions. These findings provide further support for the unique contribution of the quality of teacher-student interactions in first grade and suggest that it may be an important mechanism to improve academic skills.

Studied contributions of maternal psychological distress, family stress load, maternal and family risk factors, and family coping strategies in predicting behavior problems in 441 inner-city black primary-grade children. Results indicated maternal psychological distress and high family stress load were associated with high child behavior problems. Family coping strategies offered no protection against risk, while coping with life difficulties by reframing them was detrimental to child behavioral adjustment. Active help-seeking strategies (i.e., family mobilization, acquiring social supports) served to moderate the effects of maternal psychological distress and family risk attributes for boys, but exacerbated the effects of dysfunctional maternal social and psychiatric histories for girls. Implications for understanding vulnerability and resilience in inner-city black children and recommendations for future research are discussed.

Qualitative studies suggest that children react to parental imprisonment by developing internalizing as well as externalizing behaviors. However, no previous study has examined the effects of parental imprisonment on children's internalizing problems using standardized instruments, appropriate comparison groups, and long-term follow-up. Using prospective longitudinal data from the Cambridge Study in Delinquent Development, we compared boys separated because of parental imprisonment during their first 10 years of life with four control groups: boys who did not experience separation, boys separated because of hospitalization or death, boys separated for other reasons (usually parental disharmony), and boys whose parents were only imprisoned before the boys' births. Individual, parenting, and family risk factors for internalizing problems were measured when boys were ages 8–11 years. Separation because of parental imprisonment predicted boys' internalizing problems from age 14 to 48, even after controlling for childhood risk factors including parental criminality. Separation because of parental imprisonment also predicted the co-occurrence of internalizing and antisocial problems. These results suggest that parental imprisonment might cause long-lasting internalizing and antisocial problems for children.

Rates of alcohol, tobacco, and marijuana use among runaway/homeless youth are substantially higher than found among American high school students. To understand the risk and protective factors associated with substance use, this study (1) assessed cigarette, alcohol, and marijuana use among a national sample of runaway/homeless youth, (2) identified risk/protective factors associated with lifetime substance use, and (3) examined risk/protective factors associated with six month frequency of substance use. Unduplicated cases (n = 11,841) from the 1997 Runaway/Homeless Youth Management Information System (RHY MIS) were analyzed. Results showed that substance use levels are greater than previously reported for this population. Predictors of cigarette, alcohol, and marijuana use and frequency were predominately individual youth risk factors and demographics rather than family risk factors. Providers in emergency youth shelters are in a prime position to assess substance use behaviors, as well as the associated risk factors. Provision of appropriate screening and referral to other services is essential to meet the needs of these youth.

This study explored the possible links between family risk factors (i.e., parent gambling and parenting practices) and adolescent gambling. A community sample of 938 adolescents (496 females and 442 males) completed the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA; K. C. Winters, R. Stinchfield, & J. Fulkerson, 1993b) along with a questionnaire assessing parenting practices. Both parents completed the SOGS (H. R. Lesieur & S. B. Blume, 1987). Results showed that adolescent gambling frequency was related to both parents' gambling frequency and problems. However, adolescent gambling problems were linked only to fathers' severity of gambling problems. Low levels of parental monitoring enhanced adolescents' risk of getting involved in gambling activities and developing related problems. A higher level of inadequate disciplinary practices was also related to greater gambling problems in youth. These links were significant after controlling for socioeconomic status, gender, and impulsivity-hyperactivity problems.

OBJECTIVE To analyze the influence of family history of cardiovascular disease (CVD) on lipoprotein (a) (Lpa) values in obese children. SUBJECTS AND METHODS Lpa values were measured by a nephelometric technique in 837 prepubertal obese children (442 girls, 395 boys) aged 6-8 years. Lpa > 30 mg/dl were determined to be a risk factor for CVD after complete recording of dietary norms, family history of CVD and coronary risk in relatives aged less than 50 years old. RESULTS The obese children's group with BMI > 30 and with family history of CVD presented higher values of Lpa (32.07 +/- 1.2 mg/dl) in comparison to the less obese group with family history of CVD (27.19 +/- 0.8 mg/dl) (p < 0.01), and both of these groups had significantly higher Lpa values than the groups with no family history of CVD. CONCLUSIONS Childhood obesity with high BMI increases the risk of CVD when these children become adults in children with family risk factors for CVD.

Editor,—Little information is available on the aetiology of primary not transient congenital hypothyroidism due to thyroid malformations. Usually it is considered to be a sporadic disease; however, to date, there are no reliable studies to identify some possible family risk factors for the disease.1 2Therefore between April and September 1996, during therapeutic follow up of affected children, we examined the mothers of 19 consecutive infants with congenital hypothyroidism (group A) screened through our regional newborn screening program (Emilia-Romagna, Italy) and 17 age matched volunteer mothers of unaffected children …

Parents of pediatric patients attending regional otologic medical clinics were given a questionnaire to document family risk factors predictive of poor appointment attendance, and to determine barriers which caused non-attendance of medical appointments. Family risk factors which affected clinic attendance were studied using univariate and multivariate analyses. Univariate analyses revealed all factors except patients' sex and family size to be correlated with attendance. However, multivariate analysis revealed that parental age (p less than 0.0153), ownership of car (p less than 0.0012), parental education (p less than 0.0048), and age of patient (p less than 0.0023) were major predictors of clinic attendance. Although ownership of a car was a major independent factor, it was highly correlated with parental age and parental education and only shown to be significant in the subset of patients not having access to public transportation. The identified parental factors which affect pediatric health care delivery underscores the importance of family centered case management in promoting the health care of children and casts doubt on the effectiveness of interventions which are solely centered on the patient or are designed to mitigate only one of these factors.