Antisocial personality, substance abuse, and exposure to parental violence in males referred for domestic violence.

This study investigated whether childhood disruptive behavior (hyperactivity, oppositional-defiance, conduct problems) plus adult psychopathic adjustment are associated with domestic violence. Adult males (n = 66) in diversion programs completed the Wender Utah Rating Scale (WURS), MMPI Psychopathic Deviate scale (PD), Conflict Tactics Scales representing themselves and their parents, and substance use measures. Substance use and lifespan antisocial personality (measured by high WURS and PD scores) were robust predictors of verbal and moderate physical domestic abuse. Violence in the family of origin was associated with abuse when tested alone, but failed to exhibit unique association with abuse when other predictors were taken into account. The possibility that antisocial batterers respond to contingencies by moderating physical harm, while persisting at psychological harm, is discussed.

Father absence and familial antisocial characteristics.

This study examined family antisocial characteristics according to whether biological fathers live at home and agree to be study participants. Antisocial symptoms were tabulated for 161 clinic-referred children and their parents. Families with fathers at home had fewer paternal, maternal, and child antisocial symptoms, and scored higher on multiple SES indicators, than did families with departed fathers. Antisocial characteristics were highest, and SES was lowest, when fathers could not be located or recruited. Results suggest that requiring father participation (as in family-trio genetic designs) screens out the more antisocial families. Of clinical interest, antisocial behavior in any family member is more likely if the father is absent and nonparticipating. The heightened antisocial behavior in children associated with absent biological fathers was not mitigated by presence of stepfathers and was not accounted for by lower SES. The ethical use of mother report on absent fathers is discussed.

Symptom properties as a function of ADHD type: an argument for continued study of sluggish cognitive tempo.

Inconsistent alertness and orientation (sluggishness, drowsiness, daydreaming) were reported to accompany Attention Deficit Disorder (ADD) without Hyperactivity in DSM-III. Such Sluggish Cognitive Tempo items were tested in the DSM-IV Field Trial for ADHD, but were discarded from the Inattention symptom list because of poor negative predictive power. Using 692 children referred to a pediatric subspecialty clinic for ADHD, Sluggish Tempo items were re-evaluated. When Hyperactivity-Impulsivity was absent (i.e., using only cases of Inattentive Type plus clinic controls), Sluggish Tempo items showed substantially improved utility as symptoms of Inattention. Factor analyses distinguished a Sluggish Tempo factor from an Inattention factor. When DSM-IV ADHD types were compared, Inattentive Type was uniquely elevated on Sluggish Tempo. These findings suggest that (a) Sluggish Tempo items are adequate symptoms for Inattentive Type, or (b) Sluggish Tempo may distinguish two subtypes of Inattentive Type. Either conclusion is incompatible with ADHD nosology in DSM-IV.

Interventions to enhance social competence.

Social Impairment associated with attention deficit/hyperactivity disorder (ADHD) is difficult to treat. Stimulant treatment often improves social functioning, but rarely results in normalization. Behavioral approaches to improving social skills have progressed from unimodal techniques (contingency management) to packages that may combine multiple cognitive and behavioral techniques targeted directly to children and mediated by parents, teachers, other adults, and peers. Medication and behavioral treatment may improve different aspects of social impairment and may complement each other when used together. Much of the progress of treating social problems can be attributed to efforts to increase generalization across settings and durability of effects. A promising multimodal psychosocial approach is presented in detail.

Experimental cross-validation of DSM-IV types of attention-deficit/hyperactivity disorder.

OBJECTIVE: To examine the discriminant validity of DSM-IV attention-deficit/hyperactivity disorder (ADHD) types by testing the hypothesis that types are associated with specific kinds of functional impairment and to compare overlap of DSM-IV and DSM-III-R ADHD. METHOD: Consecutive referrals (n = 692) to a pediatric subspecialty clinic for ADHD were classified into 1 of each of the 3 DSM-IV types of ADHD using parent and teacher checklist ratings of ADHD symptoms. The resulting types were compared on clinical correlates and on whether the children also met criteria for DSM-III-R ADHD. RESULTS: The validity of DSM-IV types was supported by dimension-specific impairment and other distinct correlates. Academic problems aggregated in the 2 types defined by extreme inattention, and externalizing problems aggregated in the 2 types defined by extreme hyperactivity. CONCLUSION: DSM-IV appeared superior to DSM-III-R in subcategorical homogeneity and in exhaustiveness (ability to classify all apparent cases).

Social skills training with parent generalization: treatment effects for children with attention deficit disorder.

The effectiveness of brief social skills training (SST) was evaluated in a controlled outcome study with 27 children meeting criteria of the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) for an attention deficit disorder. Children were randomly assigned to either SST with parent-mediated generalization (SST-PG), child-only SST, or a wait-list control group. SST consisted of 8 group sessions in which skill modules were taught sequentially. Parents of children in the SST-PG group simultaneously participated in group generalization training designed to support their children's transfer of skills. Significant improvement in children's skill knowledge and in parent reports of social skills and disruptive behavior occurred for both treatment groups relative to the wait-list control group and maintained at a 4-month follow-up. More modest evidence was found for generalization of SST to the school setting.

Effects of maternal discipline and nurturance on toddler's behavior and affect.

Oppositional behavior problems frequently begin in early childhood and remain stable over time. Correlational data point to the importance of parental discipline and nurturance in their development. This study investigated experimentally some of the hypotheses suggested by these correlational data. The effects of immediate, short, firm reprimands and delayed, long, gentle reprimands on transgressions and appropriate play were examined in the context of either high or low nurturant maternal interaction. Forty children (18-31 months) and their mothers participated. Children exposed to reprimands that were immediate, short, and firm transgressed significantly less often and exhibited more negative affect than those exposed to reprimands that were delayed, long, and gentle. The only effect of nurturance was on children's negative affect, with a high level of nurturance increasing negative affect when immediate, short, firm reprimands were delivered. The results indicate that the manner in which reprimands are delivered is critical in influencing children's misbehavior, but the role of nurturance during disciplinary situations is less clear.

Marital conflict, parenting, and toddler conduct problems.

The present research examined relationships involving marital conflict, parenting, and toddler conduct problems. Sixty mother-toddler dyads (30 boys and 30 girls) participated as subjects. Mothers completed measures of general marital satisfaction, overt marital conflict, and toddler conduct problems. Maternal parenting and toddler deviance were assessed during a laboratory observation. Marital conflict was positively correlated with observations of toddler deviance and maternal reports of conduct problems. Marital conflict also correlated positively with the frequency of maternal disapproval statements directed toward sons' misbehaviors and was correlated negatively with the ratio of disapproval statements to daughters' misbehaviors. The present results indicate that marital conflict is associated with toddler conduct problems. The results also suggest the importance of examining parenting practices and child characteristics that may mediate the relationship between marital conflict and child behavior problems.

The efficacy of all-positive management as a function of the prior use of negative consequences.

Previous work suggests that an all-positive approach to child management can be effective. The present investigation extends these findings by examining the efficacy of an enhanced all-positive management system in the absence of a history of negative consequences. The on-task behavior and academic performance of 8 first- through third-grade children with academic and/or behavioral problems were observed in the classroom. Results indicated that, in the absence of a history of negative consequences, enhanced positive consequences were not sufficient to maintain on-task rates or academic accuracy at acceptable levels. The addition of negative consequences resulted in an immediate increase in on-task behavior and academic accuracy; a primarily positive approach appeared to be successful in maintaining these gains following the gradual (as opposed to abrupt) removal of the negative consequences.

The efficacy of an all-positive approach to classroom management.

This study addressed the question of whether an all-positive approach to classroom management can be effective. The on-task behavior and academic performance of eight, second- and third-grade children with behavior problems were examined. Results indicated that an all-positive approach that relied primarily on praise was not effective. However, when an individualized reward system was used, the children's rates of on-task behavior were high and stable. Similar effects were observed for academic productivity. Thus, a classroom can be managed using only positive consequences. However, to be successful, such an approach may require a considerable amount of teacher time and effort, particularly potent, varied and individual rewards, and high rates of appropriate behavior previously established using both positive and negative consequences.

The importance of prudent negative consequences for maintaining the appropriate behavior of hyperactive students.

Teachers use both positive and negative consequences to influence classroom behaviors. Four experiments were conducted to examine the differential affects of these two types of consequences on the maintenance of appropriate behaviors of hyperactive children. Results of Experiment 1 showed that the use of both positive and negative consequences (combined) was associated with high levels of on-task behaviors. Withdrawal of negative consequences caused a significant and dramatic decrease in on-task performance. The withdrawal of positive consequences produced no change in the rate of on-task behaviors. In Experiments 2, 3, and 4, the on-task results of Experiment 1 were replicated using a different teacher, different children, a counterbalanced design, longer phases, and different types of negative consequences. The withdrawal of negative consequences led to decreases in productivity in Experiment 2. The results of Experiment 3 also suggested that a prudent (e.g., calm, concrete, and consistent) approach to discipline was more effective than an imprudent (e.g., loud, emotional, and inconsistent) approach. Some level of mild negative consequences for inappropriate behavior is an important ingredient in effective classroom management, and qualitatively different negative consequences may have drastically different effects on the behavior of hyperactive students.