Caregiver adverse childhood experiences and preschool externalizing problems: The role of factors that contribute to caregiver resilience.

BACKGROUND: Preschool children with externalizing problems are at risk for short- and long-term difficulties and preschool externalizing problems (PEP) are influenced by several caregiver factors. One such factor is caregiver adverse childhood experiences (ACEs). Researchers have investigated how caregiver ACEs are related to PEP by identifying risk factors to account for this association. However, research on caregiver factors associated with fewer PEP is limited. Particularly, factors that contribute to caregiver resilience may be adaptive caregiver characteristics that negatively relate to PEP, even when adjusting for caregiver ACEs. OBJECTIVE: The present study sought to address a gap in the literature by examining the impact of different types of factors that contribute to caregiver resilience (e.g., caregiver social-ecological factors or caregiver positive childhood experiences) as promotive factors of lower PEP. PARTICIPANTS AND SETTING: Participants included 125 caregiver-child dyads recruited from the community. METHOD: Participating caregivers completed measures of their own and their child's demographic information, caregiver ACEs, caregiver social-ecological factors, caregiver positive childhood experiences, and PEP. RESULTS: Overall, positive caregiver childhood experiences (r = -0.25, p < .01), and not caregiver social-ecological factors (r = -0.13, p = .15), demonstrated a significant negative association with PEP. However, this relation became statistically non-significant when adjusting for caregiver ACEs (ß = -0.12, p = .20). CONCLUSIONS: Given the association between caregiver ACEs and PEP, this study highlights the importance of assessing a caregiver's ACEs, specifically when working with caregivers seeking parent training for disruptive child behaviors. There should be a continued focus on ecological and family strengths and differential impacts as they relate to PEP.

Multimodal Analysis of Secondary Cerebellar Alterations After Pediatric Traumatic Brain Injury.

Importance: Traumatic brain injury (TBI) is known to cause widespread neural disruption in the cerebrum. However, less is known about the association of TBI with cerebellar structure and how such changes may alter executive functioning. Objective: To investigate alterations in subregional cerebellum volume and cerebral white matter microstructure after pediatric TBI and examine subsequent changes in executive function. Design, Setting, and Participants: This retrospective cohort study combined 12 data sets (collected between 2006 and 2020) from 9 sites in the Enhancing Neuroimaging Genetics Through Meta-Analysis Consortium Pediatric TBI working group in a mega-analysis of cerebellar structure. Participants with TBI or healthy controls (some with orthopedic injury) were recruited from trauma centers, clinics, and institutional trauma registries, some of which were followed longitudinally over a period of 0.7 to 1.9 years. Healthy controls were recruited from the surrounding community. Data analysis occurred from October to December 2022. Exposure: Accidental mild complicated-severe TBI (msTBI) for those in the TBI group. Some controls received a diagnosis of orthopedic injury. Main Outcomes and Measures: Volume of 18 cerebellar lobules and vermal regions were estimated from 3-dimensional T1-weighted magnetic resonance imaging (MRI) scans. White matter organization in 28 regions of interest was assessed with diffusion tensor MRI. Executive function was measured by parent-reported scores from the Behavior Rating Inventory of Executive Functioning. Results: A total of 598 children and adolescents (mean [SD] age, 14.05 [3.06] years; range, 5.45-19.70 years; 386 male participants [64.5%]; 212 female participants [35.5%]) were included in the study, with 314 participants in the msTBI group, and 284 participants in the non-TBI group (133 healthy individuals and 151 orthopedically injured individuals). Significantly smaller total cerebellum volume (d = -0.37; 95% CI, -0.52 to -0.22; P < .001) and subregional cerebellum volumes (eg, corpus medullare; d = -0.43; 95% CI, -0.58 to -0.28; P < .001) were observed in the msTBI group. These alterations were primarily seen in participants in the chronic phase (ie, >6 months postinjury) of injury (total cerebellar volume, d = -0.55; 95% CI, -0.75 to -0.35; P < .001). Smaller cerebellum volumes were associated with higher scores on the Behavior Rating Inventory of Executive Functioning Global Executive Composite score (ß = -208.9 mm3; 95% CI, -319.0 to -98.0 mm3; P = .008) and Metacognition Index score (ß = -202.5 mm3; 95% CI, -319.0 to -85.0 mm3; P = .02). In a subset of 185 participants with longitudinal data, younger msTBI participants exhibited cerebellum volume reductions (ß = 0.0052 mm3; 95% CI, 0.0013 to 0.0090 mm3; P = .01), and older participants slower growth rates. Poorer white matter organization in the first months postinjury was associated with decreases in cerebellum volume over time (ß=0.52 mm3; 95% CI, 0.19 to 0.84 mm3; P = .005). Conclusions and Relevance: In this cohort study of pediatric msTBI, our results demonstrated robust cerebellar volume alterations associated with pediatric TBI, localized to the posterior lobe. Furthermore, longitudinal cerebellum changes were associated with baseline diffusion tensor MRI metrics, suggesting secondary cerebellar atrophy. These results provide further understanding of secondary injury mechanisms and may point to new opportunities for intervention.

Evaluation of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Questionnaire and its Relations to Cannabis-Related Problems.

Cannabis use and the prevalence of cannabis use disorder (CUD) among emerging adults are on the rise. Several indicators of cannabis use (e.g., quantity, frequency) as they relate to negative outcomes have been posited in the extant literature. Despite research examining links between indicators and cannabis outcomes, few assessments of cannabis use indicators exist. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU) was developed to assess cannabis use across a range of factors. However, the factor structure of the DFAQ-CU has not been replicated. Further, the DFAQ-CU was modeled using reflective strategies despite formative strategies being conceptually appropriate. The present study utilized principal components analyses (PCA) and principal axis factoring (PAF) to evaluate the structure of the DFAQ-CU. PCA yielded a four-component solution; PAF resulted in a five-factor solution. Linear regression found significant relations between PCA components and PAF factors with CUD symptoms and cannabis-related problems; however, effect sizes were larger for the PAF suggesting possible misdisattenuation. The PCA components demonstrated evidence of discriminant and convergent validity with measures of cannabis and alcohol behavior. The study informs research and clinical work through the refinement of cannabis use assessment and enhancing our understanding of the importance of model selection.

Adult Attention-Deficit/Hyperactivity Disorder: a Narrative Review of Biological Mechanisms, Treatments, and Outcomes.

PURPOSE OF REVIEW: Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous and complex neurodevelopmental disorder related to disruptions in various neuronal structures and pathways, dopamine (DA) transporter, and receptor genes, resulting in cognitive and regulation deficits. This article reviews recent research on the biological mechanisms and markers, clinical manifestations, treatments, and outcomes of adult ADHD as well as current controversies within the field. RECENT FINDINGS: New research identifies white matter disruptions in multiple cortical pathways in adults with ADHD. New treatments for ADHD in adults such as viloxazine ER have shown preliminary effectiveness in addition to research showing transcranial direct current stimulation can be an effective treatment for adults with ADHD. Although questions exist about the effectiveness of current assessments of and treatments for adult ADHD, recent findings represent a step towards improving the quality of life and outcomes for individuals experiencing this life-long, chronic health condition.

The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes.

OBJECTIVE: While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment. METHOD: The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university. RESULTS: The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P. CONCLUSIONS: Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.

Conner's Continuous Performance Test and Adult ADHD: A Systematic Literature Review.

OBJECTIVE: ADHD is a neurodevelopmental disorder affecting millions of adults worldwide. Continuous performance tests (CPTs) are widely used as assessment and diagnostic tools; however, their use in diagnosing undiagnosed ADHD in adults has been questioned due to their lack of specificity and sensitivity. This review sought to outline relevant findings concerning the diagnostic utility of the Conner's Continuous Performance Test (CCPT) in adults. METHOD: This systematic review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were gathered from PsycINFO, PsycArticles, Cochrane, Scopus, Google Scholar, and PubMed. RESULTS: Thirty-five articles were reviewed and analyzed. Most articles reviewed used outpatient and university populations. Moderate reliability, subpar discriminant and ecological validity, and mixed sensitivity and specificity were noted. CONCLUSION: The results of this review lend support to previous critiques of the CCPT's diagnostic and utility as a treatment measure.

Doctoral students' intention to use assessments in their career: The incremental role of self-reported competence.

OBJECTIVE: Attaining competence in assessment is a necessary step in graduate training and has been defined to include multiple domains of training relevant to this attainment. While important to ensure trainees meet these standards of training, it is critical to understand how and if competence shapes a trainees' professional identity, therein promoting lifelong competency. METHODS: The current study assessed currently enrolled graduate trainees' knowledge and perception of their capabilities related to assessment to determine if self-reported and performance-based competence would incrementally predict their intention to use assessment in their future above basic training characteristics and intended career interests. RESULTS: Self-reported competence, but not performance-based competence, played an incremental role in trainees' intention to use assessments in their careers. Multiple graduate training characteristics and practice experiences were insignificant predictors after accounting for other relative predictors (i.e., intended career settings, integrated reports). CONCLUSION: Findings are discussed about the critical importance of incorporating a hybrid competency-capability assessment training framework to further emphasize the role of trainee self-efficacy in hopes of promoting lifelong competence in their continued use of assessments.

Risky Early Family Environment and Genetic Associations with Adult Metabolic Dysregulation.

Growing up in a family environment characterized by neglectful parenting, overt conflict, and unsupportive relationships is associated with poor health in adulthood. A risky early family environment may also be associated with obesity in adulthood, likely through the activation of the HPA axis. Likewise, the GABAergic (gamma-aminobutyric acid) T>C single nucleotide polymorphism in the 1519 nucleotide position of the GABAAα6 receptor subunit gene has been associated with a predisposition to a higher body mass index and a larger waist circumference. Participants (n = 213, Mage = 30.13 years, SD = 10.85; 57.7% men) from the Pittsburgh Cold Study 3 completed a demographic questionnaire, the Risky Families Questionnaire (RFQ) and had their height, weight, and waist circumference measured during a physical exam. Participant DNA was recovered from buccal swabs and genotyped for the various allelic types of the SNP according to published protocols. In secondary data analyses, we tested the hypothesis that early family environment and GABRA6 would be positively associated with body mass index and waist circumference. We also examined diurnal cortisol as a mechanism linking both early risky family environment and GABRA6 to metabolic outcomes. The findings provide evidence that a risky early family environment may exert more influence than genetic predisposition when determining the indices of metabolic health in adulthood.

An Examination of Sleep as a Mediator of the Relationship between Childhood Adversity and Depression in Hispanic and Non-Hispanic Young Adults.

The current study integrates previous research on adverse childhood experiences (ACEs) and long-term health outcomes to examine associations between ACEs, sleep duration, and depression in a diverse, mostly healthy, sample of young adults. We examine whether sleep duration mediates the association between ACEs and depression among young adults, and whether ethnicity may moderate observed relationships between ACEs, sleep duration and depression. Data were collected from 518 young adults (66.8% female, Mage=19.79 years, SDage=3.43 years) enrolled in undergraduate Psychology courses at a large Southwestern university. Participants primarily reported their racial/ethnic background as Non-Hispanic White (60.6%) and Hispanic/Latino (25.1%). Participants self-reported their ACEs exposure, sleep characteristics, and depressive symptoms. In addition to calculating overall exposure to ACEs, scores for the specific dimensions of adversity were also calculated (Abuse, Neglect, Exposure to Violence). Results supported a mediation model whereby higher reports of ACEs were associated with depressive symptoms both directly and through sleep duration. Results were not moderated by ethnicity. Findings provide support for sleep duration as one potential pathway through which ACEs may be associated with depressive symptoms in young adulthood, and suggest that this pathway is similar in Hispanic and non-Hispanic young adults.

Confounding Factors Impacting microRNA Expression in Human Saliva: Methodological and Biological Considerations.

There is growing interest in saliva microRNAs (miRNAs) as non-invasive biomarkers for human disease. Such an approach requires understanding how differences in experimental design affect miRNA expression. Variations in technical methodologies, coupled with inter-individual variability may reduce study reproducibility and generalizability. Another barrier facing salivary miRNA biomarker research is a lack of recognized "control miRNAs". In one of the largest studies of human salivary miRNA to date (922 healthy individuals), we utilized 1225 saliva samples to quantify variability in miRNA expression resulting from aligner selection (Bowtie1 vs. Bowtie2), saliva collection method (expectorated vs. swabbed), RNA stabilizer (presence vs. absence), and individual biological factors (sex, age, body mass index, exercise, caloric intake). Differential expression analyses revealed that absence of RNA stabilizer introduced the greatest variability, followed by differences in methods of collection and aligner. Biological factors generally affected a smaller number of miRNAs. We also reported coefficients of variations for 643 miRNAs consistently present in saliva, highlighting several salivary miRNAs to serve as reference genes. Thus, the results of this analysis can be used by researchers to optimize parameters of salivary miRNA measurement, exclude miRNAs confounded by numerous biologic factors, and identify appropriate miRNA controls.

Guidelines to Address Barriers in Clinical Training for Trainees with Sensory Disabilities.

Disability is an important facet of diversity. Although diversity in clinical training in health service psychology has improved considerably, training often neglects accessibility and inclusion for individuals with sensory disabilities. The limited research to date documents that trainees with sensory disabilities (TSD) report extensive barriers and are consistently under-represented in clinical settings. Further, few resources have been developed to guide accommodating TSD in clinical training. Accordingly, our goals in this article are two-fold: (1) to highlight the barriers in clinical training faced by TSD and (2) to provide recommendations for trainees, supervisors, clinical leadership, and directors of clinical training to improve accessibility and inclusion for TSD. We offer vignettes to illustrate barriers faced by TSD and suggest guidelines to improve access for TSD.

The UPPS Model of Impulsivity and Suicide: A Systematic Literature Review.

INTRODUCTION: Suicide is a leading cause of death worldwide. Although inconsistent, impulsivity has been identified as a risk factor for suicidal thoughts and behaviors, and these inconsistent findings can largely be attributed to varying operationalizations of impulsivity. As such, the UPPS model of impulsivity provides a clear definition of impulsivity and its associated features that may provide utility in clarifying unreliable findings between impulsivity and suicide. This review aimed to summarize relevant information pertaining to the UPPS model of impulsivity and suicide. METHODS: This systematic review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were gathered from PsycINFO, PsycArticles, Scopus, and PubMed. RESULTS: Twenty-eight articles were reviewed and analyzed. Most articles reviewed reported on indirect (i.e., through mediators and moderators) associations between the UPPS dimensions and suicidal behaviors. Additionally, results noted limited between-group differences in UPPS facets among individuals with a history of suicide attempts and those without a history of suicide attempts, those with a history of suicide attempts and individuals with suicide ideation, and those with suicide ideation and those without suicide ideation, with the exception of lack of premeditation. DISCUSSION: The results of this review indicate support for the UPPS model of impulsivity as a theoretical starting point when examining the relation between impulsivity and suicide. Further, findings are helpful for clinicians and case conceptualization. Particularly, suicide risk assessment and treatment would be impacted based on impulsivity traits and suicide history.

Modeling the Adverse Childhood Experiences Questionnaire-International Version.

Adverse childhood experiences (ACEs) are related to a host of deleterious physical and mental health outcomes. The ACE-International Questionnaire (ACE-IQ) was developed to assess categories of ACEs (e.g., sexual, emotional, and physical abuse) in internationally representative samples. Though the ACE-IQ has been used world-wide, little work has examined the structure of this measure. Further, much of the modeling techniques implemented lacked theoretical rationale. The present work used two principal components analyses (PCA) to evaluate the ACE-IQ structure using both the identified ACE categories as defined by the World Health Organization (WHO) and using the ACE-IQ items as individual indicators. Using the WHO method, a two-component structure was indicated. Alternatively, a PCA of the individual items yielded a six-component structure. Results highlight the importance of theoretically grounded measure evaluation and the potential distinctions amongst types of ACEs. Implications and future directions for research and practice are discussed.

Executive function capacity links future thinking and exercise intent.

OBJECTIVE: Environmental barriers limit exercise in adolescents, but the contribution of cognitive barriers are not as well characterized. Previous findings suggest future thinking may predict exercise intent, which has been linked to health and actual exercise. However, these models may be incomplete as they do not systematically incorporate potential cognitive contributions (e.g., executive function capacity) to exercise intent. This study investigated the possible mediating role of executive function capacity in the relation between future thinking and exercise intent. METHODS: Data for the mediation models was collected from 101 adolescents aged 11-17 (M = 13.09) in a summer enrichment program. Adolescent participants completed self-report measures including Consideration of Future Consequences Scale (CFCS), Intent to Exercise, and Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2). RESULTS: This study found that self-reported executive function capacity mediated the relation between future thinking and exercise intent even when controlling for age and subjective socioeconomic status. CONCLUSIONS: While some exercise interventions aim to increase future thinking, this study provides support for additional research into how interventions may benefit from targeting executive function capacity directly to increase exercise intent and actual exercise.

Diffusion Tensor Imaging Correlates of Resilience Following Adolescent Traumatic Brain Injury.

BACKGROUND: Traumatic brain injury (TBI) is associated with considerable mortality and morbidity in adolescents, but positive outcomes are possible. Resilience is the concept that some individuals flourish despite significant adversity. OBJECTIVE: To determine if there is a relationship between resilience-promoting factors that are known to promote resilience and white matter (WM) microstructure 1 year after complicated mild TBI or moderate or severe TBI that is sustained by adolescents. METHOD: We examined the relationship between performance on a self-report measure of resilience-promoting factors and WM integrity assessed by diffusion tensor imaging in a group of adolescents who had sustained either a TBI (n = 38) or an orthopedic injury (OI) (n = 23). RESULTS: Immediately following injury, the individuals with TBI and the OI controls had comparable levels of resilience-promoting factors; however, at 1 year post injury, the TBI group endorsed fewer resilience-promoting factors and exhibited WM disruption compared with the OI controls. The individuals with TBI who had more resilience-promoting factors at 1 year post injury exhibited increased WM integrity, but the OI controls did not. Findings were particularly strong for the following structures: anterior corona radiata, anterior limb of the internal capsule, and genu of the corpus callosum-structures that are implicated in social cognition and are frequently disrupted after TBI. Relationships were notable for caregiver and community-level resilience-promoting factors. CONCLUSION: The current findings are some of the first to indicate neurobiological evidence of previously noted buffering effects of resilience-promoting factors in individuals with TBI.

Applicant factors contributing to interview selection, ranking determination, and judgement of "Fit" among health service psychology internship training programs.

BACKGROUND: The predoctoral internshipAQ4 training year is the capstone training experience for health service doctoral students. Previous research has explored what applicant characteristics are desired by internship sites and has not thoroughly explored differences between types of sites or criteria importance at different stages of applicant consideration (interview vs. ranking). AIMS: We evaluate current perceptions of doctoral student internship applications by training directors. MATERIALS AND METHODS: Internship training directors of APA-accredited sites report on the importance of different application materials during interview and ranking decisions. We also compare these rankings across site types. RESULTS: Results indicate that internship sites were generally consistent in their criteria rankings; however, there were also some differences. Intern applicant "fit" continues to be the most important criteria by which applicants are judged at all stages of consideration. Qualitative analysis found that "fit" varied by site across themes of treatment, applicant, and site characteristics. DISCUSSION: We discuss implications in their preparation of internship applications. In addition to the practical guidance for students, we discuss how program changes can increase applicant site competitiveness.

White Matter Disruption in Pediatric Traumatic Brain Injury: Results from ENIGMA Pediatric Moderate to Severe Traumatic Brain Injury.

OBJECTIVE: Our study addressed aims: (1) test the hypothesis that moderate-severe TBI in pediatric patients is associated with widespread white matter (WM) disruption; (2) test the hypothesis that age and sex impact WM organization after injury; and (3) examine associations between WM organization and neurobehavioral outcomes. METHODS: Data from ten previously enrolled, existing cohorts recruited from local hospitals and clinics were shared with the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric msTBI working group. We conducted a coordinated analysis of diffusion MRI (dMRI) data using the ENIGMA dMRI processing pipeline. RESULTS: Five hundred and seven children and adolescents (244 with complicated mild to severe TBI [msTBI] and 263 controls) were included. Patients were clustered into three post-injury intervals: acute/subacute - <2 months, post-acute - 2-6 months, chronic - 6+ months. Outcomes were dMRI metrics and post-injury behavioral problems as indexed by the Child Behavior Checklist (CBCL). Our analyses revealed altered WM diffusion metrics across multiple tracts and all post-injury intervals (effect sizes ranging between d=-0.5 to -1.3). Injury severity is a significant contributor to the extent of WM alterations but explained less variance in dMRI measures with increasing time post-injury. We observed a sex-by-group interaction: females with TBI had significantly lower fractional anisotropy in the uncinate fasciculus than controls (𝞫=0.043), which coincided with more parent-reported behavioral problems (𝞫=-0.0027). CONCLUSIONS: WM disruption after msTBI is widespread, persistent, and influenced by demographic and clinical variables. Future work will test techniques for harmonizing neurocognitive data, enabling more advanced analyses to identify symptom clusters and clinically-meaningful patient subtypes.

Childhood self-control forecasts the pace of midlife aging and preparedness for old age.

The ability to control one's own emotions, thoughts, and behaviors in early life predicts a range of positive outcomes in later life, including longevity. Does it also predict how well people age? We studied the association between self-control and midlife aging in a population-representative cohort of children followed from birth to age 45 y, the Dunedin Study. We measured children's self-control across their first decade of life using a multi-occasion/multi-informant strategy. We measured their pace of aging and aging preparedness in midlife using measures derived from biological and physiological assessments, structural brain-imaging scans, observer ratings, self-reports, informant reports, and administrative records. As adults, children with better self-control aged more slowly in their bodies and showed fewer signs of aging in their brains. By midlife, these children were also better equipped to manage a range of later-life health, financial, and social demands. Associations with children's self-control could be separated from their social class origins and intelligence, indicating that self-control might be an active ingredient in healthy aging. Children also shifted naturally in their level of self-control across adult life, suggesting the possibility that self-control may be a malleable target for intervention. Furthermore, individuals' self-control in adulthood was associated with their aging outcomes after accounting for their self-control in childhood, indicating that midlife might offer another window of opportunity to promote healthy aging.

Identifying the Contributions of Maternal Factors and Early Childhood Externalizing Behavior on Adolescent Delinquency.

We examined whether childhood externalizing group subtypes were uniquely related to maternal depression and victimization and whether these subtypes differentially predicted adolescent delinquency. Data were drawn from the Longitudinal Study on Child Abuse and Neglect (LONGSCAN) consortium (N = 1091; 51.3% female, 52.2% African American). Latent class analysis indicated three groups at age 4 (titled "well-adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking"). Caregiver victimization and depression significantly predicted group membership such that aggressive/rule-breaking group had higher levels of maternal depression and victimization although the well-adjusted group had higher levels of maternal victimization relative to the hyperactive/oppositional group. Further, membership in higher externalizing groups at age four is associated with greater risk of adolescent delinquency at age 16. These findings underscore the need to address maternal risk factors in the treatment of childhood disruptive behavior and provide evidence of the continuity of disruptive behaviors from early childhood to adolescence.

Does Stress Mediate the Relation between Caregivers' Victimization and Child Behavioral Outcomes? A Prospective Examination.

Children with internalizing and externalizing difficulties are at risk for long-term negative effects in adulthood and are impacted by several caregiver factors. Findings of the present study are consistent with previous studies that found direct associations between caregiver victimization history (e.g., physical and sexual abuse) and child behavior problems. Examination of potential mechanisms revealed that caregiver everyday stress related to relationships/responsibilities (RR) served as a mediator between caregiver victimization history and increased children's internalizing symptoms. Though there may be other pathways that contribute to this relation, there does seem to be clinical and policy utility of this knowledge, particularly for at-risk families that are faced with high levels of everyday RR stress. Attenuation of this impact may be accomplished through connection to community resources such as access to family counseling to mitigate relational stress and policy addressing disparities.