The relation between behavioral problems and social competence: A correlational Meta-analysis.

BACKGROUND: Previous studies have shown that children who display behavioral problems also tend to display low social competence. The relation does however vary according to type of behavior being measured, as well as demographic characteristics of the respondent. The present meta-analysis examined the correlation between different types of behavioral problems and social competence among children aged 3-13, and investigated possible moderators in this relation. METHODS: A systematic literature search was conducted for English language studies from January 2008 to January 2018 that reported correlations between three types of behavioral problems (i.e., externalizing behaviors, conduct problems, or aggression) and two types of social competence (i.e., social competence or social skills). The studies included reports from parents and teachers, or both as a dyad. The review included data from 54 independent studies and a total of 46,828 participants. Effect sizes were estimated using a random effects approach and moderator analyses between subsets of categorical variables were tested by the significant Q test. RESULTS: Results showed an overall correlation between behavioral problems and social competence of medium effect size (r = -.42, p < .01). Moderation analyses indicated no significant differences for different types of behavioral problems or social competence. However, a significant difference was found with regard to type of respondent; the correlation was significantly higher when both measures were reported by the same respondent (teacher or parent) compared to when measures were reported by parent-teacher as a dyad. CONCLUSIONS: Findings summarized and quantified a robust negative correlation between behavioral problems and social competence. The results indicate that intervention programs targeting problem behaviors in children would benefit from reducing behavioral problems and in concert, increase social competence to help children with emerging or present problem behaviors.

General and specific factors of working alliance in parent training: A bifactor exploratory structural equation modelling approach.

The Working Alliance Inventory Short form (WAI-S) comprises 12 items that measure 3 subdomains (goal, task, and bond). In the present study, we evaluated the factor structure of WAI-S in a parent management training (PMT) context, by investigating a series of different factor models, including standard confirmatory factor analyses (CFA) models and more recent alternatives, like the exploratory structural equation model (ESEM), the bifactor-CFA, and the bifactor exploratory structural equation model (B-ESEM). The study sample consisted of 259 Norwegian parents receiving PMT - the Oregon model (PMTO). Alliance was rated by parents of children with emerging or present conduct problems after the first therapy session. Results showed that the B-ESEM model provided best model fit to the data. Estimated sources of variance and omega reliabilities supported a strong general alliance factor, but revealed poor quality of the specific factors. Overall, the present study implies that specific factors of working alliance should be interpreted with caution; rather one should rely on a general working alliance construct. Clinical or methodological significance of this article: Findings suggest that working alliance, as measured by WAI-S in a PMT context, is best reflected by a general construct that also take into account multidimensionality. However, only the general factors provide acceptable reliability. Consequently, practitioners should use the specific factors with caution. The indicators of the specific factors should be improved.

Dimensionality of oppositional defiant disorder.

BACKGROUND: The present study examined dimensionality of oppositional defiant disorder (ODD) using 10 alternative items using network analysis and confirmatory factor analysis. METHODS: The sample constituted 551 Norwegian children aged 2-12 and their parents. We used network analysis to investigate the connections between different symptoms. Next, we analysed data using traditional confirmatory factor methods, including the more recently proposed bifactor approach. RESULTS: The bifactor model, with a strong general factor and three specific factors, provided the best model fit. Omega values did, however, reveal that only the general and the specific hurtful factor had satisfactory reliability. Network analysis showed that symptoms in general were positively connected within the ODD network. Strong connections between several symptoms within the irritable and hurtful cluster emerged, whereas some symptoms of the headstrong cluster seem to function as bridge nodes between the irritable and hurtful symptom clusters. CONCLUSIONS: The findings support a bifactor model of ODD indicators, but omegas only gave support to the use of a general latent factor, and one specific factor. Network analysis did, however, provide some additional and interesting findings, revealing clusters of strongly connected symptoms and central bridge node symptoms. Implications of the results are discussed.

The Eyberg Child Behavior Inventory: Factorial invariance in problem behaviors across gender and age.

The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widely used instrument in both clinical work and research. Evidence suggests that the short ECBI version, comprising 22 items, can be reduced into the three oblique factors: Oppositional defiant behavior; Conduct problem behavior; and Inattentive behavior. The present study aimed to evaluate this three-factor model in a Norwegian sample of 554 children, and examine multi-group invariance across gender and age. Consistent with previous research, results confirmed a tripartite model, with the same residual covariances and cross-loading appearing across groups. Multi-group confirmatory factor analysis demonstrated partial measurement invariance across gender and age. Overall, findings support a meaningful comparison of the short ECBI across gender and age. The study makes a contribution to the generalizability issue of the ECBI.

The short Working Alliance Inventory in parent training: Factor structure and longitudinal invariance.

OBJECTIVE: The purposes of the present study were twofold: (a) to examine the factor structure of the Working Alliance Inventory, Short (WAI-S) and (b) to investigate if factor loadings and thresholds fulfilled properties of longitudinal measurement invariance across two waves of data. METHOD: The study sample consisted of 259 Norwegian parents receiving Parent Management Training, the Oregon model. Parents rated alliance at sessions 3 and 12 during the therapy. Confirmatory factor analyses to assess the fit of a one-, two-, and three-factor model were performed using robust weighted least squares estimation for categorical indicators. RESULTS: The results showed that data provided best fit for the three-factor solution with goal, task, and bond. Furthermore, results demonstrated satisfactory invariance for factor loadings and thresholds across time. CONCLUSIONS: Overall, the results indicate that the WAI-S three-factor solution has acceptable psychometric properties for longitudinal measurement comparisons.

A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth.

The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age = 15.1 years, range = 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. = 5.78, d = 0.51), 95% CI [2.32, 9.23]; depression (est. = 7.00, d = 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. = 2.54, d = 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. = -1.05, d = -0.55), 95% CI [-1.67, -0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. = 4.34, d = 0.30), 95% CI [-1.50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, χ(2)(1, N = 116) = 4.61, p = .031, Phi = .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.

Assessing social competence and antisocial behaviors in children: item response theory analysis of the home and community social behavior scales.

BACKGROUND: The Home and Community Social Behavior Scales (HCSBS) is a rating scale that assesses social competence and antisocial behavior among children and youths between ages 5-18. The present study aimed to investigate the psychometric properties of the HCSBS by applying item response theory (IRT). METHODS: The HCSBS was completed by parents of 551 Norwegian children refereed to three independent interventions towards problem behaviors. Data used in this study was collected before the interventions started. IRT was carried out in R version 4.0.0 to investigate HCSBS items, subscales and main scales. RESULTS: The results showed that the two-dimensional IRT models for social competence and antisocial behavior were the most appropriate. The measurement precision of the scales was high for a large range of the latent spectrum, and estimated reliabilities were satisfactory. Model evaluations indicated that the overall model fit for the scales were acceptable, but some misfit existed with respect to specific item pairs. CONCLUSION: The results indicate that the HCSBS is a reliable measurement instrument although there is still a potential for improvement by revising some of the items.

Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women.

BACKGROUND: Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. METHODS: The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression. RESULTS: Women who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models. CONCLUSIONS: The likelihood of attendance in an organized screening program was higher among women who were aware of cervical screening, which suggests a potential for a higher attendance rate through improving the public knowledge of screening. Further, the lower awareness among opportunistic than reminded attendees suggests that physicians may inform their patients better when smears are taken at the physician's initiative.

The dimensionality of posttraumatic stress symptoms and their relationship to depression in children and adolescents.

The aims of the study were twofold: to investigate 6 different factor structures in posttraumatic stress symptoms using confirmatory factor analyses with polychoric correlations, and to examine to what extent posttraumatic stress disorder (PTSD) is different from depression. The study was based on a clinical sample of 312 children and adolescents 10 to 18 years old who had experienced different types of traumatic events. Results showed that 3 out of the 6 models demonstrated good fit, but the dysphoria model provided the best fit to the data. Furthermore, correlations between depression and subscales of the dysphoria and numbing models provided additional support for the dysphoria model.

An examination of validity and reliability of the Parental Stress Scale in a population based sample of Norwegian parents.

The parental stress scale (PSS) is a widely used instrument that assesses stress related to child rearing. Even though several studies have investigated the construct validity and reliability of the PSS, no consensus has been reached regarding which and how many of the original eighteen items that should be included, or a robust factor structure with satisfactory reliability. The present study tested the psychometric properties of the Norwegian version of the PSS and used the advantages of complementary exploratory and confirmatory factor analyses to investigate the underlying factor structure of the PSS items. Data stem from a community sample of 1096 parents from five counties in Norway with a one-year-old child. The sample was randomly split (N = 553/543), and exploratory and confirmatory analyses were performed on each of the samples. Using predefined criteria for the selection of robust items, results revealed a two-dimensional structure (Parental stressors and Lack of rewards) across 13 PSS items, displaying satisfactory reliability. Network analyses revealed differential associations within item constellations and with covariates. Implications of the findings and study limitations are discussed.

A Reexamination of Child Problem Behaviors as Measured by ECBI: Factor Structure and Measurement Invariance Across Two Parent Training Interventions.

The Eyberg Child Behavior Inventory (ECBI) is a widely used instrument that assesses disruptive problem behaviors via parent report. The present study compares three different conceptualizations of problem behaviors using traditional confirmatory factor analysis (CFA), a bifactor-CFA, and a bifactor exploratory structural equation model, whereof the latter two represent novel conceptualizations of disruptive problem behaviors. Data were derived from 353 Norwegian parents assigned to parent management training-the Oregon model (PMTO; N = 137) or brief parent training (BPT; N = 216), who rated their child's problem behavior (age 3-12 years). The factor models were estimated within the PMTO and BPT samples, and in the total sample. Results showed that the bifactor-CFA, with a general problem behavior factor and three specific factors representing oppositional defiant, conduct problem, and inattentive behavior provided the best model fit. Furthermore, factorial invariance across control/intervention groups and across time (pre/post intervention) was estimated within the PMTO and BPT samples. Results revealed properties of metric and intercept invariance across intervention/control groups and over time, within both interventions. Implications of the results are discussed.

Latent interaction effects in the theory of planned behaviour applied to quitting smoking.

OBJECTIVES: This study applies three latent interaction models in the theory of planned behaviour (TPB; Ajzen, 1988, Attitudes, personality, and behavior. Homewood, IL: Dorsey Press; Ajzen, 1991, Organ. Behav. Hum. Decis. Process., 50, 179) to quitting smoking: (1) attitude × perceived behavioural control on intention; (2) subjective norms (SN) × attitude on intention; and (3) perceived behavioural control × intention on quitting behaviour. METHODS: The data derive from a longitudinal Internet survey of 939 smokers aged 15-74 over a period of 4 months. Latent interaction effects were estimated using the double-mean-centred unconstrained approach (Lin et al., 2010, Struct. Equ. Modeling, 17, 374) in LISREL. RESULTS: Attitude × SN and attitude × perceived behavioural control both showed a significant interaction effect on intention. No significant interaction effect was found for perceived behavioural control × intention on quitting. CONCLUSIONS: The latent interaction approach is a useful method for investigating specific conditions between TPB components in the context of quitting behaviour. Theoretical and practical implications of the results are discussed.

Diagnostic utility of CPSS vs. CAPS-CA for assessing posttraumatic stress symptoms in children and adolescents.

OBJECTIVES: This study compared the diagnostic utility of the symptom part of the child PTSD symptom scale (CPSS) screening instrument with the clinician-administered PTSD scale for children and adolescents (CAPS-CA). METHODS: The study included a clinical sample of traumatized children and adolescents (mean age 15.1, range 10-18) living in Norway, who were assessed for posttraumatic stress symptoms using the CPSS and the CAPS-CA. Diagnostic utility was investigated using receiver operating characteristic analyses. RESULTS: The results showed that CPSS reached medium effect sizes (AUC from .63 to .76). The sensitivity was good (.80), but the specificity was relatively low (.56). Kappa between CPSS and CAPS-CA was low (κ=.27). CONCLUSIONS: Findings suggests that CPSS is a good tool for screening purposes, but not as a diagnostic instrument in an early phase of assessment. Implications and limitations of the findings are discussed.

Working alliance and treatment fidelity as predictors of externalizing problem behaviors in parent management training.

OBJECTIVE: The study investigated treatment fidelity and working alliance in the Parent Management Training-Oregon model (PMTO) and investigated how these relate to children's externalizing problem behaviors, as reported by parents and teachers. METHOD: Participants were 331 Norwegian parents who rated the client-therapist working alliance at 3 time points (Sessions 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions using the Fidelity of Implementation (FIMP) system (Knutson, Forgatch, & Rains, 2003). Parents and teachers reported children's problem behaviors at baseline and at the end of therapy. Structural equation modeling was used to analyze the repeated measures data. RESULTS: Parents reported high and stable levels of alliance and fidelity from Time 1 to Time 3, with no correlational or direct relations between the 2. Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. CONCLUSIONS: The findings point to treatment fidelity as an active ingredient in PMTO and working alliance as a negative predictor of postassessment parent-reported externalizing behavior. More research is needed to investigate whether these findings can be replicated and extended beyond PMTO.

A randomized trial of group parent training: reducing child conduct problems in real-world settings.

OBJECTIVE: Group-based Parent Management Training, the Oregon model (PMTO, 12 sessions) was delivered by the regular staff of municipal child and family services. PMTO is based on social interaction learning theory and promotes positive parenting skills in parents of children with conduct problems. This study examined the effectiveness of the group-based training intervention in real world settings both immediately following and six months after termination of the intervention. METHODS: One hundred thirty-seven children (3-12 years) and their parents participated in this study. The families were randomly assigned to group-based training or a comparison group. Data were collected from parents and teachers. RESULTS: The caregiver assessments of parenting practices and child conduct problems and caregiver and teacher reported social competence revealed immediate and significant intervention effects. Short- and long-term beneficial effects were reported from parents, although no follow-up effects were evident on teacher reports. CONCLUSIONS: These effectiveness findings and the potential for increasing the number of families served to support the further dissemination and implementation of group-based parent training.

Using the Prototype/Willingness model to predict smoking behaviour among Norwegian adolescents.

This paper examines cognitive antecedents of non-smoking among adolescents who reported smoking less than 1-2 times a week, and reported non-smoking intentions and willingness, in the framework of the Prototype/Willingness model. Two waves of data were obtained from a nation-wide sample of 760 Norwegian adolescents who responded to a school-based survey on smoking. Structural equation modelling was used to evaluate the predictive power of the social reaction pathway (prototype and willingness) of the P/W model, and in addition, the constructs from the Theory of Reasoned Action (subjective norm, attitude and intention). Results demonstrated the unique importance of the social reaction path when examining smoking behaviour among non-smoking adolescents. Implications of the findings and possible applications are discussed.