Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care: A Randomized Clinical Trial using the Family Check-Up.

This study evaluated acceptability, engagement in prevention, and efficacy of a primary care screening-and-referral-to-prevention program to reduce substance use in early adolescence. Screening tools were the Youth Risk Index and Transmissible Liability Index and prevention consisted of the Family Check-Up (FCU). Three hundred sixty-one 10- to 13-year-olds from low resource neighborhoods (85.9% African American; 52.4% female) screened "at risk" during primary care visits and were randomized to the FCU (n = 123) or usual care (n = 238). Screening was acceptable to parents and youths: nearly 95% of each rated it as important, about 90% of each were happy with or did not mind it, and only 2.4% of parents did not want their child to be screened at their next check-up. Of parents who had a chance to receive the FCU (or waitlist-control), 87.5% followed through with researchers while 93.5% who were offered FCU engaged in it. FCU efficacy primarily involved interactions such that youth with greater risk at baseline experienced larger benefits. At 12-month follow-up, FCU was associated with 11% reduced risk of initiating a new substance per substance that had been initiated before baseline; greater reductions in tolerance of deviance among those with higher tolerance of deviance at baseline; and a main effect of reduced anxiety, but no effect for conduct problems. Pediatric well-child check-up screening can identify high-risk youth before, or in the initial stages of, problematic SU; engage families in a preventive intervention; and reduce rates of substance use and related risk factors.

Socialization of Emotion and Offspring Internalizing Symptoms in Mothers with Childhood-Onset Depression.

This study examines how mothers with and without a history of childhood-onset depression respond to their 3-9 year-old children's emotions. Mother-child dyads included 55 offspring of mothers with a history of childhood-onset depressive disorders and 57 offspring of never-depressed mothers. Mothers with a history of childhood depression were less likely than were control mothers to respond in supportive ways to their children's negative emotions and were more likely to magnify, punish, or neglect their children's negative emotions. Magnification, neglect, and punishment of children's negative emotions were concurrently associated with children's internalizing symptoms, and neglect and punishment were associated with internalizing over a one year follow-up. Maternal neglect of children's negative emotion was positively associated with later internalizing symptoms for children who already had higher internalizing symptoms at the initial assessment. Findings suggest that atypical socialization of emotion may be one mechanism in the development of internalizing disorders.

Young adolescent sleep is associated with parental monitoring.

OBJECTIVES: Insufficient sleep can increase risk for adverse psychological and physical outcomes. Parental monitoring of daily activities is associated with youth health behaviors. We examined parental monitoring of waking and bedtime behaviors and sleep in a community sample of high-risk youth. METHODS: One-hundred sixty-five 10- to 14-year-olds from low-socioeconomic status families participated (11.8 years ±1.16, 52% female; 78% Black/African American). Parents and youth evaluated parental monitoring of waking activities. Parent expectations about bedtime and parent knowledge about adolescent's bedtime and sleep routine were independently rated. Youth sleep was assessed via parent report and actigraphy over 7 days. RESULTS: More parental knowledge about bedtime was associated with longer parent-reported sleep duration (ß = .18, P < .05). Parental monitoring of waking activities (youth reported) was associated with more actigraph-assessed sleep over 7 days (B = 2.73, SE = .91), weekdays (B = 2.44, SE = .01), and weekends (B = 3.88, SE = .1.41, all Ps < .05), whereas parent reported monitoring was associated with more sleep on weekdays only (B = 2.10, SE = .87, P < .05). Parental knowledge and expectations about bedtime behaviors were not associated with actigraph-assessed sleep (P values > .05). Parental monitoring of waking and bedtime behaviors was not associated with sleep duration variability (P values > .05). CONCLUSIONS: Parental monitoring of waking activities may indirectly influence adolescent sleep via increased structure and felt security in the parent-adolescent relationship. Youth perception of monitoring may be particularly relevant for youth sleep duration.

Emotion regulation in preschoolers: the roles of behavioral inhibition, maternal affective behavior, and maternal depression.

BACKGROUND: This study examined preschoolers' emotion regulation (ER) strategies and the association with temperament, maternal interactive style, and maternal history of childhood-onset depression (COD). METHODS: Participants were 62 children and their mothers, 37 of whom had mothers with COD. Children's ER was assessed using a disappointment paradigm; temperament assessment also was laboratory-based. RESULTS: Maternal COD was inversely related to offspring's active ER and positive mood. Among children of COD mothers, behavioral inhibition was associated with passive regulation and sadness, and maternal positivity toward these children was associated with child active ER and positive mood. CONCLUSION: Behavioral inhibition may place children of COD mothers at risk for developing maladaptive ways of regulating negative emotion, whereas mothers' positivity may serve as a protective factor for them.