The role of stress and family relationships in mediating problem drinking and fathers' personal adjustment.

OBJECTIVE: To test a stress process model in which family stress (negative life events) and fathers' family system resources (marital adjustment and positive father-child relationships) were evaluated as mediators of the relationship between problem drinking (fathers' and mothers') and fathers' personal adjustment. METHOD: Structural equation modeling was used to analyze data from fathers and mothers in 93 two-parent families with early adolescent children. RESULTS: Fathers' problem drinking contributed marginally to family stress and directly to fathers' diminished personal adjustment. Family stress was related to reduced marital adjustment and personal adjustment. Mothers' problem drinking contributed only to less positive father-child relationships. CONCLUSIONS: Stress process models for fathers and mothers differ; in particular, family relationships do not appear to play a significant mediational role for fathers whereas they do for mothers. Interventions for symptomatic fathers might best concentrate on alleviating problem drinking and extrafamilial sources of stress.

Validity of children's reports of parental alcohol abuse.

Data from interviews with parents and 9-12 year old children from 303 families were used to test the validity of children's reports of parental alcoholism or problem drinking status. Children's responses to several single-item screening questions that had been used previously to identify children of alcoholics, as well as their responses to the Short Michigan Alcoholism Screening Test for each parent, were compared to parents' alcoholism diagnosis and screening test scores. In general, children's responses correctly identified only a small portion of alcoholic parents and, when all screening items were combined into a single screening tool to increase sensitivity, the false positive rate became unreasonable for most applications. The screening items were better at identifying active alcoholics than abstaining alcoholics but were also better at identifying problem drinking parents than alcoholic parents. None of the screening options tested had optimal characteristics for use in research or intervention applications.

The children of alcoholics life-events schedule: a stress scale for children of alcohol-abusing parents.

Children of alcoholic parents have been shown to be at risk for the development of mental health problems. However, there is little empirical research that would allow one to determine which of these children are most at risk. Hypothesizing that the amount of parental drinking-related stress a child experiences may be a factor that discriminates those children of alcoholics who are most at risk from others, the Children of Alcoholics Life-Events Schedule (COALES) was developed. Using samples of high-school students, the COALES was found to have satisfactory test-retest reliability, internal-consistency reliability and construct and concurrent validity. Children who self-identified as having an alcoholic parent reported higher levels of negative events and lower levels of positive events than did their peers from nonalcoholic homes. Scores on the positive- and negative-event subscales were significantly correlated with the children's scores on measures of anxiety and depression.

The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups.

To investigate the relation of child sexual abuse to depression and whether this relation differed by ethnicity (African Americans, Mexican Americans, Native Americans, and non-Hispanic whites), we surveyed 2,003 women between 18 and 22 years of age about family histories, sexual abuse, and depression. Reported rates of child sexual abuse were similar across ethnic groups; approximately one-third of each group reported some form of sexual abuse and about one-fifth of each ethnic group reported experiencing rape. After controlling for background characteristics identified as risk factors for both child sexual abuse and depression, severity of child sexual abuse was significantly related to depressive symptoms only for non-Hispanic whites and Mexican Americans. Child sexual abuse variables accounted for more variance in depression than background variables only for Mexican American women. Child physical abuse was the strongest predictor of adult depression and the only significant predictor for each ethnic group.

A mediational model of the impact of interparental conflict on child adjustment in a multiethnic, low-income sample.

Path analysis was used to determine whether the effects of interparental conflict on children's depression and conduct disorder are mediated by 3 dimensions of parenting: acceptance, inconsistent discipline, and hostile control. The study extends the literature by testing this mediational model with a low-income, predominantly ethnic minority sample of preadolescent children and by examining the effects of multiple dimensions of interparental conflict from the child's perspective. Results supported the mediational model when analyses were based on child's reports of all variables but not when mother's reports were used to assess child depression and conduct problems. Exploratory analyses revealed unique mediational paths associated with conflict frequency and resolution, which were examined along with intensity as distinct dimensions of interparental conflict.

Short-term effects of teenage parenting programs on knowledge and attitudes.

The short-term effects of teenage parenting programs upon the knowledge and attitudes of pregnant teenagers were assessed. The programs studied produced a significant change in the teenagers' knowledge of sexuality and child development while having no apparent effect on the teenagers' parenting attitudes. The implications of producing changes in knowledge without accompanying changes in attitudes are discussed.

PIP: This study evaluated the short-term impact of parenting programs that included family living and parenting education on teenagers' knowledge and attitudes. It is expected that school-based programs will have a positive effect upon the teenagers' knowledge levels. Subjects were recruited from 3 scattered, urban teenage parenting programs in Arizona. Each was part of the local school system and an alternative to attending classes with nonpregnant peers. Courses were given in family living and parenting/child development. The goals were to help the teenagers control their fertility and help them become better parents. The average age of the 31 subjects was 16.1 years; the average grade level was 10.9; the ethnic breakdown was 10% black, 42% Hispanic and 48% white. The Maternal Attitude Scale was designed to measure emotional responses to various aspects of mother-child interaction. 3 subscales used were: 1) maternal satisfaction versus feelings of depletion and hostility; 2) encouragement of positive interaction versus hostility toward children; and 3) maternal anxiety. The pretest and posttest scores showed significant increases in knowledge of child development and human reproduction. However, there were no significant changes from pretest to posttest in the attitude scores for the 3 scales.

Teenage and older mothers and their infants: a descriptive comparison.

A multivariate comparison of the childbearing and childbearing experiences of teenage and older mothers was undertaken to investigate factors assumed to be responsible for developmental deficits experienced by children born to teenage mothers. The two groups of mothers and infants were compared on demographic and socioeconomic characteristics, pregnancy and delivery experiences, neonatal status, maternal attitudes, infant temperament, and mother-infant interaction variables. The two groups were found to be quite similar on most of the variables studied. The present findings challenge much of the extant literature on teenage pregnancy and point out the need for a more detailed and objective examination of teenage childbearing and childbearing.

Maternal age, social class, and the obstetric performance of teenagers.

PIP: The purpose of the study is to examine the interaction of social class, maternal age, and obstetric and neonatal outcome. It has been widely reported that teenage mothers experience more complictions of labor and delivery as well as higher rates of prematurity and los birthweight infants than women 20-30 years old. However, a few studies have suggested that birth complications are related to social class, not mternal age. The data for this study were collected from the medical records of 2 hospitals in a large metropolitan area in the southwestern US. 1 of the hospitals handles the overwhelming majority of all births to low-income families in the area. The other hospital serves a middle class clientele. All nontwin 1st births that occurred in these 2 hospitals in 1980 to women between 15 and 30 years old were included in the data for this study. When the samples of primiparous low-income and middle-income teenagers (15019 years) were compared with samples of primiparous low-income and middle-income women (20-30 years), the reported differences by maternal age did not emerge. Instead, the results support the notion that there is a complex interaction among social class, maternal age, and obstetric performance. 1) The 4 groups of mothers differed significantly on only 5 of the 12 measures of obstetric performance or birth outcome used. 2) The widely reported differences in prematurity rate and birthweight by maternal age did not emerge, although there was a nonsignificant trend favoring the older mothers on the prematurity rate. 3) 1 or both groups of teenage mothers performed as well as, or better than, either group of older mothers on 4 of the 5 measures that differentiated the groups. 4) only the infant birthweight data exhibited a trend that favored the middle-class mothers, regardless of age group. Finally, the analysis suggests that the group most likely to be at risk was the older, low-income primiparous women. Nothing in these data support the notion that primiparous teenage mothers, per se, sould be considered an at-risk group as far as obstetric performance is concerned. Youth itself is not an accurate predictor of obstetric risk, nor does it protect mothers from the hazards of childbirth. It is suggested that risk assessment based on social class or maternal age alone is too simplistic to be useful.^ieng

A comparative study of pregnant teenagers' parenting attitudes and knowledge of sexuality and child development.

PIP: A survey was taken to determine pregnant teenagers' knowledge of sexuality and child development and their parenting attitudes relative to comparison groups. The results indicate that the knowledge and attitude base of pregnant teenagers is almost identical to that of never-pregnant teenagers. However, adult mothers scored slightly but significantly higher than the teenagers on a measure of child development knowledge and considerably lower than the teenagers on a measure of knowledge of sexuality. The results illustrate the importance of using comparison groups in studies of pregnant teenagers. The implications for sex education programs include focusing on factors beyond sexual knowledge or lack of it as an explanation for teenage pregnancy. Further research is needed on teenage values, handling of sexual information, and perception of contraceptive availability.^ieng

Some thoughts about resilience versus positive development, main effects versus interactions, and the value of resilience.

Interaction effects are the defining feature of resilience and resilience research and are responsible for the unique contributions of this field of study to our understanding of human development. The methodological and statistical challenges posed by interaction effects do not, by themselves, undermine the value of resilience as a construct.

Measurement issues in family assessment: the case of the Family Environment Scale.

The internal consistency reliabilities of 5 subscales of the Family Environment Scale were re-examined in a study of 311 stressed and 74 control families. The reliability coefficients generated were lower than those originally reported for this instrument; most coefficients generated were below the acceptable level for practical or research use, and there was considerable variation in the reliabilities across type of stressed family. An attempt to generate more reliable scales using the original items was unsuccessful, and questions about the validity of the subscales were raised. Our results illustrate the importance of examining reliabilities of instruments, even well-known and widely used instruments, for each sample studied.

Family characteristics of children who self-select into a prevention program for children of alcoholics.

Evaluated the efficacy of a self-selection recruitment process designed to attract fourth-, fifth-, and sixth-grade children into a school-based prevention program for children of alcoholics. Participants were 296 families comprising one child and either one or both parents. Family members' self- and collateral reports were used to assess parental problem drinking, family characteristics, and individual pathology. Analyses revealed that the recruitment process was not effective in recruiting children of alcohol-abusing parents. Furthermore, families in which children received parental consent to participate in the prevention program were indistinguishable from families whose children either showed interest without obtaining consent or showed no interest at all. Implications for recruitment strategies for future prevention programs for children of alcoholics are discussed.

Family characteristics as mediators of the influence of problem drinking and multiple risk status on child mental health.

Structural equation modeling was used to test a theoretical model in which family cohesion and family reframing coping were hypothesized as mediators between family drinking problems, multiple risk factors, negative life events, and child mental health (conduct disorder, depression, anxiety) in two-parent families. Family cohesion mediated the relationships of family drinking problems and negative life events to child conduct disorder and depression. Negative life events mediated the relationships of family drinking problems and family multiple risk to child conduct disorder. Family reframing coping did not function as a mediator nor was it related to child mental health when other factors were considered simultaneously. Results indicate that increasing family cohesion and reducing sources of stress within the family (negative life events) represent promising areas of interventions for children with problem-drinking parents.

Teenage parenting and child development: a literature review.

PIP: Research on teenage parenting together with medical and behavioral research related to child development is reviewed in an effort to determine causal factors related to reported developmental deficits among children of teenage parents. 4 general conclusions are suggested: 1) several researchers agree that children of teenage parents show poor social and intellectual competence when compared with children on non-teen parents. However, the amount of sound empirical data to support this view is minimal. For example, there are few published studies of the longterm effects of teenage parenting or of actual behavioral interactions of teenage mothers and their children. 2) It is unlikely that research along the lines of the "continuum of reproductive casualty" will lead to identification of causal factors sufficient to account for developmental deficits in children of teenage mothers. 3) Research along the lines of "the continuum of caretaking casualty" suggest numerous behavioral and environmental variables that may be related to the development of children of teenage mothers. 4) Research designs applied to the study of teenage parenting must shift from linear models to complex multivariate models that permit simultaneous analysis of organismic, environmental, and behavioral determinants of development. Finally, mental health specialists, government agencies, and researchers alike, must be willing to entertain the hypothesis that much of our knowledge of the childrearing skills of teenage mothers is based on myth rather than empirical fact. 1 such myth may be that below 19 years of age, maternal age in and of itself is an important determinant of infant development and parent-infant interaction. Poor social-economic status, family support systems, marital stability, nutrition and prenatal care may be far more important determinants of development for these children than the age of their mothers.^ieng

Children's self-selection into prevention programs: evaluation of an innovative recruitment strategy for children of alcoholics.

Systematically evaluated the efficacy of a self-selection strategy to recruit elementary-aged children into a school-based prevention program for children of alcoholics. Recruitment involved: a film about parental alcoholism, a follow-up meeting, and an invitation to participate in a prevention program. Of the 844 4th-6th graders exposed to recruitment, 67% showed no interest in the program, 26% attended the follow-up meeting, and 11% obtained parental permission. Analyses focused on group differences according to selection classification on measures of symptomatology and resources available to the child. Significant differences were noted on level of concern about parents' drinking, depression, conduct disorder, and self-worth. Children interested in the program tended to score higher on measures of symptomatology. The potential of a self-selection model for identifying children at risk and areas for future research are discussed.

Risk status of adolescent children of problem-drinking parents.

These studies assessed the risk status of children of untreated alcoholics. In Study 1, a cross-sectional survey of 208 high school students identified 18% as having serious concern about their parents' drinking. In Study 2, 32 children of problem-drinking parents and 39 others who participated in self-help groups were surveyed. Children of problem-drinking parents were more at risk of depression, low self-esteem, and heavy drinking than their peers in the general high school population. Within self-help groups, however, children's symptomatology was not related to their parents' drinking status. The results support the need for preventive intervention for children of problem-drinking parents and for developing strategies for improving the participation rate of such children in the intervention programs that are available.

Interpreting children's reports of concern about parental drinking: indicators of risk status?

Examined several self-report items traditionally used to identify children of alcoholics for their utility in identifying mental health risk status. The meaning of children's responses to these items was also examined. Collectively, these items reflected children's concern about their parents' drinking. Across multiple studies, children who reported concern about parental drinking reported higher levels of psychological and behavioral problems. This pattern existed whether or not children had a problem-drinking parent. Discriminant analyses with data from child and mother reports showed that children who reported concern were from homes with greater stress, lower income, and less supportive mother-child relationships.

A dispositional and situational assessment of children's coping: testing alternative models of coping.

Dispositional and situational measures of children's coping were developed using a theoretically based approach. Two studies (N1 = 217; N2 = 303) assessed the psychometric characteristics of these measures in fourth- through sixth-grade children. Confirmatory factor analyses indicated that a four-factor model of dispositional coping (active, distraction, avoidant, and support seeking) provided a better fit to the data than either the problem- versus emotion-focused (Lazarus & Folkman, 1984) or passive versus active (Billings & Moos, 1981) coping models. The four-factor model was largely invariant with respect to age and gender. Moderate to high correlations were found between the parallel subscales of the dispositional and situational measures of coping. Although the four factor structures of the dispositional and situational measures were generally similar, factor loadings and correlations between dimensions were not equivalent.

Development of a school-based prevention program for children in alcoholic families.

The systematic development of a preventive intervention for elementary-aged children of alcoholics (COAs) is described. First, the risk status of children of untreated alcoholics was established. Second, risk and protective factors that appeared to be mediators of mental health status for COAs were identified. Third, a preventive intervention was designed to teach coping skills and enhance self-esteem. Fourth, the intervention was pilot tested to assess its feasibility and potential. Finally, plans for a large scale experimental field trial of the revised curriculum are outlined. The advantages of following a systematic intervention development plan are demonstrated.

Do coping styles differ across sociocultural groups? The role of measurement equivalence in making this judgment.

Cross-sociocultural group measurement equivalency is an important issue that generally has not been studied in the coping literature. Measurement equivalency of the COPE (Carver, Scheier, & Weintraub, 1989) was assessed across two sociocultural groups, a sample of 100 Anglo middle-class divorced mothers and a sample of 122 low-income Mexican American/Mexican immigrant mothers. A series of restrictive confirmatory factor analyses revealed that seven of the COPE's subscales may be measuring the same underlying construct across populations. However, scores derived from the subscales may not represent the same magnitude of the construct in these two groups. This study makes an important first step in furthering the understanding of coping strategies in low-income Mexican American/Mexican immigrant mothers. This study also illustrates the importance of testing for measurement equivalency before conducting comparative research in disparate populations.