Co-regulation and parenting stress over time in full-term, very low birthweight preterm, and psycho-socially at-risk infant-mother dyads: Implications for fostering the development of healthy relationships.

From birth, mothers and infants co-regulate their interactions that are shaped by their socio-emotional development, relationship history, current circumstances, and goals. However, few studies have longitudinally explored co-regulation in the context of medical and psycho-social risk. The present 4-wave longitudinal study sought to shed light on factors associated with co-regulation over time in infants from 6- to 48-months. The objectives were to 1) identify differences in co-regulation among low- and at-risk infant-mother dyads, 2) explore changes in co-regulation over time, and 3) explore the associations between infant-mother co-regulation and parenting stress in these low- and at-risk groups over time. Participants included three groups of infant-mother dyads (full-term [FT], n = 48; very low birthweight/preterm [VLBW/preterm] born 26-32 weeks, weighing 800-1500 g, n = 61; psycho-socially at-risk where parents had histories of socioeconomic disadvantage, n = 54) followed longitudinally at 6-, 12-, 18-, and 48-months of age. Dyads engaged in a free play in their homes that was coded for co-regulation using Fogel, de Koeyer, Secrist, Sipherd, Hafen, and Fricke's (2003) Revised Relational Coding System (RRCS), and mothers reported on their level of parenting stress. Results from MANOVAs at each time point indicated significant differences between the groups at 18-months, with psycho-socially at-risk dyads engaging in more one-sided interactions than FT and VLBW/preterm dyads, and more dysregulation and miscommunication than VLBW/preterm dyads. Multi-level models of co-regulation revealed that dyads became progressively less synchronous from 6- to 12-months, followed by greater synchrony and mutual reciprocity from 12-months onwards. Parenting stress was associated with less synchrony and less mutual reciprocity amongst the at-risk groups. Maternal education was associated with greater engagement and girls tended to engage in more synchronous interactions than boys. Our results underscore the value and implications of considering background risk and concurrent parent perceptions in the development and reciprocity of parent-infant co-regulation and their subsequent relationships from infancy onwards.

Majority language skill, not measures of bilingualism, predicts executive attention in bilingual children.

Evidence is mixed regarding whether and why bilingual children might be advantaged in the development of executive functions. Five preregistered hypotheses regarding sources of a bilingual advantage were tested with data from 102 Spanish-English bilingual children and 25 English monolingual children who were administered a test of executive attention, the flanker task, at 7, 8, and 9 years of age. Measures of the children's early and concurrent bilingual exposure and their concurrent English and Spanish skill were available from a larger longitudinal study in which these children participated. Tests of the preregistered hypotheses yielded null findings: The bilingual children's executive attention abilities were unrelated to their amount of early exposure to mixed input, to balance in their early dual language exposure, to balance in their concurrent exposure, to their degree of bilingualism, or to their combined Spanish + English vocabulary score. English vocabulary score was a positive significant correlate of executive attention among the bilingual children, but those bilingual children above the group median in English vocabulary did not outperform the monolingual children when the comparison was adjusted for nonverbal IQ. These findings suggest that a language learning ability may explain the association between bilingualism and executive function. Because the best statistical approach to testing for effects on differences is a matter of dispute, all analyses were conducted with both a difference score and a residual gain score as the outcome variable. The central findings, but not all findings, were the same with both approaches.

Who Cares? Preferences for Formal and Informal Care Among Older Adults in Québec.

Policy makers, practitioners, and scholars are increasingly examining the types of care services (formal vs. informal) offered to older adults. This study evaluates predictors of these adults' preferences for care types in Québec, Canada, based on a province-wide survey inserted in a magazine of the largest seniors' club in Canada (FADOQ). More than twice as many respondents indicated a preference for formal rather than informal care. Multinomial logistic regressions demonstrate that older adults' past and current experiences and perceptions of formal and informal services continue to play an important role in their preference formation regarding care services. The study determined that preferring informal care is significantly more prevalent when one is accustomed to this type of care, and that men are significantly more likely to prefer informal care than women, and that lower-income individuals are less likely to favor formal care.

A genetically-controlled, cross-lagged study of the association between friends' deviance and participants' delinquency during adolescence: A replication.

The goal of the present study was to replicate Burt et al. (2009) and Hou et al. (2013) findings by determining the contribution of peers' deviance to changes in participants' (monozygotic [MZ] twins') self-reported delinquency from mid- to late adolescence while controlling for possible gene-environment correlations (rGE) through the use of the cotwin method in the context of a cross-lagged design. Two separate samples were used to this purpose. The first sample included 289 MZ-twin pairs (48.42% female; 65.5% of European descent, 21.7% of African descent, 12.8% other; average age at first assessment = 16.20 years) and relied on perceived measures of peer deviance, as in the two original studies. The second sample comprised 181 MZ-twin pairs (50.67% female; 84% of European descent, 3% of African descent, 2% of Asian descent, 2% Native North Americans, and 9% unspecified; average age at first assessment = 13.05 years) and used direct measures to assess peers' deviance. Participants in the first sample were part of a large representative sample of American adolescents, whereas the second sample included families with twins born in a large Canadian city. Results showed that within-pair differences in self-reported delinquency were stable from midadolescence to late adolescence in both samples. As in Burt et al. (2009) and Hou et al. (2013) within-pair differences in peer deviance did not predict changes in within-pair differences in self-reported delinquency in both samples (i.e., no socialization effect). In contrast to Burt et al. (2009) and Hou et al. (2013), however, we found no predictive link from twins' self-reported delinquency to peers' deviance (i.e., no selection effect). Finally, as in Burt et al. (2009) we found that peers' deviance was stable from middle to late adolescence and that peers' deviance and participants' delinquency were cross-sectionally correlated in the first sample, but not in the second sample. These results are interpreted in the context of the ongoing debate in regard to peers' socialization vs selection effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Revisiting the hypothesis that friends buffer against diminished self-esteem arising from poor quality parent-adolescent relationships: A replication study.

This replication study revisited conclusions from 2 previous investigations (Gauze, Bukowski, Aquan-Assee, & Sippola, 1996; van Aken & Asendorpf, 1997), which suggested that support from friends buffers against diminished self-esteem arising from poor quality relationships with mothers during the transition into adolescence. The aim of this replication study was to conduct an independent test of these findings with both concurrent and longitudinal data. Concurrent data for replication analyses were drawn from 4 projects, involving a total of 959 boys and 1,119 girls (ages 10 to 14) from Canada and the United States. Three samples reported participant ethnic descent: Africa (12.1%), Asia (5.6%), Europe (65.3%), Latin America (12.1%), and Native North America (0.9%). Child and mother reports of mother-child relationship quality assayed (a) maternal social support (in 3 data sets), and (b) family cohesion and adaptability (in 2 data sets). Main effects were replicated but hypothesized buffering effects were not. Maternal social support and friend social support were independently associated with adolescent self-esteem, concurrently, but not longitudinally. Family cohesion (but not adaptability) was associated with adolescent self-esteem, concurrently and longitudinally. Friend social support did not moderate associations between mother-child relationship quality and adolescent self-esteem, concurrently or longitudinally. The findings are consistent with a cumulative effects model wherein friends uniquely contribute to adolescent self-worth, over and above the contribution of mothers. The findings do not support claims that friends moderate associations between mother-child relationship quality and adolescent self-esteem. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Crisis Facing Older People Living with Neurodiversity and Their Aging Family Carers: A Social Work Perspective.

This commentary addresses barriers to care among older adults living with neurodiversity (ND), and their aging family carers in the context of the COVID-19 pandemic in Canada. Factors contributing to inequities are described and the significant negative consequences of current policy decisions on the social and mental health of older adults with ND and their aging family carers are highlighted. The commentary calls for a collective social work response that highlights the critical role of support and advocacy necessary to redress social exclusion.

Conflict Resolution and Emotional Expression in Mother-Preadolescent Dyads: Longitudinal Associations with Children's Socioemotional Development.

How youth learn to manage emotions during mother-child conflict influences their socioemotional development. Ninety-four mother-preadolescent (aged 9-13, 57.4% female) dyads were observed during conflict discussions and completed questionnaire measures at one prior time-point (Time 1; ages 6-10) and one subsequent time-point (Time 3; ages 11-16) to the observations (Time 2). The temporal associations between individuals' emotional expressions and their own and their partners' verbal conflict behaviors were observed. Mothers and preadolescents were more attacking and assertive when angry, and more conciliatory and avoidant when sad. Neutral affect predicted the most constructive behaviors, while positive affect promoted avoidance. The responses were similar following their partners' emotions. Maternal conflict-escalating responses to anger were associated with difficult characteristics in earlier childhood and socioemotional difficulties in adolescence. Maternal and child de-escalation following sadness predicted socioemotional adjustment in adolescence. These results demonstrate that conflict resolution between preadolescents and their mothers is influenced by the emotional climate of the interaction, and that the management of negative emotions within the dyad is tied to youth's socioemotional development.

An exploratory analysis of the association of circadian rhythm dysregulation and insomnia with suicidal ideation over the course of treatment in individuals with depression, insomnia, and suicidal ideation.

STUDY OBJECTIVES: Sleep disturbance is significantly associated with suicidal ideation. However, the majority of past research has examined the relationship between insomnia and suicidality. The current exploratory study examined the relationship of circadian rhythm dysregulation (eveningness, seasonality, and rhythmicity) with suicidality. METHODS: We examined the association of insomnia, eveningness, seasonality, and rhythmicity with suicidal ideation in 103 participants with depression, insomnia, and suicidality within a larger 8-week double-blinded randomized control trial primarily examining whether cautious use of zolpidem extended-release or placebo reduced suicidal ideation. All participants additionally received an open-label selective serotonin reuptake inhibitor. Methodological strengths of the current analyses included consideration of multiple sleep-wake constructs, adjustment for relevant covariates, investigation of relationships over the course of treatment, and use of both self-report measures and objective measurement with actigraphy. RESULTS: Over the course of treatment, self-reported eveningness and greater insomnia severity were independently correlated with greater suicidal ideation, whereas actigraphic delayed sleep timing was related to suicidal ideation at a trend level. At the end of treatment, those with greater suicidal ideation demonstrated lower actigraphic activity levels. There were no significant relationships between self-reported seasonality and actigraphic measures of sleep disturbance and suicidality. CONCLUSIONS: Self-reported delays in sleep timing, objectively lower activity levels, and self-reported insomnia severity correlated independently with greater suicidal ideation in those with depression, insomnia, and suicidality. These exploratory findings highlight the need to consider sleep-wake constructs more broadly in those with suicidality in future research studies in order to improve more definitively both assessment and intervention efforts. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Reducing Suicidal Ideation through Insomnia Treatment; URL: https://clinicaltrials.gov/ct2/show/NCT01689909; Identifier: NCT01689909 Rumble ME, McCall MV, Dickson DA, Krystal AD, Rosenquist PB, Benca RM. An exploratory analysis of the association of circadian rhythm dysregulation and insomnia with suicidal ideation over the course of treatment in individuals with depression, insomnia, and suicidal ideation. J Clin Sleep Med. 2020;16(8):XXX-XXX.

Predicting psychosis-spectrum diagnoses in adulthood from social behaviors and neighborhood contexts in childhood.

Research showing that risk for schizophrenia, bipolar disorder with psychosis, and other psychosis-spectrum diagnoses in adulthood is multidetermined has underscored the necessity of studying the additive and interactive factors in childhood that precede and predict future disorders. In this study, risk for the development of psychosis-spectrum disorders was examined in a 2-generation, 30-year prospective longitudinal study of 3,905 urban families against a sociocultural backdrop of changing economic and social conditions. Peer nominations of aggression, withdrawal, and likeability and national census information on neighborhood-level socioeconomic disadvantage in childhood, as well as changes in neighborhood socioeconomic conditions over the lifespan, were examined as predictors of diagnoses of schizophrenia, bipolar disorder, and other psychosis-spectrum disorders in adulthood relative to developing only nonpsychotic disorders or no psychiatric disorders. Individuals who were both highly aggressive and highly withdrawn were at greater risk for other psychosis-spectrum diagnoses when they experienced greater neighborhood disadvantage in childhood or worsening neighborhood conditions over maturation. Males who were highly aggressive but low on withdrawal were at greater risk for schizophrenia diagnoses. Childhood neighborhood disadvantage predicted both schizophrenia and bipolar diagnoses, regardless of childhood social behavior. Results provided strong support for multiple-domain models of psychopathology, and suggest that universal preventive interventions and social policies aimed at improving neighborhood conditions may be particularly important for decreasing the prevalence of psychosis-spectrum diagnoses in the future.

Math interest and self-concept among latino/a students: Reciprocal influences across the transition to middle school.

INTRODUCTION: Psychological factors like math interest and self-concept typically decline between late childhood and early adolescence; both are key to math achievement. The present study examined the reciprocal interplay between math interest and self-concept across the transition into middle school, and whether associations are moderated by success attributions. METHODS: A total of 263 (120 boys, 143 girls) Latino students (Mage = 10.5 years at outset) from an agricultural community in California (USA) completed surveys at three time points, from the end of primary school to the first year of middle school. Surveys measured math self-concept and math interest, as well as attributions to success in math. Cross-lagged panel models examined possible bidirectional associations between math self-concept and math interest, and whether attributions of success moderated these association. RESULTS: Lower initial levels of math self-concept anticipated greater declines in math interest, an association that was buffered by attributions of math success. The smallest declines in math interest occurred among adolescents who had both the highest math self-concept and were most inclined to attribute success in math to internal factors like studying. These associations remained when potential confounding variables (e.g., school grades, conduct problems) were included. CONCLUSION: The results replicate, in an understudied sample of Latino/a youth, the oft-reported link from low math self-concept to declining interest in math. Unique to this study is evidence of the protection afforded by belief in the efficacy of studying. The findings offer important guidance for teachers and parents seeking to mobilize resources for underperforming students.

Longitudinal interplay between gambling participation and substance use during late adolescence: A genetically-informed study.

Substance use and gambling participation during adolescence are correlated, both concurrently and over time. It is unclear, however, whether this association can be explained by common underlying genetic vulnerabilities or environmental factors. The present study explored the concurrent and longitudinal associations between substance use and gambling participation and their genetic and environmental underpinnings by late adolescence. Participants were 373 pairs of monozygotic and dizygotic twins. Self-reports of substance use and gambling participation were collected at Ages 17 and 19 years. Results showed concurrent associations between substance use and gambling participation as well as a small, but significant unidirectional longitudinal association over time from substance use to gambling participation. Common genetic factors largely accounted for the concurrent associations at Ages 17 and 19, as well as for the unidirectional longitudinal association between substance use and gambling participation. Substance use and gambling participation share a common genetic component that account for most of their concurrent and longitudinal links during late adolescence. However, these behaviors are also influenced by specific environmental factors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Derisive Parenting Fosters Dysregulated Anger in Adolescent Children and Subsequent Difficulties with Peers.

Bullying and victimization are manifest in the peer social world, but have origins in the home. Uncertainty surrounds the mechanisms that convey problems between these settings. The present study describes the indirect transmission of hostility and coercion from parents to adolescent children through emotional dysregulation. In this model, derisive parenting-behaviors that demean or belittle children-fosters dysregulated anger, which precipitates peer difficulties. A total of 1409 participants (48% female; Mage = 13.4 years at the outset) were followed across secondary school (Grades 7-9) for three consecutive years. The results indicated that derisive parenting in Grade 7 was associated with increases in adolescent dysregulated anger from Grade 7 to 8, which, in turn, was associated with increases in bullying and victimization from Grade 8 to 9. The findings suggest that parents who are derisive, have children who struggle with emotional regulation and, ultimately, with constructive peer relationships.

The role of change in self-criticism across young adulthood in explaining developmental outcomes and psychological wellbeing.

OBJECTIVE: Past research has confirmed the role of self-criticism in numerous forms of psychopathology and negative interpersonal outcomes. However, the majority of these studies were cross-sectional and have not addressed the role of possible changes in self-criticism across time for future outcomes. The current study investigated the degree to which changes in self-criticism during young adulthood precede better psychological outcomes beyond the contribution of their baseline levels. METHOD: A total of 168 Israeli emerging adults were followed for 12 years. Participants completed assessments of self-criticism at age 23, 24, 26.5, and 29, and of developmental tasks and psychological adaptation at age 35. Analyses assessed the extent to which the intercept and linear slope of self-criticism were associated with assessments of coping with age-related tasks and psychological well-being at age 35. RESULTS: Findings indicated that decreases in self-criticism between the ages of 23 and 29 were associated with better coping with age-related task outcomes and psychological health at age 35. CONCLUSIONS: These findings are among the first to show that decreases in self-criticism serve as important precursors of coping with age-related tasks and psychological outcomes and point to the positive contributions of changes in personality attributes for future development.

Maternal Emotion Socialization Mediates the Relationship between Maternal and Adolescent Negative Emotionality.

Parents and children with high negative emotionality may be more likely to provide and receive non-supportive contingencies, respectively. However, no study has examined child and parent negative emotionality in the same study and explored whether the link between child and parent negative emotionality may exist in part because of parental emotion socialization. The present study was designed to explore the link between the negative emotionality of mothers and their adolescent children and the potential mechanisms for this similarity. Maternal emotion socialization was explored as a mediator between maternal and adolescent negative emotionality, and between maternal negative emotionality and adolescent internalizing symptoms. Participants were mothers (M age = 30.47) with their children at two time points: preschool (Time 1; M age = 4.55 years old) and adolescence (Time 2; M = 13.73), with 81 boys and 94 girls. Negative emotionality was measured using a questionnaire, with mothers reporting for herself and her child. Maternal emotion socialization was measured by mothers' self-report of their contingencies to their adolescent child's negative emotions: 1) Punish; 2) magnify; 3) ignore; 4) override; and 5) support. The results revealed that the maternal punishing of the adolescent's negative emotions was a mediator between concurrent mother negative emotionality and adolescent negative emotionality, such that higher mother negative emotionality was associated with more punishing, and more punishing was associated with higher adolescent negative emotionality, controlling for previous levels of maternal and child negative emotionality. Furthermore, being supportive of a child's negative emotions was negatively associated with concurrent levels of adolescent internalizing symptoms, while magnifying a child's emotions held a marginal positive association, controlling for previous levels of internalizing symptoms. The results highlight the importance of considering maternal emotion socialization strategies, even into adolescence, for a more comprehensive understanding of children's emotional well-being. The findings have implications for developing and implementing emotion-based parenting interventions.

Parent contributions to friendship stability during the primary school years.

The present study examines whether characteristics of parents predict the stability of a child's best friendships across the primary school years. Participants included 1,523 Finnish children (766 boys) who reported involvement in a total of 1,326 reciprocated friendship dyads in the 1st grade (M = 7.16 years old). At the onset of the study, mothers and fathers completed questionnaires describing their own parenting (i.e., behavioral control, psychological control, and affection toward the child) and depressive symptoms. Child scores for peer status (i.e., acceptance and rejection) were derived from 1st grade peer nomination data. Discrete-time survival analyses predicted the occurrence and timing of friendship dissolution, across 1st to 6th grades, for friendships that began in 1st grade. Parent depression and parent psychological control uniquely predicted subsequent child friendship dissolution, above and beyond the contribution of peer status variables. (PsycINFO Database Record

The gene-environmental architecture of the development of adolescent substance use.

BACKGROUND: Using a longitudinal twin design and a latent growth curve/autoregressive approach, this study examined the genetic-environmental architecture of substance use across adolescence. METHODS: Self-reports of substance use (i.e. alcohol, marijuana) were collected at ages 13, 14, 15, and 17 years from 476 twin pairs (475 boys, 477 girls) living in the Province of Quebec, Canada. Substance use increased linearly across the adolescent years. RESULTS: ACE modeling revealed that genetic, as well as shared and non-shared environmental factors explained the overall level of substance use and that these same factors also partly accounted for growth in substance use from age 13 to 17. Additional genetic factors predicted the growth in substance use. Finally, autoregressive effects revealed age-specific non-shared environmental influences and, to a lesser degree, age-specific genetic influences, which together accounted for the stability of substance use across adolescence. CONCLUSIONS: The results support and expand the notion that genetic and environmental influences on substance use during adolescence are both developmentally stable and developmentally dynamic.

Persistence of Effects of VLBW/PT Birth Status and Maternal Emotional Availability (EA) on Child EA Trajectories.

Few studies have examined the longitudinal impact of birth status on the infant-mother relationship and on children's socio-emotional development. In the present study we investigated developmental patterns of such relationships [using the Emotional Availability (EA) Scales] in fullterm and VLBW/PT infants from infancy to emerging school age. Our objectives were to: (a) model the developmental trajectories of EA dimensions (maternal sensitivity, structuring, non-hostility; child responsiveness, involvement) in a VLBW/PT and fullterm sample, (b) identify potential effects of VLBW/PT status on these trajectories, and (c) determine whether the effects of VLBW/PT status on children's socio-emotional development (child EA) remained after accounting for the effect of maternal EA. Child-mother dyads (n = 109) were observed in home-based interactions (face-to-face and free play) when children were 6, 12, 18, and 57-months-old in fullterm (37-41 weeks, >2500 g; n = 48) and healthy VLBW/PT (26-32 weeks gestation, birth weight 800-1500 g, corrected for gestational age; n = 61) children. Developmental trajectories of maternal and child EA were assessed using multilevel growth modeling in Mplus. Results indicated that, even after controlling for maternal EA, there was a persistent negative effect of VLBW/PT birth status on child EA trajectories. Both initially and over time, VLBW/PT infants lagged behind their fullterm counterparts on levels of responsiveness and involvement with mothers. There was also a persistent positive effect of maternal EA (sensitivity and structuring) on child EA trajectories. Higher average levels of maternal sensitivity and structuring across time were also associated with higher and persistent levels of child responsiveness and involvement of their mothers. Importantly, results held after modeling both effects together, and after controlling for maternal education and child gender. Our results have implications for VLBW/PT children's development, the parent-child relationship, and integrating family level factors and relationship dimensions in early prevention and intervention programs.

The relationship of person-specific eveningness chronotype, greater seasonality, and less rhythmicity to suicidal behavior: A literature review.

BACKGROUND: Epidemiological data have demonstrated seasonal and circadian patterns of suicidal deaths. Several reviews and meta-analyses have confirmed the relationship between sleep disturbance and suicidality. However, these reviews/meta-analyses have not focused on seasonal and circadian dysfunction in relation to suicidality, despite the common presence of this dysfunction in patients with mood disorders. Thus, the current literature review analyzed studies investigating person-specific chronotype, seasonality, and rhythmicity in relation to suicidal thoughts and behaviors. METHODS: Study authors reviewed articles related to individual-level chronotype, seasonality, and rhythmicity and suicidality that were written in English and not case reports or reviews. RESULTS: This review supports a relationship between an eveningness chronotype, greater seasonality, and decreased rhythmicity with suicidal thoughts and behaviors in those with unipolar depression, as well as in other psychiatric disorders and in children/adolescents. LIMITATIONS: These findings need to be explored more fully in mood disordered populations and other psychiatric populations, in both adults and children, with objective measurement such as actigraphy, and with chronotype, seasonality, and rhythmicity as well as broader sleep disturbance measurement all included so the construct(s) most strongly linked to suicidality can be best identified. CONCLUSIONS: Eveningness, greater seasonality, and less rhythmicity should be considered in individuals who may be at risk for suicidal thoughts and behaviors and may be helpful in further tailoring assessment and treatment to improve patient outcome.

Relations of Parenting to Adolescent Externalizing and Internalizing Distress Moderated by Perception of Neighborhood Danger.

Parental monitoring and warmth have traditionally been studied in the context of White, middle-class families. This article explores optimal levels of these parenting behaviors in preventing adolescent psychopathology in impoverished, urban high-crime areas while accounting for child perceptions of neighborhood danger. In this study, data were collected longitudinally at 2 time points 1 year apart from a sample of 254 African American young adolescents (T1: M age = 12.6 years, 41% male) and their parents. Parental monitoring and warmth, child perception of neighborhood danger, and child internalizing and externalizing behaviors were measured using questionnaires. Child internalizing behaviors were also measured using a time sampling technique capturing in vivo accounts of daily distress. Findings indicated associations between parental monitoring and children's externalizing behaviors along with linear and quadratic associations between parental monitoring and internalizing behaviors. Monitoring and warmth were differentially related to symptoms depending on neighborhood danger level. When children perceived less danger, more monitoring related to less externalizing. When children perceived more danger, more warmth related to less internalizing. In addition, adolescents' perceptions of neighborhood danger emerged as equally strong as monitoring and warmth in predicting symptoms. This study underscores the influence of carefully considering parenting approaches and which techniques optimally prevent adolescents' externalizing, as well as prevent internalizing difficulties. It also highlights how context affects mental health, specifically how perceptions of danger negatively influence adolescents' psychopathology, emphasizing the importance of initiatives to reduce violence in communities.

Does the Hospital Predict Readmission? A Multi-level Survival Analysis Approach.

Time to psychiatric rehospitalization was predicted for a sample of 1473 Medicaid-insured youth in Illinois in 2005 and 2006. A multi-level model statistical strategy was employed to account for the fact that youth days to rehospitalization were nested within hospital and to test the hypothesis that hospitals would vary significantly in return rates, controlling for individual-level (e.g., symptom, demographic) variables. Hospitals did not vary significantly in days to rehospitalization. At the individual-level, level of externalizing behavior and residential treatment placement predicted a faster return to the hospital. These results support the perspective that hospital outcomes are best operationalized using variables tied more directly to the inpatient episode (e.g., LOS, reductions in acuity).