Vicky Phares

Where's poppa?: The relative lack of attention to the role of fathers in child and adolescent psychopathology

Compared with mothers, fathers are dramatically underrepresented in clinical child and adolescent research. The author reviewed empirical and theoretical clinical child and adolescent literature to ascertain the reasons for this underrepresentation. Four somewhat interrelated factors are discussed: practical issues in participant recruitment, differential base rates of paternal vs. maternal psychopathology, theory-driven research based on sexist theories, and research assumptions based on outdated societal norms. Suggestions for future research are discussed, including parallel investigations of paternal characteristics whenever maternal characteristics are investigated, assessment of both similarities and differences in the role of fathers and mothers in child and adolescent psychopathology, and investigation of parenting factors for both fathers and mothers (e.g., time spent in actual caretaking, career vs. family orientation) in relation to child and adolescent psychopathology.

Seven-Year Outcome of the Vermont Intervention Program for Low-Birthweight Infants

We compared 24 low-birthweight subjects of an experimental intervention (LBWE), 32 no-treatment controls (LBWC), and 37 normal birthweight (NBW) subjects. The intervention involved 7 hospital sessions and 4 home sessions in which a nurse helped mothers adapt to their LBW babies. At age 7, LBWE scored significantly higher than LBWC on the Kaufman Mental Processing Composite (p less than .001), Sequential (p = .02), and Simultaneous (p = .001) Scales, after statistical adjustments for socioeconomic status. LBWE did not differ from NBW (F less than 1). These results bear out a divergence between the LBWE and LBWC that first became statistically significant at age 3. The findings suggest that the intervention prevented cognitive lags among LBW children, and that long-term follow-ups are needed to evaluate the developmental effects of efforts to overcome major biological and environmental risks.

The connections between adolescents' perceptions of parents, parental psychological symptoms, and adolescent functioning

A total of 150 biological mother–father–adolescent triads were interviewed to investigate adolescents’ perceptions of parents with and without high levels of psychological symptoms in relation to adolescents’ emotional/behavioral functioning. There was a more consistent pattern for sons to show greater externalizing emotional/behavioral problems in relation to levels of adolescents’ perceptions of maternal behaviors (i.e., lower acceptance and higher negative affect toward mother). Daughters, however, appeared to show greater internalizing emotional/behavioral problems in relation to higher levels of paternal depression and anxiety and lower levels of maternal control. Furthermore, both sons and daughters showed evidence of higher emotional/behavioral problems (especially internalizing problems) in relation to triangulation and interparental conflict. The complex patterns of the findings relating to the mother–father–adolescent triads emphasize the importance of including both mothers and fathers in future research of adolescents’ perceptions of parents. D 2003 Elsevier Science Inc. All rights reserved.

Mothers, Fathers, Gender Role, and Time Parents Spend With Their Children

To examine the relationships among the sex of the parent, gender role, and the time parents spend with their children, 272 parents completed the Bem Sex-Role Inventory, a questionnaire about the time spent with their children, and a demographics questionnaire. Analyses indicated that neither the sex of the parent nor gender role was predictive of the amount of time parents were spending in direct interaction with or being accessible to their children. The sex of the parent, qualified by earning status, was predictive of the level of responsibility parents had for child-related activities. Further, the sex of the parent, qualified by femininity, was predictive of parental satisfaction with level of child-related responsibilities. These results emphasize the importance of examining parental characteristics in relation to the time parents spend with their children and their levels of responsibility for child-related activities.

Prevention of Child Sexual Abuse Are we Doing Enough

In response to an increase in public awareness and interest in the problem of child sexual abuse, programs have been developed to promote the awareness, prevention, and treatment of sexual abuse. These programs have been varied in scope, focus, and effectiveness. This article reviews the child sexual abuse literature, with particular emphasis on efforts aimed at the prevention of child sexual abuse. Prevention efforts targeting potential victims as well as parents, teachers, and offenders, are reviewed and evaluated. Overall, there is not enough adequate work being done to prevent child sexual abuse. More efforts need to address child sexual abuse prevention by targeting adults who can help children avoid such an experience and adults who may perpetrate against children. Suggestions about future preventive endeavors, based on this review, are offered.

Quality of life in obsessive-compulsive disorder: the role of mediating variables.

This study examined the association of various clinical features of obsessive-compulsive disorder (OCD) with quality of life (QoL) in 102 adults with a principal diagnosis of OCD. Participants were assessed by trained clinicians using the Anxiety Disorders Interview Schedule 4th edition, the Yale-Brown Obsessive-Compulsive Scale, and an unstructured clinical interview. Subjects completed the MOS-36 Item Short Form Health Survey, and Beck Depression Inventory-II. Obsessive-compulsive symptom severity was negatively correlated with emotional health, social functioning and general health QoL. Depressive symptoms mediated the relationship between obsessive-compulsive symptom severity and emotional health, social functioning and general health QoL. Additionally, interference of obsessive-compulsive symptoms mediated the relationship between obsessive-compulsive symptom severity and emotional health, social functioning and general health QoL. Resistance against obsessive-compulsive symptoms mediated the relationship between obsessive-compulsive symptom severity and social functioning QoL. Diminished QoL is present in persons with OCD and is essential in understanding the complete clinical picture of OCD.

A meta-analysis of family accommodation and OCD symptom severity

Family accommodation in obsessive-compulsive disorder (OCD) is characterized by myriad behaviors, such as modifying family routines, facilitating avoidance, and engaging in compulsions to reduce obsessional distress. It has been linked to various deleterious outcomes including increased functional impairment and poorer treatment response for OCD. Although extant literature suggests a linear relationship between family accommodation and OCD symptom severity, the magnitude and statistical significance of this association has been inconsistent across studies, indicating that moderators may be influencing this relationship. The present study examined this relationship using meta-analytic techniques, and investigated sample-dependent (age, gender, comorbid anxiety/mood disorders) and methodological (administration method and number of items used in family accommodation measure, informant type, sample size, publication year) moderators. Forty-one studies were included in the present meta-analysis, and the overall effect size (ES) for the correlation between family accommodation and OCD symptom severity was moderate (r=.42). Moderator analyses revealed that the number of items on the family accommodation scale moderated the ES. No other sample-dependent or methodological characteristics emerged as moderators. In addition to being the first systematic examination of family accommodation moderators, these results highlight the moderate relationship between family accommodation and OCD severity that is influenced by measurement scales. Findings may be used to guide clinical care and inform future investigations by providing a more nuanced understanding of family accommodation in OCD.

Gender and Age Differences in the Topics of Parent-Adolescent Conflict

As part of an examination of topics of parent-adolescent conflict, 139 biological mother-father-adolescent triads reported the three most common topics of conflict in their relationships. Using 2 analyses, results indicated that, within the context of their gender and age, adolescents differed in the topics of conflict they listed for their mothers and fathers. When listed by mothers and fathers, frequencies of the topics of parent-adolescent conflict also differed significantly with the gender and age of adolescents. Using analyses of variance, agreement for topics selected by adolescents and their parents was not better for sons versus daughters or for adolescents of a particular age group. These results demonstrated the importance of examining topics of parent-adolescent conflict, in addition to its frequency of occurrence and intensity, as a first step to understanding the dynamics of such conflict. With complete information about parent-adolescent conflicts, clinical interventions can address such conflicts adequately.

Dysregulation in pediatric obsessive compulsive disorder

Although obsessive compulsive disorder (OCD) and common co-occurring conditions share deficits in self-regulatory abilities, there has been minimal examination of impaired self-regulation (dysregulation) in youth with OCD. This study examined the association of dysregulation with symptom severity, impairment, and treatment outcome in pediatric OCD. Clinicians assessed obsessive-compulsive severity, family accommodation and global severity in 144 youth with OCD. Youth completed self-report severity ratings of anxiety and depressive symptoms. Parents completed the Child Behavior Checklist (CBCL), and both children and parents completed parallel ratings of obsessive-compulsive impairment. Ninety-seven youth received cognitive behavioral therapy (CBT) and were re-assessed after treatment. Dysregulation was assessed using the CBCL-Dysregulation Profile. Before treatment, dysregulated youth exhibited greater obsessive-compulsive symptom severity, depressive mood, family accommodation, and impairment than non-dysregulated youth. The magnitude of dysregulation directly predicted child-rated impairment, parent-rated impairment, and family accommodation, beyond obsessive-compulsive severity. The magnitude of pretreatment dysregulation predicted treatment discontinuation but not treatment response. Obsessive-compulsive symptom severity and dysregulation level significantly decreased after CBT. Dysregulated youth with OCD presented as more clinically severe than their non-dysregulated counterparts, and may require more individualized interventions to reduce dysregulated behavior to prevent CBT attrition. For treatment completers, CBT was associated with a decrease in dysregulation level.

Symptom Endorsement Differences on the Children's Depression Inventory With Children and Adolescents on an Inpatient Unit

Responses to the Childrens Depression Inventory (CDI; Kovacs, 1992), administered during intake, were collected from 521 children and adolescents (aged 7 to 17) at an inpatient crisis stabilization unit. Participants were grouped into 1 of 3 diagnostic groups: solely depressive, solely aggressive, or both depressive and aggressive. Self-report of symptoms for each diagnostic group, age and gender differences, and racial and ethnic differences in symptoms were examined in this study. There was a significant difference between the endorsement pattern of solely depressive and solely aggressive participants, whereas those categorized as both depressive and aggressive displayed an endorsement pattern similar to those who were solely aggressive. There was a significant gender difference in overall symptom report, with girls showing higher overall symptom levels than boys. This gender difference was significant for both the younger and the older age groups. These results held true even when gender was covaried out of the diagnostic group analyses and when diagnostic group was covaried out of the gender analyses. Symptom endorsement did not differ based on race and ethnicity. The primary contribution of this study centers around the findings from the item analyses of the CDI. These results are discussed in relation to the discriminant validity of the CDI and the need for additional research into comorbidity.