W. Hobart Davies

Child Sexual Behavior Inventory: normative, psychiatric, and sexual abuse comparisons

A normative sample of 1,114 children was contrasted with a sample of 620 sexually abused children and 577 psychiatric outpatients on the Child Sexual Behavior Inventory (CSBI), a 38-item behavior checklist assessing sexual behavior in children 2 to 12 years old. The CSBI total score and each individual item differed significantly between the three groups after controlling for age, sex, maternal education, and family income. Sexually abused children exhibited a greater frequency of sexual behaviors than either the normative or psychiatric outpatient samples. Test-retest reliability and interitem correlation were satisfactory. Sexual behavior problems were related to other generic behavior problems. This contributed to the reduced discrimination between psychiatric outpatients and sexually abused children when compared to the normative/sexually abused discrimination.

Controlled Study of Critical Parent and Family Factors in the Obesigenic Environment

Objective: Critical gaps remain in our understanding of the obesigenic family environment. This study examines parent and family characteristics among obese youth presenting for treatment in a clinic setting.

Sexual behavior problems in preteen children: developmental, ecological, and behavioral correlates

Abstract: A large sample of 2–12 year old children (N= 2311) was studied to determine the relationship between three sexually intrusive behavior items (SIBs) measured by the Child Sexual Behavior Inventory (CSBI) and a range of developmental, ecological, and behavioral correlates. The variables studied included age, gender, race, family income, single parent status, maternal education, family sexual behaviors, physical abuse, sexual abuse, domestic violence, social competence of the child, and three scales from the CBCL (Internalizing, Externalizing, and PTSD). Sexual abuse was not the primary predictor of SIB, but a model incorporating family adversity, modeling of coercive behavior, child behavior, and modeling of sexuality predicted a significant amount of variance.

Social Interactions between Children with Cancer or Sickle Cell Disease and Their Peers: Teacher Ratings.

We evaluated the social reputation of children with cancer (nonprimary brain tumors) (n = 26) children with a primary malignancy involving the central nervous system (n = 15), and children with sickle cell disease (SCD) (n = 33) using a standardized measure of social reputation, the Revised Class Play (RCP). Each childs classroom teacher completed the RCP, an instrument designed to assess sociability-leadership, aggressive-disruptive, and sensitive-isolated interpersonal qualities. Matched-pairs analyses comparing the child with chronic illness to one peer in each class who was the same gender/race and the closest date of birth showed children with cancer were nominated more often for sociability-leadership roles and less often for aggressive-disruptive roles. Brain tumor survivors were nominated more often for sensitive-isolated roles. Children with SCD were not significantly different from peers. Findings suggest that the stressful life events associated with cancer or SCD did not have a significant negative impact on social adjustment for schoolaged children with these diseases. The data demonstrate the critical need for appropriate controls when evaluating psychosocial morbidity and chronic illness. Better understanding of the processes of resilience for these children who are routinely exposed to heightened stress provides an opportunity to improve the competence of other high-risk youth. J Dev Behav Pediatr 13:187–193, 1992. Index terms: chronic illness, peer relationships.

The impact of cognitive distortions, stress, and adherence on metabolic control in youths with type 1 diabetes.

PURPOSE To investigate the role of cognitive distortions in the relationship between adherence behavior, diabetes-specific stress, general stress, and metabolic control. METHODS Obtained questionnaire data, glucometer readings, and glycosylated hemoglobin (HbgA(1c)) assays from 143 youths (11-18 years old) with type 1 diabetes. Examined path model of relationships between cognitive distortions, stress, adherence behavior, and metabolic control. Data were analyzed using path analysis. RESULTS Higher levels of negative cognitive distortions were associated with more stress (both diabetes-specific and general). Higher levels of general stress then led to less adherent behavior and subsequently poorer metabolic control (higher HbgA(1c)). More diabetes-specific stress also led to poorer metabolic control, as well as general stress. CONCLUSIONS The findings indicate an indirect role of negative cognitive distortions in metabolic control. The current findings suggest that instead of the proposed direct link between cognitive distortions and adherence behavior, an indirect relationship may exist through stress.

A Stress Management Intervention for Adolescents With Type I Diabetes

PURPOSE The purpose of this project was to examine the effectiveness of a stress management training program in helping adolescents with diabetes cope with stress. METHODS Youths who displayed evidence of metabolic control problems received training in the use of both cognitive-restructuring and problem-solving strategies. Treatment impact was assessed on measures of coping, anxiety level, diabetes-specific stress, and metabolic control. RESULTS Analyses of covariance showed no differences between the training group and a control group at posttest and follow-up. However, the small sample size and within-group variability may have precluded finding significant results. Therefore, within-group comparisons were conducted, and improvements were found in the training group on pretest to posttest and pretest to follow-up comparisons for anxiety, stress, and coping measures. No differences were found in the control group. CONCLUSIONS Results suggest that the intervention had some positive impact, although this interpretation must be considered preliminary. Future research should replicate this study and explore the applicability and effectiveness of this intervention in specific populations.

Cognitive behavioral interventions for sexually abused children exhibiting PTSD symptomatology

This investigation examined the effectiveness of a cognitive behavioral intervention with 4 sexually abused children exhibiting posttraumatic stress disorder (PTSD), using a multiple baseline design. Participants ranged in age from 8 to 10 years. Intervention effectiveness was measured with pre-, post-, and 3-month follow-up assessments of PTSD symptomatology and affective (depression and anxiety) measures. In addition, these instruments were administered during baseline and prior to each treatment session. The intervention focused on the training of relaxation skills, positive self-talk, and cognitive restructuring. All 4 participants reported decreases in their PTSD symptomatology. The 3 participants who had elevated levels of depression and anxiety during baseline showed decreases with treatment. The results of this study suggest that cognitive behavioral techniques can be an effective approach for working with this population.

A Biopsychosocial Model of Normative and Problematic Pediatric Feeding

A comprehensive model is presented that (a) highlights factors that have been implicated in the development and maintenance of feeding problems in both normal and clinical populations; and (b) provides a framework for the prevention, management, and treatment of feeding problems across the range of physically healthy children to children with acute and chronic illnesses. Relevant literatures and feeding models were synthesized to present a comprehensive unified biopsychosocial model that may aid in the prediction and synthesis of information about feeding and eating in both normal and clinical populations and provide a framework for interdisciplinary research and intervention.

Assessing Family-based Feeding Strategies, Strengths, and Mealtime Structure with the Feeding Strategies Questionnaire

OBJECTIVE Develop a questionnaire to assess family-based feeding strategies, strengths, and mealtime structure for use with children with feeding problems; validate this new instrument with caregivers of young children from the community and a specialty feeding-clinic; and examine preliminary evidence for reliability and validity. METHODS Community caregivers (n = 702) and caregivers seeking services at a pediatric feeding specialty clinic (n = 288) completed the Feeding Strategies Questionnaire (FSQ). A smaller portion of these families also completed an established feeding measure. RESULTS Exploratory and confirmatory factor analyses were conducted to develop and validate the FSQ factor structure that resulted in six scales: Mealtime Structure, Consistent Mealtime Schedule, Child Control of Intake, Parent Control of Intake, Between Meal Grazing and Encourages Clean Plate. Evidence of reliability and validity was obtained. CONCLUSION It appears the FSQ can aid the assessment of feeding strategies relevant to the prevention or treatment of pediatric feeding difficulties.

Social, emotional, and behavioral functioning of children with hemophilia.

ABSTRACT. This study examines the social, emotional, and behavioral functioning of children with hemophilia. Data were collected in the homes and schools of 40 boys with hemophilia and 40 comparison boys of the same race and age. Data on social, emotional, and behavioral functioning were collected from teachers, classmates, parents, and the participants. Children with hemophilia scored comparably with comparison peers in all areas of social functioning but reported more difficulties with emotional well-being, including more depressive symptomatology and lower self-perceptions. Parent report also indicated more difficulties with emotional well-being. Parents did not report significant differences in externalizing behavior problems. In conclusion, children with hemophilia were not found to be at increased risk of social or behavioral difficulties. However, both children with hemophilia and their parents identified more difficulties with emotional well-being. Nevertheless, approximately all mean scores for both groups remained within the normal range.