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Are Parental Depression and Child Disruptive Behavior Related?

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Are Parental Depression and Child Disruptive Behavior Related?
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INGALLS, COURTNEY ANN ( Author, Primary )
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2008

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Child psychology ( jstor )
Children ( jstor )
Clinical psychology ( jstor )
Developmental psychology ( jstor )
Fathers ( jstor )
Modeling ( jstor )
Mothers ( jstor )
Parents ( jstor )
Psychology ( jstor )
Symptomatology ( jstor )

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University of Florida
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University of Florida
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Copyright Courtney Ann Ingalls. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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5/31/2010

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ARE PARENTAL DEPRESSION AND CHILD DISRUPTIVE BEHAVIOR RELATED? By COURTNEY ANN INGALLS A THESIS PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLOR IDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE UNIVERSITY OF FLORIDA 2007 1

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2007 Courtney Ann Ingalls 2

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ACKNOWLEDGMENTS I thank Sheila Eyberg, my supervisory comm ittee chair and research supervisor, for her mentorship, editing hand, and encouragement as I worked on this thesis. I would also like to thank my supervisory committee members Dawn Bowers, Sam Sears, and Stephen Boggs for the time and energy they devoted to offering thoughtful feedback. I thank all of the members of the Child Study Lab, past and present, for their effort s in data collection and their guidance during the process of completing this thesis. Finally, I want to acknowledge the National Institute of Mental Health (RO1 46727 and RO1 60632) for fundi ng the projects from which data for this thesis were drawn. 3

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TABLE OF CONTENTS page ACKNOWLEDGMENTS ...............................................................................................................3 LIST OF TABLES ...........................................................................................................................5 LIST OF FIGURES .........................................................................................................................6 ABSTRACT.....................................................................................................................................7 CHAPTER 1 INTRODUCTION................................................................................................................. ...8 Parent Depressive Symptomatology and Child Disruptive Behavior.......................................8 Mediational Properties of Parent Negative Behavior ...............................................................9 Specific Aims..........................................................................................................................10 2 METHODS...................................................................................................................... .......12 Participants .............................................................................................................................12 Measures .................................................................................................................................12 Procedure ................................................................................................................................14 3 RESULTS...................................................................................................................... .........16 Descriptive Data for Mothers, Fathers, and Children .............................................................16 Pearson Correlational Analyses wi thin Model of Family Functioning ..................................16 Mediation Analyses ................................................................................................................17 Model of Dysfunctional Family Functioning .........................................................................17 Observational versus Parent Report M easures of Child Disruptive Behavior.......................18 Ad Hoc Mediational Analyses . ...............................................................................................18 4 DISCUSSION................................................................................................................... ......26 Observational Model of Dysfunctional Family Functioning ..................................................26 Parent-Child Observational Measur es versus Parent Report Measures .................................27 Limitations and Future Directions ..........................................................................................30 LIST OF REFERENCES ...............................................................................................................32 BIOGRAPHICAL SKETCH .........................................................................................................38 4

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LIST OF TABLES Table page 3-1 Means and Standard Deviations of Parent and Child Measures ........................................21 3-2 Pearson Correlations Between Maternal and Paternal Variables ......................................22 3-3 Mediation Hierarchical Re gression Analysis Predicting Ou tcome: Final Block of the Regression ..........................................................................................................................23 5

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LIST OF FIGURES Figure page 1-1 Model of Differing Relationships between Parent Depression and Child Disruptive Behavior as Measured by Parent Report and Observational Data. ....................................11 3-1 Systems Model of Dysfunctional Family Functioning. .....................................................24 3-2 Mediational Model for Asso ciations Between Father Ne gative Behavior and Child Disruptive Behavior with Father as Me diated by Mother Negative Behavior..................25 6

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Abstract of Thesis Presen ted to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Master of Science ARE PARENTAL DEPRESSION AND CHILD DISRUPTIVE BEHAVIOR RELATED? By Courtney Ann Ingalls May 2007 Chair: Sheila Eyberg Major: Psychology Our study examined relations among parent self-reported depression and the negative behaviors of mothers, fathers, and children dur ing dyadic parent-child interactions of conductdisordered children between the ages of 3 and 6. Findings revealed significant relations among all negative interaction behavior s. Further, negative mother be havior mediated the relations between negative father and child behaviors during father-child interactions. However, neither mother nor father reports of de pression were related to any of the behaviors observed during parent-child interactions. By substituting parent report measures for the observational measures of child behavior. However, both mother and fa ther depression were si gnificantly related to disruptive child behavior. Results highlight the strong influence of family members’ behaviors on one another’s behaviors, and also challenge the assumption that observational and parent report measures of disruptive child beha vior capture the same construct. 7

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CHAPTER 1 INTRODUCTION Parent Depressive Symptomatology and Child Disruptive Behavior Reviews of the psychological li terature suggest that depressi on interferes with effective parenting (Beardslee, Bemporad, Keller, & Klerman, 1983; Huang & Warner, 2005; Sheppard, 1994), and that parental depression is related to negative psychological outcomes for children (Azar & Wolfe, 1989; Copper & Murray, 1997; C. Hammen, 1991; M. Radke-Yarrow, 1998). Specifically, maternal depression has been negativ ely correlated with attachment (Milgrom & McCloud, 1996), children’s cognitive abilitie s (Murray, 1992), and child development (Cummings & Davies, 1994). Compared to nondep ressed mothers with th eir children, depressed mothers display lower levels of empathy (L utenbacher, 2002), exhibit higher levels of aggression, and maltreat their children more often (Bishop & Leadbeat er, 1999; Zuravin, 1989). In contrast to maternal depres sion, depression in fathers has b een essentially ignored in the family relations literature. Phares and Compas (2002) attribute this fact to two key factors. First, there are simply more depressed mothers than fathers. The Diagnostic and Sta tistical Manual – Fourth Edition, Text Revision (DSM-IV-TR) indicates that 10 to 25 % of women, compared to 5 to 12 % of men, experience an episode of depr ession during their lifet ime. Secondly, women more often serve as primary caregivers and ar e therefore more often the focus of parenting studies (Phares & Compas, 1992). Although these are reasonable expl anations, they are not valid excuses for ignoring fathers. Several recent studies su ggest that father involvement in chil d raising relates to enhanced child functioning (Amato & Gilbreth, 1999; Bagner & Eyberg, 2003; Yogman, Kindlon, & Earls, 1995), and in families of disruptive children, evidence suggests that mothers and fathers each contribute uniquely to the variance of their child ’s disruptive behavior (Calzada, Eyberg, Rich, & 8

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Querido, 2004). Additionally, father depres sion was significantly correlated with child/adolescent psychopat hology in 14 of 19 studies that exam ined this relationship (Phares, Duhig, & Watkins, 2002). Parental depression appears to a ffect more than just a child’s behavior in the home. Jacob and Johnson (1997) found that depression in either the mother or father was associated with decreased affective expression in other family members as well as the child’s behavior. Further, depressive symptoms of mothers and fathers at just one month post partum have been found to predict children’s observed school behavior prob lems two and three year s later (Harnish, Dodge, & Valente, 1995). Mediational Properties Of Parent Negative Behavior Lyons-Ruth (2002) argued for models of pare ntal depression and family functioning to expand beyond genetic to environmental, process, and systems perspectives. Many studies have addressed potential mediators of the relation be tween parental depression and child disruptive behavior. Goodman and Gotlib (1999) hypothesized that factors such as genetic vulnerabilities, disruptions in the prenatal envi ronment, suboptimal mother-child interactions, and contextual risk factors that could account for the relation between maternal depression and child behavioral outcomes. Harnish et al. (1995) found higher leve ls of disruptive child behavior as well as poorer mother-child interactions in families from lower SES groups. Depressed mothers have been found to engage in more angry, intrusive, hostile, and conflictual behavior with their children (F ield, Healy, Goldstein, Guthertz, 1990; Goodman, Adamson, Riniti, and Cole 1994; Hammen 1991). In direct observations of mother-child interactions, depressed mothers have been found to express more criticism to their children than non-depressed mothers (Hammen, Adrian, a nd Hiroto, 1988; Webster-Stratton and Hammond 1988). 9

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The emergence of risk factors (e.g., parental depression) in a child’s lifetime affect a child’s outcomes. Likewise, the current status of the child or family system has the power to influence the emergence of a risk factor (Got lib & Wheaton, 1997). Figure 1-1 depicts a systems model of family functioning that includes pare nt depressive symptoma tology, parent negative behavior, and child disruptive behavior. In this m odel, parent depression and its relationship with overall family functioning is examined through co rrelational analyses. This model, rooted in theory asserting that parents a nd children have reciprocal infl uences on each other, allows examination of interrelations between mother, father, and child. Specific Aims The purpose of this study was to investig ate relations between parent depressive symptomatology and child externalizing behaviors a nd the role of negative parenting behavior in mediating these relations. Our first hypothesis wa s that both mother and father depression would be significantly related to child disruptive beha vior. Our second hypothesis was that mother and father depressive symptomatology would be positiv ely correlated with the negative parenting behaviors of mothers and fathers, respectively. Our third hypothesis was that negative parenting behaviors of mothers and father s would partially mediate relati ons between parent (mother and father) depressive symptomatology and child disr uptive behavior. An exploratory aim of this study was to compare relations among family me mbers when using observational measures and parent report measures of child disruptive behavior. 10

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MNB FNB FDS MDS CDBM CDBF Figure 1-1. Model of Differing Re lationships between Parent De pression and Child Disruptive Behavior as Measured by Parent Report a nd Observational Data. Solid lines represent significant correlations when observation measures from DPICS were used to quantify parent and child disruptive be havior, p < 0.01. Dotted Lines represent significant correlations between variables wh en parent report was used to quantify disruptive child behavior and observational measures (DPICS) were used to quantify negative parent behavior; MDS= Mother Depressive Symptoms; FDS= Father Depressive Symptoms; MNB= Mother Nega tive Behavior; FNB= Negative Father Behavior; CDBM= Child Disruptive Behavior with Mother; CDBF = Child Disruptive Behavior with Father 11

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CHAPTER 2 METHODS Participants Participants were 78 two-parent families with a child between the ages of 3 and 6 referred for treatment of disruptive behavior in one of tw o larger treatment studies. Both studies (Study A and Study B) implemented similar inclusion and exclusion criteria: (a) children met diagnostic criteria for oppositional defiant disorder (ODD); (b) children’s hyperactivity medication status and dosage were constant for at least one mont h prior to the pre-treatment assessment; (c) children and parents obtained standard score equivalents > 70 (Study A) or > 75 (Study B) on a cognitive screening measure (d) Children did not have a history of severe sensory or mental impairment, such as deafness, blindness, or autis m; and (e) families did not present an immediate crisis requiring out-o f-home placement. The sample included 37 families from Study A and 41 families from Study B. Of the 78 participating children, 76 % were male a nd 24 % were female. The children were 84 % Caucasian, 8 % African American, 3 % Asian Amer ican, 3 % bi-racial, 1 % Hispanic, and 1 % other. The mean age of mothers was 35 and th e mean age of fathers was 37. Annual household incomes ranged from under $6,000 to over $50,000: 24 % of the sample earned under $30,000, 80 % earned between $30,000 and $50,000, and 22 % earned over $50,000. Thirty-five percent of mothers and 31 % of fathers ha d a college education or higher. Measures Beck Depression Inventory (BDI). Parent depressive sympto matology was measured by the BDI (Beck, 1972) in Study A and the BDI-II ((Bec k, Steer, & Brown, 1996) in Study B. This 21item self-report measure is one of the most freque ntly used instruments for assessing the severity of mood, cognitive, and somatic symptoms of de pression in adults. It has demonstrated good 12

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psychometric properties including adequate reliability and cons truct validity (Beck, Steer, & Garbin, 1988; Shaw, Vallis, & McCabe, 1985). Mean scores are approximately two points higher in the BDI-II compared to the BDI, and therefor e in this study we adde d two points to scores from Study A (Beck, Steer, Ball, & Ranieri, 1996). Severity of depressive symptoms is categorized according to the following scale: minimal depression (0), mild depression (14– 19), moderate depression (20), and severe depression (29) (Bec k, Steer, & Brown, 1996). BDI scores, converted to z-scores for comparab le analyses, were used to represent mother depressive symptomatology and father depressive symptomatology. Dyadic Parent-Child Interaction Coding System (DPICS) . The DPICS (Eyberg, Nelson, Duke, & Boggs, 2005) is a behavioral observation coding system developed to assess the quality of parent-child social interacti ons. This system measures parent-c hild interactions during three 5minute standard situations that vary in the degr ee of parental control required: child-led play (CLP); parent-led play (PLP); and clean-up (CU). The first five minutes of CLP and PLP were used as a warm-up period for the dyad to become accustomed to the situation and were not coded. The parent and child cate gories include verbalizations (e .g., critical statements, praise, commands) vocalizations (e.g., yell) and physical behaviors (e.g., nega tive physical touch, positive physical touch). Most DPICS scores represent the frequencies of child and parent behaviors across 15 minutes of observation. Additi onal codes exist within the syst em to capture sequences of behaviors. For example following a parent comm and, a child is coded comply, noncomply, or no opportunity to comply. This study quantifies noncom pliance as the ratio of the total number of child noncomply events to the to tal number parent commands. 13

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Reliability and validity of the DPICS categ ories have been summarized in the DPICS manual (Eyberg et.al, 2004). Undergraduate and graduate student coders were trained to 80 percent agreement with criterion tapes before coding family interact ions for this study. For this study, several compos ite DPICS variables capturing parent and child disruptive behavior were created: mother ne gative behavior (MNB), father negative behavior (FNB), child disruptive behavior with mother (CDBM), and child disruptive be havior with father (CDBF). Child disruptive behavior was comprised of 6 DPICS codes: critical talk, whine, yell, smart talk, negative touch, and noncompliance. The first five codes, simple 0 frequency counts, were summed, and the sum was converted to a standardized z score; noncompliance was also converted to a standardized z scor e. Finally, the z scores from th e frequency and ratio codes were added together to create composite scores for ch ild disruptive behavior with mother and father. Mother and father negative behavior was each co mprised of 4 codes: critical talk, smart talk, yell, and physical negative. The frequencies of each of these beha viors across the three observation situations were summed and converted to standardized z-scores. Eyberg Child Behavior Inventory (ECBI). The ECBI (Eyberg & Pincus, 1999) is a 36-item parent-report measure of disruptive behavior that assesses behavior on an Intensity Scale and a Problem Scale. A score above 132 on the Intensity s cale indicates clinically significant disruptive behavior. The Intensity Scale has been found internally consistent and stable over time, and its construct validity has been supported by demonstra tions of convergent and discriminate validity in several studies (Eyberg & Pincus, 1999). Procedure Data were drawn from the initial pretreatment assessment of all two-parent families in Studies A and B, in which the parents each completed several questionnaires including a 14

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demographic questionnaire and the BDI. Each parent was then videotaped in teracting with his or her child in the three DPICS standard situ ations (detailed in the DPICS section). 15

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CHAPTER 3 RESULTS Descriptive Data for Mothers, Fathers, and Children Differences between scores of mothers and fathers on all measures were examined using t tests. There was no significance difference in se lf-reported depression scores between mothers and fathers, t (149) = 1.69, p = .93. Mothers reported significantly higher levels of disruptive child behavior than fathers, t (152) = 2.50, p = .01. Additionally, observed parent negative behavior, t (153) = 2.06, p = .04, and child disruptive behavior, t (153) = 2.55, p = .01, were both significantly higher during mo ther-child than father-child interactions. BDI scores ranged from 0 to 32 for mothers an d from 0 to 31 for fathers (see Table 4-1 for descriptive statistics). Using criteria set forth by Beck, Steer, Brown (1996), 14 % of mothers and 15 % of fathers were in the mild (BDI 14) depression range, 12 % of mothers and 6 % of fathers were in the moderate (BDI 20) depr ession range, and 4 % of mothers and 1 % of fathers were in the severe (BDI 29) depressi on range. Overall 30 % of mothers and 22 % of fathers showed clinically signifi cant depressive symptomatology. Pearson Correlational Analyses within Model of Family Functioning Table 4-2 shows the correlation matrix for the six primary variables of interest: mother and father depressive symptomatology, father and mother negative behavior, and child disruptive behavior with mother and father. Mother and father depressive symptomatology were significantly correlated with each other, r (n = 76) = .35, p < .01, but neither parents’ BDI scores were significantly correlated w ith observed child disruptive be haviors or negative parenting behaviors during parent child inte ractions (see Table 4-2). Neither mother or father depressive symptomatology was significantly correlated with any other variable in the model. 16

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Mediation Analyses Our hypothesized mediational model posits that higher levels of depressive symptomatology would contribute to higher frequencies of negative mother and father behavior, which in turn would relate to increased levels of child disruptive behavior with mother and father, respectively. Baron and Kenny’s (1986) guid elines for mediation were followed to test this model. Two separate regression analyses were computed for each of the two dependent variables: child disruptive behavi or with mother and child disruptive behavior with father. The following criteria are necessary for mediati on: (I) the predictor (parent depressive symptomatology) is significantl y associated with the outcome variables (child disruptive behavior with mother and child disruptive behavior with father); (II) the predictor is significantly associated with the mediator (mother and fath er negative behavior); (III) the mediator is associated with the outcome variable (with the predictor accounted for); and (IV) the addition of the mediator to the full model reduces the re lation between the predic tor and criterion (as assessed by the Sobel [1988] test). Analyses did not support the hypothes is that mother and father negative behavior medi ate the relationship between parent depressive symptomatology and child disruptive behavior with mother a nd father respectively, as criterion I was not substantiated. Model of Dysfunctional Family Functioning Further examination of the co rrelation matrix (Table 4-2) revealed all observational variables of mother, father, and child disruptive behavior to be si gnificantly correlated with one another, suggesting a reduced model of dysfunc tional family functioning. Figure 4-2 depicts the correlational relationships present in this syst ems model of dysfunctional family functioning. 17

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Observational versus Parent Report Mea sures of Child Disruptive Behavior Considering the abundance of literature supporting the relation between maternal depression and negative outcomes in children, we had hypothesized a sign ificant relationship between parent depression and child disruptive behavior. When data did not follow predicted patterns, the model was re-examined by replacin g the observational measure of child disruptive behavior with a parent-report measure. Table 4-2 displays correlations among study variables when ch ild disruptive behavior is measured by parent report (ECBI). Figure 1-1 i llustrates the contrasti ng relationships that emerged in the model when child disruptive behavi or is measured by parent report rather than observationally. Mother, r (n = 78) = .29, p < .05, and father, r (n = 72) = .25, p < .05, depressive symptomatology were significantly related to mother and father report of child disruptive behavior. Mother depr essive symptomatology was also significantly co rrelated with father report of child disruptive behavior, r (n = 76) = .35, p < .01. When parent report replaced observational variables of child disruptive behavior, only two relationships from the observational model of dysfunctional family f unctioning, remained significant: negative father behavior and mother report of child disruptive behavior, r (n = 76) = .23 p < .05, and mother and father’s reports of disr uptive child behavior, r (n = 76) = .63, p < .01. Using parent report, a relationship between parent depression and child disruptive behavior is supported, but parent depression and parent negative behavior remain unrelated. Ad Hoc Mediational Analyses To further explore the observational model of dysfunctional family functioning, Baron and Kenny’s (1986) criteria were implemented to test the role of the parent’s negative behavior in mediating the relationship between their spouse’s negative behavior and with the child and the child’s disruptive behavior with the spouse. Tw o separate regression analyses were computed 18

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for each of the two dependent variables: child disruptive behavior with mother and child disruptive with father. Observed child disruptive behavior with father as the outcome variable . Regression techniques were used to identify the direct effect of father ne gative behavior on child disruptive behavior with father (criterion I) and mother negative behavior (criterion II). Results, depicted in Figure 4-3, indicated that father negativ e behavior significantly predicted 34%, F (1,75) = 38.28, p<.001, of the variance of child disr uptive behavior with father, meeting the first requirement for mediation and 26%, F (1,75) = 26.95, p < .001, of the variance in mother negative behavior, satisfying the second requirement for mediation. In accordance with criterion III, mother negative behavior predicted 25%, F(1,75) = 24.73, p < .001, of the variance in child disruptive behavior with father, with the effects of father negative behavior accounted for in the equation. Finally, the relation between father negative behavior and child di sruptive behavior with father was reduced from 34% to 14%, F(1,75) = 23.816, p<.001] when mother negative behavior was accounted for, demonstrating criteria IV for mediation (see Table 4-3). The Sobel (1988) significance test, which tests for a decrease in th e total effect of the predictor on the criterion after controlling for the mediator provides additional support for criterion IV (Sobel z = 2.38, p < .05), showing that mother negative behavior me diates the relation between negative father behavior and child disruptive behavior with father. The addition of the mediator reduced the direct path between father negati ve behavior and child disruptive behavior with father to a nonsignificant value, suggesting full mediati on. Table4-3 presents these data. Observed child disruptive behavior with mother as the outcome variable. Analyses did not support the hypothesis that father negative behavior mediates the relationship between mother 19

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negative behavior and child disruptive behavi or with mother, because criterion I was not substantiated. 20

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Table 3-1. Means and Standard Deviat ions of Parent and Child Measures Mother Father M SD n SD n M t 78 73 BDI 10.84 7.88 8.81 6.86 1.69 78 76 ECBI 164.33 24.67 152.99 31.39 2.50* 78 77 Negative Parent Behavior 18.22 16.48 13.68 10.22 2.06* Child Disruptive Behavior with Parent 29.35 18.65 78 29.94 77 21.56 2.55* Note. BDI = Beck Depression Inventory; E CBI = Eyberg Child Behavior Inventory. * p < .05. 21

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Table 3-2. Pearson Correl ations Between Maternal and Paternal Variables Variable 1 2 3 4 5 6 7 8 1. Mother BDI — .35** -.10 .02 -.03 -.17 .29* .35** 2. Father BDI — -.07 -.15 -.11 -.14 .09 .25* 3. DPICS: Father Negative Behavior — .52** .37** .38** .23* .17 4. DPICS: Mother Negative Behavior — .66** .42** .13 .03 5. DPICS: Child Disruptive Behavior with Mother — .55** .12 .10 6. DPICS: Child Disruptive Behavior with Father — -.04 .04 7. ECBI: Child Disruptive Behavior with Mother — .63** 8. ECBI: Child Disruptive Behavior with Father — Note. BDI = Beck Depression Inventory.; Sample included 79 families, with missing data resulting in differences in the total numb er of participants for some analyses. *p < 0.05. ** p < 0.01. 22

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Table 3-3. Mediation Hierarchical Regression Analysis Predicting Outcome: Final Block of the Regression Step Variable(s) R 2 R 2 F Outcome Variable = Child Disruptive Behavior with Father 1 .25 .25 11.5* Mother Negative Behavior .5 2 .40 .14 23.82* Mother Negative Behavior .27 Father Negative Behavior .44 * p < . 001 23

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MNB FNB CDBM CDBF Figure 3-1. Systems Model of Dysfunctional Family Functioning. Solid lines represent significant correlations when observation measures from DPICS were used to quantify parent and child disruptive be havior, p < 0.01. MNB= Mother Negative Behavior; FNB= Negative Father Behavior ; CDBM= Child Disruptive Behavior with Mother; CDBF = Child Disruptive Behavior with Father 24

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MNB FNB CDBF .52* .42*(.50*) .38*(.45*) z=2.38* Figure 3-2. Mediational Model fo r Associations Between Father Negative Behavior and Child Disruptive Behavior with Fath er as Mediated by Mother Negative Behavior. Values on the paths represent zero-or der correlations (rs) outside the parentheses and path coefficients (standardized regression coefficients [ ]) inside the parentheses. Sobel’s test is represented as a z value. * p < .01 FNB= Negative Father Behavior; MNB= Mother Negative Behavior; CDBF = Child Disruptive Behavior with Father 25

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CHAPTER 4 DISCUSSION Observational Model of Dysfunc tional Family Functioning Previous studies have suggested that to understand the relati onship between a parent and child it is imperative to examine the dyad with in a framework of the larger family context (Lamb, 1997; Parke, 1996; Parke & Buriel, 1998 ). Observational studies have found that depressed mothers and their children engage in a “reciprocal pattern of negativity and hostility” (Coyne, Downey, & Boergers, 1992). This family-systems approach views the family not as a static entity but rather as an ever-changing system in which the behaviors of each family member impact the behavior of the other members. Although initial correlational analyses using obs ervational measures of child behavior did not support a relationship between parental depr ession child disruptive behavior, exploratory analyses suggested an important model of dysfunc tional family functioning for further study (see Figure 4-2). The statistically significant relationships among all family members’ observed negative behaviors highlight the ro le of one individual’s negative behavior in contributing to a more global pattern of dysfunctional behavior within the family. This model encourages implementation of family systems theory when c onceptualizing cases of disruptive behavior in preschoolers as well as including both pa rent(s) and child in treatment. Follow-up analyses revealed that mother ne gative behavior mediated the relationship between father negative behavior and child di sruptive behavior with father (Figure 4-3), highlighting a fascinating pathway within the fam ily system. This pathway is consistent with previous studies in suggesting that father-child relationships are particul arly sensitive to the overall family context (Cummings, Davies, & Campbell, 2000). For example, lower marital quality (Cummings & O'Reilly, 1997), divorce, and social support have been shown to have a 26

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more negative impact on father-child relationshi ps than mother-child relationships (Amato & Keith, 1991a, 1991b; Lamb & Elster, 1985). Cummings et al. (2000) suggests mothers to supp ort or inhibit the father-child relationship. Our mediational data provide some support for this assertion. Perhaps mothers’ tendency to be with their children more often than fathers’, al lows maternal behavior a greater opportunity to impact the family system, as in the old saying, “If momma ain’t happy, ain’t nobody happy!” Parent-Child Observational Measures versus Parent Report Measures The discrepancy between parent-report and observational measures of child disruptive behavior revealed in this st udy, challenges previous findings of strong associations between parent depression and child disr uptive behavior based solely on parent-report measures. It is important to consider the additi onal insight these observational data offer. First, these results highlight the need for future studies to incorporate both parent-report a nd observational data of child behavior that target the same construct. A literature review dedicated to comparing outcome measures used to assess child behavior in relation to parental depression would be a valuable for further understanding this complex parent-child relationship. Second, these findings challenge researchers an d clinicians to esta blish more evidencebased assessment methods of integrating data across multiple informants and situations. Countless studies have been dedicated to establ ishing a wide array of validity and reliability estimates for measures across different ages, ethnicities, and socioeconomic groups (Mash and Hunsley, 2005). Recommendations to implement relia ble and valid measures in assessment have become more frequent and form the foundation of the increasingly popular movement towards evidence-based assessment (Kazdin, 2005; Mash and Hunsley, 2005; McMahon and Frick, 2005). Ironically, a thorough review of the current child assessment literature concludes there was “no ‘gold standard’ by which to validate assessments” (Kazdin, 2005). This study highlights 27

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two highly reliable and valid measures of child disruptive behavior: the Eyberg Child Behavior Inventory, Intensity Scale (ECBI) and a composite measure of child disruptive behavior from The Dyadic Parent-Child Inte raction Coding System (DPICS ). Despite the psychometric integrity of each of these measur es, they are not significantly co rrelated among variables in this population and form differing patterns of relationships within families. Kazdin (2005) asserts that multiple measures are needed to assess different dimensions of childhood psychopathology. The practice of soliciting m easures from multiple sources has a rich tradition in clinical child psychology (Mash and Hunsle y, 2005). Achenbach et al. (1987) produced data demonstrating the relatively low correlational relationships among multiple informants of child behavior (e.g., teachers, pare nts, observers, mental health workers). Their data suggest that different methods of measur ement of the same construct may provide unique information. Some researchers have argued that low correla tions between two informnatns of the same constract, to cast doubt on one or both of the informants (Garris on & Earls, 1985) as well as the measures (Gould & Schaffer, 1985). Stoneman and Brody (1987) argued that observational methods permit access to data that cannot be obtained in any other manner; it provides information from “inside the family” without be ing biased by individuals ’ appraisals of their own behavior (Kerig, 2001). Althou gh DPICS categories provide rich da ta, is it fair to assert it to be the “gold standard” against which all other measures (e.g., parent re port) should be judged? This perspective fails to account for the possibility that different types of measures completed by different informants add important information th at, when appropriately in tegrated, constructs a more complete and comprehensive clinical pi cture (Achenbach, McConaughy, & Howell, 1987). 28

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Querido, Eyberg, and Boggs (2001) began to tackle the large discrepancy found between parent-report and observational data of child behavior among depressed mothers. Their study concluded that increased levels of depression to yielded more accurate maternal reports of child behavior problems. These findings speak to the bias inherent in parent-report measures of child behavior. There is a limitless list of tertiary variables (eg. depression, pa rental stress, marital satisfaction) that potentially can impact a pare nt’s view of their child’s behavior. A clever clinician would carefully consider the possibili ty that the presence of a deviant informant indicates a need to target the informant’s percepti ons or behaviors in treatment (Achenbach et al., 1987). A study conducted by Dawson et al. (2003) also serves as a nice comparison for the results of this study. Similar to our findings, signi ficant positive correlations were found between maternal depression and mother report of child externalizing behavior on the Child Behavior Checklist. Mother and father reports of child problem behavior were also significantly correlated. Although a weak case might arise that both parents are giving distorted reports of their child’s behavior (Cicchetti, Rogosch, & To th, 1998), these data seems to provide a strong argument against the depressed mother distorti on hypothesis. Another study compared responses on the CBCL between a group of mothers with a BD I below 16 to a group of mothers with a BDI above 16 and did not find a significant diffe rence, again arguing against the distortion hypothesis. Using the same criteria the current data set held consistent with previous findings. As the field builds its unde rstanding of evidence-based a ssessment, exploring ways in which multiple measures should be appropriate ly weighted and integrated is essential (Achenbach & Rescorla, 2001). Just as steps have been outlined for carry ing out evidence-based treatment, we must begin to examine ways to in tegrate data from already established reliable and 29

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valid measures of child psychopathologies. Although the art dimension of assessment will always demand that child psychologists to us e clinical judgment, designing methods to “synthesize and disseminate” current knowledge of evidence based assessment effectively will encourage clinicians to empl oy empirically supported methods more frequently (Mash and Hunsley, 2005). To advance towards evidence based assessment, recommendations must move away from statements such as, “Assessment should include reliable and valid measures” (Smith and Dumont, 2002) towards more specific how-to statements. Alt hough complex, establishing norms of patterns among different measures would serve as another important resource in the evidencebased assessment toolbox. Just as researcher s of the Minnesota Multiphasic Personality Inventory have studied how varying combinati ons of weights among personality scales produce quite different clinical pictures, it seems prom ising that child psychologists could do the same (e.g., When Measure A (parent report) and Meas ure B (teacher report) differ by at least 2 standard scores, interv ention should target pare nt-child interaction). Limitations and Future Directions The sample was restricted to two-parent househ olds in which both parents were enrolled in treatment. This hinders the generalizability of conclusions to non-traditional families and families in which fathers did not participate in treatme nt. Additionally, this study considered the impact of parent depression and the relationships within those families with preschool age children. It should not be assumed that parent depression will maintain similar relationships with overall family functioning across the lifespa n of the family (Goodman & Gotlib, 1999). Developmental theory reminds researchers of the importance of development-dependent variables, including the chronicity of the event and severity of symptoms within the depressed parent. To tap into these important ques tions, longitudinal designs are warranted. 30

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Because this current model of family functi oning reminds clinicians and researchers that parent-child relationships function within the context of the larger family system, we must also remember the family itself is part of a larger system of community and cultural contexts (Bronfenbrenner, 1979). Future research design s targeting the impact of various community factors (e.g., quality of public sc hool education, neighborhood crime, peer relations, parent social support) will allow further understanding of the complex relationships th at exist among family members. Additionally these types of designs wi ll help researchers be tter understand why similar children with similar parents experi ence such a myriad of outcomes. 31

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Jacob, T., & Johnson, S. L. (1997). Parent-chi ld interaction among depressed fathers and mothers: Impact on child functioning. Journal of Family Psychology, 11 , 391-409. Jennings, K. D., Ross, S., Popper, S., & Elmore, M. (1999). Thoughts of harming infants in depressed and nondepressed mothers. Journal of Affective Disorders, 54 , 21-28. Kazdin, A.E. (2005). Evidence-Based Assessmen t for Children and Adolescents: Issues in Measurement Development and Clinical Application. Journal of Clinical Child and Adolescent Psychology, 34, 548-558. Kerig, P. K. (2001). Introduction and Overview: Conceptual Issues In Family Observational Research. In P. K. Kerig & K. Lindahl, M (Eds.), Family Observational Coding Systems: Resources for systemic research (Vol. xviii, pp. 1-22). Mahw ah, NJ: Lawrence Erlbaum Associates. Lamb, M. E. (Ed.). (1997). The role of the father in child development (3rd ed ) . Hoboken, NJ,US: John Wiley & Sons, Inc. Lamb, M. E., & Elster, A. B. (1985). Adol escent mother-infant-father relationships. Developmental Psychology, 21 , 768-773. Leadbeater, B. J., Bishop, S. J., & Raver, C. C. (1996). Quality of moth er-toddler interactions, maternal depressive symptoms, and behavi or problems in preschoolers of adolescent mothers. Developmental Psychology, 32 , 280-288. Lutenbacher, M. (2002). Relationships between psychosocial factors a nd abusive parenting attitudes in low-income single mothers. Nursing Research, 51 , 158-167. Marchand, J. F., & Hock, E. (1998). The relation of problem behaviors in preschool children to depressive symptoms in mothers and fathers. Journal of Genetic Psychology, 159 , 353366. Mash E.J. & Hunsley, J.E. (2005). Evidence-B ased Assessment of Child and Adolescent Disorders: Issues and Challenges. Journal of Clinical Child and Adolescent Psychology, 34, 362-379. McMahon, R.J. & Frick, P.J. (2005). EvidenceBased Assessment of Child and Adolescent Disorders: Issues and Challenges. Journal of Clinical Child and Adolescent Psychology, 34, 477-505. McNeil, C. B., Eyberg, S. M., Eisenstadt, T. H., Newcomb, K., & Funderburk, B. (1991). Parentchild interaction therapy with behavior problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology, 20 , 140-151. Milgrom, J., & McCloud, P. (1996). Parenting stress and postnatal depression. Stress Medicine, 12, 177-186. 35

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BIOGRAPHICAL SKETCH Courtney Ann Ingalls was born in Yokosuka, Japan on May 27, 1982. At the time of her birth her father was enrolled in the United States Naval Services. The ol dest of three children, she was raised primarily in Montgomery, Alab ama and graduated from Saint James High School in 2000. She earned her B.A. in experimental psychology from the University of South Carolina Honors College in 2004. Upon college graduation, Courtney worked as a research assistant in the psychology laboratory of Ronald Prinz. at the University of South Carolina. In August of 2005, she enrolled in a dual Master of Science and Doctorate of Philosophy program in the University of Florida’s Department of Clinical and Health Psychology. C ourtney currently has a research assistantship in the Child Study Laboratory under the mentorship of Sheila Eyberg and Stephen Boggs. Upon completion of her Master of Science, Courtney will continue her Doctor of Philosophy work in the Department of Clinical and Health Psychology. 38