Do parental feeding practices moderate the relationships between impulsivity and eating in children?

This study examines the relationships between children's impulsivity, their eating behaviours, and their perceptions of their parent's feeding practices. 153 10-13. year old children completed questionnaires assessing their eating behaviours, their impulsiveness and their perception of their parent's feeding practices. Children's reports of dysfunctional eating behaviours were significantly correlated with their perceptions of their parents feeding practices and with their levels of impulsivity. Children's reports of parental monitoring of their food intake significantly moderated the influence of child impulsiveness upon emotional eating. Children's perceptions of parental monitoring of their food intake may potentially have a protective effect at preventing more impulsive children from eating in response to emotional feelings. © 2011 Elsevier Ltd.

Medicines optimisation for young people with juvenile arthritis and other long-term conditions:system-level barriers to engagement

To explore the views of pharmacy and rheumatology stakeholders about system-related barriers to medicines optimisation activities with young people with long-term conditions. A three-phase consensus-building study comprising (1) focus groups with community and hospital pharmacists; (2) semi-structured telephone interviews with lay and professional adolescent rheumatology stakeholders and pharmacy policymakers, and (3) multidisciplinary discussion groups with community and hospital pharmacists and rheumatology staff. Qualitative verbatim transcripts from phases 1 and 2 were subjected to framework analysis. Themes from phase 1 underpinned a briefing for phase 2 interviewees. Themes from phases 1 and 2 generated elements of good pharmacy practice and current/future pharmacy roles for ranking in phase 3. Results from phase 3 prioritisation and ranking exercises were captured on self-completion data collection forms, entered into an Excel spreadsheet and subjected to descriptive statistical analysis. Institutional ethical approval was given by Aston University Health and Life Sciences Research Ethics Committee. Four focus groups were conducted with 18 pharmacists across England, Scotland and Wales (7 hospital, 10 community and 1 community/public health). Fifteen stakeholders took part in telephone interviews (3 pharmacist commissioners; 2 pharmacist policymakers; 2 pharmacy staff members (1 community and 1 hospital); 4 rheumatologists; 1 specialist nurse, and 3 lay juvenile arthritis advocates). Twenty-five participants took part in three discussion groups in adolescent rheumatology centres across England and Scotland (9 community pharmacists; 4 hospital pharmacists; 6 rheumatologists; 5 specialist nurses, and 1 physiotherapist). In all phases of the study, system-level issues were acknowledged as barriers to more engagement with young people and families. Community pharmacists in the focus groups reported that opportunities for engaging with young people were low if parents collected prescriptions alone, which was agreed by other stakeholders. Moreover, institutional/company prescription collection policies – an activity largely disallowed for a young person under 16 without an accompanying parent - were identified by hospital and community pharmacists as barriers to open discussion and engagement. Few community pharmacists reported using Medicines Use Review (England/Wales) or Chronic Medication Service (Scotland) as a medicines optimisation activity with young people; many were unsure about consent procedures. Despite these limitations, rheumatology stakeholders ranked highly the potential of pharmacists empowering young people with general health care skills, such as repeat prescription ordering. The pharmacy profession lacks vision for its role in the care of young people with long-term conditions. Pharmacists and rheumatology stakeholders identified system-level barriers to more engagement with young people who take medicines regularly. We acknowledge that the modest number of participants may have had a specific interest and thus bias for the topic, but this underscores their frank admission of the challenges. Professional guidance and policy, practice frameworks and institutional/company policies must promote flexibility for pharmacy staff to recognise and empower young people who are able to give consent and take responsibility for medicines activities. This will increase mutual confidence and trust, and foster pharmacy’s role in teaching general health care skills. In this way, pharmacists will be able to build long-term relationships with young people and families.

Power and influence in joint venture relationships and their impact on performance

The purpose of this research was to apply the concepts of power and influence tactics to the joint venture context by examining how they relate to venture performance. In addition, culture and the expectations of future cooperation were examined for their association with influence tactic use and joint venture performance. Data were collected from 58 parent firms of U.S.-based domestic and international joint ventures about their relationships with their partners.^ Under the theories of social exchange and power dependence, a parent's level of power is based on its partner's dependence on the relationship. The statistical results indicated that: (1) the greater the total of power of both parents in an equal power relationship, the greater the joint venture's performance; and (2) the greater the inequality between each parent's level of power, the lower the joint venture's performance. It was also found that the way in which a parent firm tried to influence its partner was related to joint venture performance. Specifically, the use of references to a partner's legitimate authority was negatively related to performance, while the use of rational arguments and compromises was positively related.^ Contrary to expectations, the cultural backgrounds of the parents were not shown to have a relationship to influence tactic use or joint venture's performance. On the other hand, greater expectation of future cooperation had a positive association with performance, and a significant relationship with influence tactic use. The greater the expectation, the less partners used more confrontational tactics such as pressure or legitimate authority. ^

Building better relationships workshop: An intervention fostering identity formation and interpersonal development in middle adolescents

The aim of this study was to further knowledge development concerning the formation of a sense of identity and intimacy. This study drew on the growing recognition by many researchers in the psychosocial development field of the need to target interventions at the interface of the development of identity and intimacy. The specific aim of the study was to address the question of whether it would be possible to develop intervention procedures for fostering identity and intimacy exploration and development. Using both qualitative and quantitative measurements, the results appeared to clearly support an affirmative answer to this question. A total of sixty-three middle adolescent students from an urban, public high school participated in this study. Twenty-nine participants in the treatment group and 34 participants in the comparison group were pre- and post tested on measures of identity and intimacy. Participants in this study consisted of multiethnic, urban youth that presented themselves for relationship counseling. Repeated measures analysis of variance's (RMANOVA's), used to evaluate the impact of the intervention on the quantitative measures of identity and intimacy exploration, clearly supported the efficacy of the intervention. In addition, the findings also provided tentative support for the view that the increase in exploration that results from entering a period of active exploration is associated with a “loosening” of commitment. Finally, the findings of this study also contributed to the empirical knowledge-base about procedures for intervening with respect to the process of intimacy development. More specifically, both the qualitative and quantitative findings of this study began to shed some light on the potential impact of exploration for interpersonal insight as that as a process for fostering intimacy development. ^

Child parent dyadic treatment for anxiety disorders in youths

There is evidence for the efficacy of treatments for childhood anxiety disorders; however, less is known about whether including parents in the child's treatment enhances child treatment response. There also are few studies that have examined predictors of treatment completion/non-completion and success/failure. In this dissertation, a child focused individual treatment was compared to a dyadic child-parent treatment. In dyadic, parent anxiety symptoms and child-parent relationships were targeted. Based on the Transfer of Control Model proposed by Silverman and Kurtines (1996a, b, 2005), it was hypothesized that treatment changes in parent anxiety symptoms and child-parent relationships would be related to positive child treatment response. ^ Participants were 119 youths (ages 6 to 16 years, M = 9.93 SD = 2.75; 68 girls) and their parents. All youth were born in the U.S. but had various backgrounds; 40 were European American, 73 were Latinos/as, 6 were of other ethnic backgrounds or did not report their ethnicity. Participants signed informed consent (assent for youths) and completed a pretreatment assessment. Participants were randomized to a child individual treatment or dyadic treatment, were assessed immediately after treatment and one year post treatment. Findings showed that treated youths improved across all measures over time. Comparison of treatment conditions across all measures showed no statistically significant differences between the child individual and dyadic treatment. Reductions in parent anxiety symptoms and improvements in child-parent relationships were significantly related to child treatment change at posttreatment and at one year follow-up across treatments. No factors differentiated completers from non-completers and only parent reported child internalizing behavior problems were significantly negatively related to child treatment response. ^ The study findings support a premise of the Transfer of Control Model that changes in parent anxiety symptoms and child-parent relationships are related to child treatment response. The study findings show that children can be successfully treated when parents are included as co-clients in dyadic treatment, thereby supporting the utility of this approach in practice. ^

Substance use and sexual risk behaviors among adolescent detainees

There is a commonly presumed link among sexual risk behavior, substance use, and other psychosocial factors among adolescents. However, these relationships have been relatively understudied in detained, low-income, minority, substance abusing adolescents. This study addresses this gap in the literature with a secondary data analysis based on a sample of adolescent offenders in two detention and treatment centers in Miami-Dade County. Univariate, bivariate statistical analysis and multivariate logistic regressions were conducted on baseline data from structured interviews with 455 adolescents participating in an NIH funded prevention intervention. Data were analyzed to assess relationships among self-reported substance use, STD history, HIV/AIDS knowledge, condom use, condom use attitudes, and skills, peer and parental approval to use condoms, and race/ethnicity. The adolescent sample was 74.1% male, and 25.9% female and 35.4% African American, 25.1% non-African American Latino, 11.2% White, and 28.4% of other race/ethnicity categories. The mean age was 15.6 years. Results suggested that alcohol use (p < 0.001) and use of marijuana, cocaine and other drugs (p < 0.001) are significant variables when explaining the variability in sexual risk behaviors. Results also suggested that unprotected vaginal, anal, and oral sex increased with higher alcohol and drug use (p < 0.001) and that positive attitudes about personally using condoms (p < 0.001) were also significantly related to condom use. Logistic regressions showed that race/ethnicity was a significant control variable when explaining the variability of condom use. Being White and Latino were significantly associated with less condom use during oral and anal sex when compared to other racial/ethnic groups. These results indicated that risky sexual behavior and HIV infection risk are significantly associated with substance use, particularly alcohol use. Therefore, proper screening and identification of alcohol use, and condom use attitudes could maximize the efficacy of referrals to programs targeting both issues and increase the potential for appropriate primary and secondary prevention and treatment among adolescent detainees.

Hispanic adolescents with severe substance abuse problems: Parental involvement, acculturation-related factors, and attachment

The main objective of the study was to investigate the relationship between parent-related, acculturation-related, and substance use-related variables found within individual, familial/parental, peer and school adolescent ecological domains, in a clinical sample (i.e. adolescents who met criteria for a Diagnostic Statistical Manual-IV [DSMIV] clinical diagnosis of substance abuse/dependence) of Hispanic adolescents from Miami, Florida. ^ The sample for this study consisted of 94 adolescent-mother pairs. The adolescent sample was 65% male, and 35% female, with a mean age of 15 years. More than half of the adolescents were born in the United States (60%) and had resided in the U.S. for an average of 12 years; 80% of the caregivers (primarily mothers) were foreign-born and lived in the U.S. for an average of 21 years. ^ Correlation and hierarchical regression were used to answer the research questions. The findings indicate that the hypothesized model and corresponding anticipated effect of the relationship between parental school and peer involvement on adolescents’ frequency of alcohol, marijuana and cocaine use was not supported by the data. Parental “acculturation-related” variables did not explain any of the variance in adolescent substance use frequency in this sample. Mediation and moderation models were not supported either. However, some interesting relationships were found: ^ The larger the acculturation gap, the lower the parental involvement in school tended to be (r = -.21, p < .05). Adolescents who experienced a greater acculturation gap with their parents (-.81, p >.01) had an earlier onset of marijuana (-.33, p < .01) and cocaine use (r = -.24, p <.01). The less acculturated parents experienced more parenting stress (r = -.31, p = < .01). Attachment was positively associated with parental peer involvement (r = .24, p < .05) and inversely associated with parenting acculturative stress (r = -.24, p < .05). Attachment was also positively associated with marijuana (r = .39, p < .01) and cocaine use (r = .33, p < .01). Adolescent males reported being more attached to their mothers when compared to adolescent females (r = .22, p >.05), they also reported using marijuana more frequently than females (.21, p >.05). ^

Effects of adolescent depressive symptoms, pubertal development, and interpersonal relationship satisfaction on sexual risk behaviors in adolescent romantic couples

This study examined links between adolescent depressive symptoms, actual pubertal development, perceived pubertal timing relative to one’s peers, adolescent-maternal relationship satisfaction, and couple sexual behavior. Assessments of these variables were made on each couple member separately and then these variables were used to predict the sexual activity of the couple. Participants were drawn from the National Longitudinal Study of Adolescent Health (Add Health; Bearman et al., 1997; Udry, 1997) data set (N = 20,088; aged 12–18 years). Dimensions of adolescent romantic experiences using the total sample were described and then a subsample of romantically paired adolescents ( n = 1,252) were used to test a risk and protective model for predicting couple sexual behavior using the factors noted above. Relevant measures from the Wave 1 Add Health measures were used. Most of the items used in Add Health to assess romantic relationship experiences, adolescent depressive symptoms, pubertal development (actual and perceived), adolescent-maternal relationship satisfaction, and couple sexual behavior were drawn from other national surveys or from scales with well documented psychometric properties. Results demonstrated that romantic relationships are part of most adolescents’ lives and that adolescents’ experiences with these relationships differ markedly by age, sex, and race/ethnicity. Further, each respective couple member’s pubertal development, perceived pubertal timing, and maternal relationship satisfaction were useful in predicting sexual risk-promoting and risk-reducing behaviors in adolescent romantic couples. Findings in this dissertation represent an initial step toward evaluating explanatory models of adolescent couple sexual behavior.

Parental involvement and group cognitive behavioral treatment for anxiety disorders in children and adolescents: Treatment specificity and mediation effects of parent and peer variables

Phobic and anxiety disorders are one of the most common, if not the most common and debilitating psychopathological conditions found among children and adolescents. As a result, a treatment research literature has accumulated showing the efficacy of cognitive behavioral treatment (CBT) for reducing anxiety disorders in youth. This dissertation study compared a CBT with parent and child (i.e., PCBT) and child group CBT (i.e., GCBT). These two treatment approaches were compared due to the recognition that a child’s context has an effect on the development, course, and outcome of childhood psychopathology and functional status. The specific aims of this dissertation were to examine treatment specificity and mediation effects of parent and peer contextual variables. The sample consisted of 183 youth and their mothers. Research questions were analyzed using analysis of variance for treatment outcome, and structural equation modeling, accounting for clustering effects, for treatment specificity and mediation effects. Results indicated that both PCBT and GCBT produced positive treatment outcomes across all indices of change (i.e., clinically significant improvement, anxiety symptom reduction) and across all informants (i.e., youths and parents) with no significant differences between treatment conditions. Results also showed partial treatment specific effects of positive peer relationships in GCBT. PCBT also showed partial treatment specific effects of parental psychological control. Mediation effects were only observed in GCBT; positive peer interactions mediated treatment response. The results support the use CBT with parents and peers for treating childhood anxiety. The findings’ implications are further discussed in terms of the need to conduct further meditational treatment outcome designs in order to continue to advance theory and research in child and anxiety treatment.

The longitudinal influence of physical activity on adolescent alcohol use

The purpose of this research was to explore the influence of physical activity on depressive symptomatology and adolescent alcohol use during an underexplored transition from middle school to high school. The study initiative is supported by the fact that research has shown a unique and simultaneous decrease in physical activity (CDC, 2010), increase in depressive symptomatology (SAMHSA, 2010) and increase in alcohol use (USDHHS, 2011) during middle adolescence. A risk and resilience framework was used in efforts to conceptualize how these variables may be inter-related. Data from waves I and II of the National Longitudinal Study of Adolescent Health (Add Health, Bearman et al., 1997; Udry, 1997) was used (N = 2,054; aged 13–15 years). The sample was ethnically and racially diverse (58.2% White, 24% African American, 11.7% Hispanic, and 6.1% other). Structural equation models were developed to test the potential influence physical activity has on adolescent alcohol use (e.g., frequency of alcohol use and binge alcohol use) and whether any of the relationship was mediated by depressive symptomatology or varied as a function of gender. Results demonstrated that there was a significant influence of structured physical activity (e.g., sports) on adolescent alcohol use. However, contrary to the proposed hypothesis, engaging in structured physical activity appeared to contribute to greater binge drinking among adolescents. Instead of demonstrating a protective feature, the findings suggest that engaging in structured physical activity places adolescents at risk for binge drinking. Furthermore, no significant relationships, positive or negative, were found for the influence of physical activity (structured and unstructured) on frequency of alcohol use. The findings regarding mediation revealed binge drinking as a mediator between physical activity (structured) and depressive symptomatology. These findings provide support for research, practice, and policy initiatives focused on developing a more comprehensive understanding of alcohol use drinking behaviors, physical activity involvement, and depressive symptomatology among adolescents, which this study demonstrates are all associated with one another. Results represent an initial step toward evaluating these relationships at a much younger age.

Late adolescents in transition: Social networks, parent relations, and well -being

A two-year longitudinal study was conducted to investigate late adolescents in transition. An initial investigation with senior high school students assessed students prior to leaving home for college and after college entrance. Of the original 131 participants recontacted two years after their graduation, 78 returned surveys. The study (a) explored changes in social network structure and function, (b) determined whether late adolescent-parent-peer relations change over time, and (c) identified prospectively the impact of social support, adolescent-parent-peer relations, and attachment security on well-being and feelings about the transition after high school. Students attending college locally reported an increase in total network support at Time 2. Regardless of location, more support from friends was received after the transition from high school, whereas family support did not vary across time. Parent relations were closer after the transition and were predictive of various well-being measures and feelings about the transition from high school. ^

Compensatory effects of parent and peer support on well -being and achievement during pre- and early adolescence

The current study was designed to explore the salience of parent and peer support in middle childhood and early adolescence across two time periods as indicated by measures of achievement (grade point average (GPA), Stanford Achievement Test (SAT) scores and teacher rated school adaptation) and well-being (loneliness, depression, self-concept and teacher-rated internalizing behaviors). ^ Participants were part of an initial study on social network relations and school adaptation in middle childhood and early adolescence. Participants at Time 1 (in the spring of 1997) included 782 children in grades 4 and 6 of eight lower and middle income public elementary schools. Participants (N = 694) were reinterviewed two years later in the spring of 1999 (Time 2). ^ Multivariate analyses of variance (MANOVA) were used to investigate the change in salience of parent and peer support from Time 1 to Time 2. In addition, Tukey-HSD (Honestly Significant Difference) post hoc tests were used to test the significance of the differences among the means of four support categories: (1) low parent-low friend, (2) low parent-high friend, (3) high parent-low friend, and (4) high parent-high friend. ^ Compensatory effects were observed for loneliness and self-concept at Time 1, as well as for SAT scores, self-concept and overall achievement at Time 2. Results were consistent with existing findings that suggest a competitive model of parent/peer influence on achievement during adolescence. This study affirms the need for a more contextual approach to research examining competing and compensatory effects on adolescent development. ^

On the developmental continuity /discontinuity of early adolescent patterns of racial identity salience: Relations with later identities and psychosocial adjustment

Given the significant amount of attention placed upon race within our society, racial identity long has been nominated as a meaningful influence upon human development (Cross, 1971; Sellers et al., 1998). Scholars investigating aspects of racial identity have largely pursued one of two lines of research: (a) describing factors and processes that contribute to the development of racial identities, or (b) empirically documenting associations between particular racial identities and key adjustment outcomes. However, few studies have integrated these two approaches to simultaneously evaluate developmental and related adjustment aspects of racial identity among minority youth. Consequently, relations between early racial identity developmental processes and correlated adjustment outcomes remain ambiguous. Even less is known regarding the direction and function of these relationships during adolescence. To address this gap, the present study examined key multivariate associations between (a) distinct profiles of racial identity salience and (b) adjustment outcomes within a community sample of African-American youth. Specifically, a person-centered analytic approach (i.e., cluster analysis) was employed to conduct a secondary analysis of two archived databases containing longitudinal data measuring levels of racial identity salience and indices of psychosocial adjustment among youth at four different measurement occasions.^ Four separate groups of analyses were conducted to investigate (a) the existence of within-group differences in levels of racial identity salience, (b) shifts among distinct racial identity types between contiguous times of measurement, (c) adjustment correlates of racial identity types at each time of measurement, and (d) predictive relations between racial identity clusters and adjustment outcomes, respectively. Results indicated significant heterogeneity in patterns of racial identity salience among these African-American youth as well as significant discontinuity in the patterns of shifts among identity profiles between contiguous measurement occasions. In addition, within developmental stages, levels of racial identity salience were associated with several adjustment outcomes, suggesting the protective value of high levels of endorsement or internalization of racial identity among the sampled youth. Collectively, these results illustrated the significance of racial identity salience as a meaningful developmental construct in the lives of African-American adolescents, the implications of which are discussed for racial identity and practice-related research literatures. ^

Caring and being cared -for: Perceptions of adolescent males at -risk for school failure

This qualitative study used grounded theory methods and purposeful sampling to explore perceptions on caring and being cared-for. Twenty-four adolescent male participants, identified as at-risk for school failure, completed a two phase interview process exploring these phenomena within three relationships; the relationship with the friend, with the most caring person they knew and with the teacher they felt cared for them. ^ Each participant was asked a predetermined set of open questions in an initial semi-structured interview. In addition each participant was encouraged to explore his own reflections on caring. A second interview allowed for member checking and for the participant to continue sharing his meaning of caring and being cared-for. ^ Line by line analysis with open, axial and selective coding was applied to interview transcripts along with a constant comparative method. Results indicated that the core category integrating all other categories was attachment bonding. Participants' stories manifested characteristics of proximity seeking, secure base, safe haven and distress upon involuntary separation from an attachment figure. ^ Strategies facilitating attachment bonding were influenced by the power positions of the relational players. Participants responded positively to the one-caring when they felt cared-for. Results further indicated that participants did not need to feel a sense of belonging in order to feel cared-for. Teacher behaviors indicating openness for authentic connections with students were specific to teacher's friendliness and professional competence. Teachers who nurtured feelings of being cared-for were uncommon in the participants' educational experience. ^ The number of adolescent males leaving high school prematurely is both a personal problem and a social problem. Despite a “mask” of indifference often exhibited by adolescent males at-risk for school failure, teachers might consider the social/emotional needs of these students when implementing the curriculum. In addition, policy makers might consider the social/emotional needs of this vulnerable population when developing programs meant to foster psychological well-being and connectedness for adolescent males at-risk for school failure. ^

Hispanic Adolescents With Severe Substance Abuse Issues: Parental Involvement, Acculturation-Related Factors and Attachment

The main objective of the study was to investigate the relationship between parent-related, acculturation-related, and substance use-related variables found within individual, familial/parental, peer and school adolescent ecological domains, in a clinical sample (i.e. adolescents who met criteria for a Diagnostic Statistical Manual-IV [DSM-IV] clinical diagnosis of substance abuse/dependence) of Hispanic adolescents from Miami, Florida. The sample for this study consisted of 94 adolescent-mother pairs. The adolescent sample was 65% male, and 35% female, with a mean age of 15 years. More than half of the adolescents were born in the United States (60%) and had resided in the U.S. for an average of 12 years; 80% of the caregivers (primarily mothers) were foreign-born and lived in the U.S. for an average of 21 years. Correlation and hierarchical regression were used to answer the research questions. The findings indicate that the hypothesized model and corresponding anticipated effect of the relationship between parental school and peer involvement on adolescents’ frequency of alcohol, marijuana and cocaine use was not supported by the data. Parental “acculturation-related” variables did not explain any of the variance in adolescent substance use frequency in this sample. Mediation and moderation models were not supported either. However, some interesting relationships were found: The larger the acculturation gap, the lower the parental involvement in school tended to be (r = -.21, p < .05). Adolescents who experienced a greater acculturation gap with their parents (-.81, p >.01) had an earlier onset of marijuana (-.33, p < .01) and cocaine use (r = -.24, p .05), they also reported using marijuana more frequently than females (.21, p >.05).