Elsevier

Psychiatry Research

Volume 141, Issue 2, 28 February 2006, Pages 141-149
Psychiatry Research

Family cohesion and children's behavior problems: A longitudinal investigation

https://doi.org/10.1016/j.psychres.2005.06.009Get rights and content

Abstract

We examine the association of family cohesion and conflict with childhood behavior problems. A stratified random sample of 823 children was evaluated at ages 6 and 11 years. Mothers rated the family environment at age 6 using the Family Environment Scale. Mothers and teachers rated children's behavior problems at ages 6 and 11, using the Child Behavior Checklist and the Teacher Report Form, respectively. Multiple regression analysis, applying generalized estimating equations, was used. Although results varied between mothers' and teachers' data, they converged in identifying family cohesion as a factor in children's mental health. Family cohesion, as rated by mothers, had a beneficial effect on children's internalizing and attention problems, as rated by both mothers and teachers, that was stable over time. The study highlights an important relationship between family cohesion and children's internalizing and attention problems.

Introduction

Family cohesion and conflict have been found to predict children's behavior problems (LeFlore, 1988, Blaske et al., 1989, Dubow and Luster, 1990, Dishion et al., 1991, Cashwell and Vacc, 1996, Slee, 1996, Clark and Shields, 1997, Kliewer and Kung, 1998, Matherne and Thomas, 2001). Compared with mothers of normal children, mothers of children with conduct disorders were found to report that their families were less cohesive and higher in conflict (Slee, 1996). Similar results were reported from comparisons of delinquent and non-delinquent children's own perceptions of their family. Family cohesion predicted frequency of delinquent acts for adolescents in nontraditional families (Matherne and Thomas, 2001), and delinquent children reported lower family cohesion than their non-delinquent counterparts (LeFlore, 1988). In a study of inner-city youth, family cohesion modified the relationship between daily hassles and internalizing problems: children from highly cohesive families were less likely to be adversely affected by daily hassles than children from less cohesive families (Kliewer and Kung, 1998).

The longitudinal course of the association between family cohesion or conflict and childhood behavior problems has not been investigated using multiple informant reports of children's behavior problems in non-clinical populations. The use of multiple informants has important implications in research studies investigating child behavior problems that rely on maternal reports. Previous research on multiple informants has shown low to moderate levels of agreement between parent and teacher ratings of children's behavior problems (Verhulst and Akkerhuis, 1989, Mitsis et al., 2000, Hudziak et al., 2003, Satake et al., 2003, Cai et al., 2004, Gross et al., 2004), with mothers rating children as having more behavior problems or symptoms than teachers (Verhulst and Akkerhuis, 1989, Hudziak et al., 2003). Disentangling problems with over-reporting versus actual behavior differences within the home and school setting can be difficult, as has been illustrated in the body of literature investigating reporter bias in depressed mothers (Richters, 1992). Relying on multiple informants gives a more comprehensive understanding of a child's behavior, especially when there is high inter-rater agreement.

This prospective study examines the potential influence of family cohesion and conflict on children's behavior problems, using data on low birthweight (LBW) (≤ 2500 g) and normal birth weight (NBW) (> 2500 g) school-age children. Low birth weight has been reported to be associated with increased attention problems and externalizing problems (Teplin et al., 1991, Hack et al., 1992, Breslau et al., 1994, Klebanov et al., 1994, Levy-Shiff et al., 1994, Breslau and Chilcoat, 2000, Elgen et al., 2002). Thus, the study offers an opportunity to compare the influence of family factors that predict behavior problems between children at high and low risk. The key research questions addressed are: 1. Do family cohesion and family conflict predict change in behavior problems over time? Alternatively, is there a stable association of family cohesion or family conflict with children's behavior problems, with no change over time? 2. Do the relationships of family cohesion and conflict and children's behavior problems vary between LBW and NBW children?

Section snippets

Sample and data

Data come from a longitudinal study of neuropsychiatric outcomes of LBW (Breslau et al., 1996, Breslau and Chilcoat, 2000). The sample was randomly selected in 1989–1990 from the 1983–1985 lists of LBW and NBW newborn discharges from two large hospitals serving socio-economically disparate communities (urban and suburban) in southeast Michigan. Children with severe neurological impairment, identified at birth and at age 6, were excluded. The initial assessment was in 1990–1992, as the children

Description of sample

Table 1 presents information on key socio-demographic characteristics of the sample. The urban and suburban groups differed widely in racial composition, maternal education, maternal age, and marital status. However, differences between LBW and NBW within each community were small. The LBW groups in both communities were similar with respect to their distribution across levels of LBW, with less than 5% of LBW children in each community weighing < 1000 g at birth. The composition of the sample at

Discussion

Family cohesion measured at age 6 was significantly associated with mothers' and teachers' ratings of children's internalizing and attention problems, and the relationship was stable from age 6 to 11; children in families with higher cohesion had fewer internalizing and attention problems, as reported by both sources. Other findings on the relationship of family cohesion and conflict with children's behavior problems varied according to type of informant and type of problems. According to

Acknowledgments

This work was supported in part by Grant No. MH44586 (NB) from the National Institute of Mental Health.

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