@article{ref1,
title="Developmental epidemiologically based preventive trials: Baseline modeling of early target behaviors and depressive symptoms",
journal="American journal of community psychology",
year="1991",
author="Kellam, S. G. and Werthamer-Larsson, L. and Dolan, Lawrence J. and Brown, C. Hendricks and Mayer, L. S. and Rebok, George W. and Anthony, James C. and Laudolff, J. and Edelsohn, G.",
volume="19",
number="4",
pages="563-584",
abstract="Describes a conceptual framework for identifying and targeting developmental antecedents in early childhood that have been shown in previous work to predict delinquency and violent behavior, heavy drug use, depression, and other psychiatric symptoms and possibly disorders in late adolescence and into adulthood. Criteria are described that guided choices of targets for two epidemiologically based, randomized preventive trials carried out in 19 elementary schools in the eastern half of Baltimore, involving more than 2,400 first-grade children over the course of first and second grades. Baseline models derived from the first of two cohorts show the evolving patterns of concurrence among the target antecedents. The central role of concentration problems emerged. From Fall to Spring in first grade, concentration problems led to shy and aggressive behavior and poor achievement in both genders and to depressive symptoms among girls. There was evidence for reciprocal relationships in girls. For example, depressive symptoms led to poor achievement in both girls and boys, whereas poor achievement led to depressive symptoms in girls but not boys, at least over the first-grade year. These results provide important epidemiological data relevant to the developmental paths leading to the problem outcomes and suggest preventive trials.  VioLit summary:   OBJECTIVE:       The aim of this paper by Kellam and Werthamer-Larsson was to describe a conceptual framework for identifying early childhood developmental antecedents of delinquency and violence, drug use, depression and other psychiatric disorders.  METHODOLOGY:       The authors employed a quasi-experimental multiple cross-sectional design with a non-probability sample of students at 19 elementary schools in five urban areas of Baltimore. The five areas represent groups of various social classes and ethnicities, and each of the schools in the groups (four schools were chosen in four of the groups, and three in the fifth group) were matched on characteristics of ethnicity, socio-economic status and standardized reading and mathematics levels of students. The study began with students entering the first grade. In each of the areas, three schools were randomly assigned to one of the trial conditions: intervention addressing learning problems, intervention aimed at shy and/or aggressive behaviors, and no intervention - a control school. Within each intervention school, classrooms were randomly assigned to either treatment or control conditions, and students were randomly assigned to their classrooms. Two cohorts of first grade children were evaluated, with 1,200 students in each group entering the schools in 1984/1985. Data were gathered in the Fall and the Spring of first grade, with core constructs being based upon social adaptational status, or adequacy of performance of social tasks, and psychological well-being, or the internal state of the student. A structured teacher interview was used to assess each child's shy and aggressive behavior, and their concentration problems, while the 24-item self-rating depression scale, the Children's Depression Inventory, was given to the first-graders in Fall 1985-Spring 1986. School achievement was measured via use of the total reading score from the California Achievement Tests. All measures exhibited adequate reliability. The total number of children included in the analyses was 511 boys and 537 girls for the overall procedures, and 466 boys and 479 girls for the self-report of depressive symptoms (only those children with written permission from their parents could complete this part of the study). Analyses included comparison of means, correlations and multiple regressions, and all were conducted separately for males and females.  FINDINGS/DISCUSSION:       The authors initially found that no relationship existed between consent to complete the depression survey and type of intervention or control status of the subject. Each of the five variables, shy behavior, aggressive behavior, concentration problems, achievement and depression, was analyzed as a continuous variable first, and then as a discrete variable, divided into thirds. The authors found no relationship between shy behavior and aggressive behavior in the results for the Fall of first grade for either males or females. However, these two behaviors accounted for 44% of the variance in concentration problems for males, and 32% of the variance for females. Both shy and aggressive behaviors were highly correlated with concentration difficulties for both males (.48 and .46 respectively) and for females (.40 and .41 respectively). Examining the analysis of the discrete variables, the authors found that almost no children exhibited concentration problems without shy or aggressive behavioral problems, and both shyness and aggression led to a high risk of concentration difficulties. The combination of shyness, aggression and concentration problems could account for 32% of the males' variance in achievement, and 33% of the females' achievement variance. For both genders, the effects of concentration (in the negative direction) upon achievement were greater than those of shyness (negative) or aggression (positive). The researchers concluded that a direct cross-sectional link could be found between concentration problems and achievement, with shyness and aggression perhaps acting upon achievement indirectly, through concentration problems. Whilst the multiple regression of all four of these variables with depression was weak (9% of variance explained for males, and 8% for females), the model was still statistically significant. For both males and females, only concentration problems and achievement were significant predictors of depression. For examination of the longitudinal relationships between Fall and Spring, the researchers used data only from the 473 control students, as data from the intervention participants were confounded by the intervention trials. For both males and females, shyness and concentration problems remained fairly stable over the year, with early concentration problems predicting later shyness. Aggression was also found to be stable, with early concentration problems predicting later aggression for males, but a reciprocal relationship existing between the two for females. Achievement scores remained fairly stable over the year, with early concentration problems in the Fall preceding achievement problems in the Spring for both males and females. Depression reports were also stable from Fall to Spring, and although no relationship was found between concentration problems and depression for males, a reciprocal relationship between the two was found for females. For both males and females, Fall depression was found to affect Spring achievement, although for females, Fall achievement also affected Spring depression. The authors concluded that concentration problems could be seen as common latent conditions underlying both social adaptation problems and difficulties with psychological well-being. These problems with concentration were seen as evidence of a general developmental problem, which could be manifested in the form of behavioral difficulties, affect disturbances and learning setbacks. The reciprocal nature of some of the relationships for girls was seen as reflecting a connection between psychological well-being and a greater concern about feedback by natural raters, or those people such as parents, teachers and peers who judge one's performance on social tasks.  AUTHORS' RECOMMENDATIONS:       The authors suggested that future research examine whether the self-reported symptoms of depression were clinically meaningful, or if they were a transient phenomenon arising out of the developmental stage through which the children were passing at the time of the study. Use of multiple assessments of depression were suggested to further understand depression in children, and concentration problems were suggested as targets of intervention research. Ratings other than those by teachers were thought to be important, perhaps with use of independent observations to assess concentration and other difficulties. Direct observation should be combined with laboratory assessments of attention to provide precision and accuracy to the measurement of the various roles of attention in the development of subsequent behavioral patterns. In order to continue research of this nature, a framework for studies should be implemented within the social and political structure of the community itself, to allow for the collaboration that is required for effective research.  EVALUATION:       The authors present a valuable and interesting examination of the roles of various factors in children's developmental process. The large sample size and the representativeness of the sample allows for good generalizability to other groups, whilst the use of well-defined and reliable measures of the key constructs indicates fairly good internal validity. The findings were presented in a clear and concise manner, although a more thorough discussion of the implications of the findings for prevention and intervention planning would have been useful. The study presents an important addition to the field of intervention research, and provides a good foundation upon which to base further studies. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)  KW  - Maryland KW  - Child Development KW  - Youth Development KW  - Elementary School Student KW  - Grade 1 KW  - Grade 2 KW  - Middle Childhood KW  - Childhood Risk Factors KW  - Childhood Predictors KW  - Violence Causes KW  - Violence Risk Factors KW  - Delinquency Risk Factors KW  - Delinquency Causes KW  - Drug Use Risk Factors KW  - Drug Use Causes KW  - Substance Use Causes KW  - Substance Use Risk Factors KW  - Juvenile Delinquency KW  - Juvenile Substance Use KW  - Juvenile Violence KW  - Child Behavior KW  - Child Problem Behavior KW  - Child Aggression KW  - Child Depression KW  - Depression Effects KW  - Aggression Effects KW  - Behavior Effects KW  - School Achievement KW  - School Performance KW  - Violence Prevention KW  - Delinquency Prevention KW  - Substance Use Prevention KW  - Drug Use Prevention  <p /> <p>Language: en</p>",
language="en",
issn="0091-0562",
doi="",
url="http://dx.doi.org/"
}