Bio-behavioral Resilience: Examining Protective Factors for Child Psychopathology

1. Resilience factors may protect at risk children, especially from anxiety-related symptoms and disorders. • Our analyses replicated previous findings that emotion regulation and intelligence protected children from externalizing or comorbid behaviors. However, both emotion regulation and intelligence were not associated with internalizing behaviors, suggesting that there are different processes going on for children with externalizing vs. internalizing. • Exploration of hypothesized observed resilience factors showed that creativity was a strong and consistent predictor for internalizing disorder, and a trend appeared for options thinking. • By teaching children resilience thinking (e.g., how to find alternative solutions to a problem), how to play in a creative way, and how to manage and cope with undesirable events may lower symptoms and diagnosis of internalizing disorders. • Notably, findings indicate the behaviorally coded resilience factors (e.g., creativity, options thinking, see Table 1) were not associated with externalizing disorders, which could be attributed to the fact that they were tapping internal thought processes. Creativity is imagining outside of reality, and options thinking is the process of assessing different outcomes when given one choice. • By better understanding resilience factors, parents, teachers, and practitioners may be able to teach children strategies that may help them live up to their potential and protect them from developing psychopathology. • Limitations of Study • The assumption of subject independence is a limitation of the study due to the sample including twins. • Direction of effects could not be assessed given the correlational nature of the study. • The bio-behavioral observed resilience measures had low variability given coder responses were typically yes / no. Low measurement variability could partly explain why effects were not found for the other three resilient measures (i.e., adaptability, expression of feelings, and decisiveness). • Analysis Plan • 2 hierarchical regressions were performed to explore which resilience variables uniquely predict psychopathology symptoms while controlling for risk variables. • 1 multinomial logistic regression was performed to test whether the resilience variables predict psychopathology diagnosis. • Variables that were significantly correlated or approached significance with internalizing or externalizing symptoms were included in the regression models. • Our hypothesis was partially confirmed such that children with higher levels of emotion regulation were less likely to have internalizing and externalizing symptoms, and children with higher levels of positive affect were less likely to have internalizing symptoms after controlling for risk variables. The proportion of the variance (11% and 46%) explained uniquely by the established resilience predictors was significant. • Furthermore, children who were more creative were less likely to have internalizing symptoms after controlling for all risk and resilience variables. The proportion of the variance (3%) explained uniquely by the predictor, creativity, was significant. • Contrary to our hypothesis, none of the hypothesized observed resilience variables predicted externalizing symptoms. Discussion & Conclusion Results Bio-behavioral Resilience: Examining Protective Factors for Child Psychopathology Angela Zamora1, Donna Hockey1, Kathryn Lemery-Chalfant1, & H. Hill Goldsmith21Department of Psychology, Arizona State University, Tempe 2Department of Psychology, University of Wisconsin-Madison • The overall multinomial logistic regression model for the full sample was significant, c2 (15, N = 240) = 106.36, p < .001. • The likelihood ratio tests on the individual variables revealed that creativity, emotion regulation, and intelligence were significant predictors of childhood psychopathology diagnosis. • The odds ratio (OR) is the ratio of the odds that an outcome will be a diagnosis to the odds of no diagnosis meaning an OR less than 1.00 indicates reduced odds for diagnosis, and an OR greater than 1.00 indicates increase odds of having diagnosis. • The odds for having internalizing diagnosis was reduced when children were more creative and displayed greater ability to think of other options during at home tasks. • The odds of having an externalizing diagnosis was reduced when children had greater ability to regulate their emotions. • The odds of having comorbid diagnoses was reduced when children had higher intelligence and when they were able to regulate their emotions. • Our sample consisted of 120 monozygotic and dizygotic twin pairs who were between the ages of 5 and 11 (M = 8.1 years) and participated in the Wisconsin Twin Project. • The present study included twin pairs where at least one twin was diagnosed with an internalizing or externalizing disorder using DSM-IV criteria. • Procedure • A novel coding system of resilient measures was created by observing children’s behavior while participating in various tasks during a videotaped four hour home visit. • Two research assistants were trained on the observational coding system, and reached high inter-coder reliability (Kappa > .70). • Using principal component analysis with varimax rotation, 5 factors summarized the observational data and reduced the overall number of variables (see Table 1 for description of measures). • The present study examined the relationship among internalizing and externalizing behaviors with established resilience factors, (e.g., IQ, positive affect, and emotion regulation) with eight year old children. • Additionally, we attempted to identify new resilient factors such as adaptability, options thinking, creativity, expression of feelings, and decisiveness (see Table 1), which have been infrequently investigated in the resilience literature. Results Method Purpose of Study Table 4 Summary of Multinomial Logistic Regression Analysis Predicting Child Psychopathology Diagnosis in 8 Year Olds (N = 240) ________________________________________________________________________________________ Likelihood of Diagnosis Relative to No Diagnosis Internalizing Externalizing Comorbid ________________ ________________ _________________ Predictors Odds ratio 95% CI Odds ratio 95% CI Odds ratio 95% CI ________________________________________________________________________________________ Intelligence 1.04 0.69-1.57 0.68 0.41-1.16 0.43** 0.24-0.79 Positive affect 1.10 0.74-1.62 1.49† 0.91-2.44 1.36 0.77-2.37 Emotion regulation 0.75 0.43-1.30 0.11*** 0.05-0.22 0.09*** 0.04-0.20 Creativity 0.59** 0.41-0.85 0.84 0.56-1.23 0.83 0.52-1.31 Options Thinking 0.73† 0.52-1.01 0.94 0.63-1.41 0.85 0.53-1.37 Subsample N 81 57 35 ________________________________________________________________________________________ †p < .10. *p < .05. **p < .01. ***p < .001. Note: Reference group is children with no disorders. The risk variables did not significantly predict psychopathology diagnosis, so they were removed from the final model. Table 3 Summary of Hierarchical Regression Analyses Predicting Child Internalizing and Externalizing Symptoms in 8 Year Olds (N = 240) _________________________________________________________________________________________________________________________________________________________________________________________ Internalizing symptoms Externalizing symptoms _____________________ ____________________ Predictors B SE B β BSE B β ____________________________________________________________________________________________ Step 1: Risk variables SES -2.04 0.84 -0.16* -0.31 0.74 -0.03 Family conflict 2.47 1.20 0.13* 2.18 1.04 0.14* Controlling mother 0.98 1.05 0.06 1.55 0.93 0.11† Warm father -3.07 1.57 -0.12†-3.05 1.37 -0.14* R2 for Step 1 0.07**0.05* Step 2: Established resilience variables Intelligence -0.36 0.76 -0.03 -0.54 0.51 -0.05 Positive affect -1.51 0.74 -0.13* -0.13 0.49 -0.01 Emotion regulation -4.10 0.85 -0.30*** -8.12 0.57 -0.69*** ΔR2 for Step 2 0.11*** 0.47*** Step 3: Hypothesized resilience factor Creativity -1.77 0.60 -0.17** 0.16 0.41 0.02 ΔR2 for Step 3 0.03** 0.00 FModel 7.66*** 31.10*** ____________________________________________________________________________________________ †p < .10. *p < .05. **p < .01. ***p < .001. • Some children develop psychopathologies such as depression (1-2%, Costellow et al., 1996), anxiety (10%, Shafer et al., 1996), conduct disorder, and attention deficit hyperactivity disorder (ADHD; 2-9%, AACAP, 1997) that decrease their ability to accomplish their goals and lead productive lives. • Many of these children may develop clinical depression, anxiety, or other psychopathology in adulthood that may result in a lower quality of life for them and their families (Harrington, Fudge, Rutter, Pickles, & Hill, 1990). • Emotional and behavioral problems can be classified in two categories: • Internalizing = over-controlled behaviors such as anxiety and depression. • Externalizing = overt behaviors such as aggression and delinquency (Achenbach & Edelbrock, 1978). • Much research has been conducted on identifying risk factors that predict child problem behaviors or psychopathology, but less research has investigated and defined resilience factors. Masten and colleagues (1990) defined resilience as: • “the process of, the capacity for, or outcome of successful adaptation despite challenging or threatening circumstances.” (p. 426). • In order to gain a deeper understanding of the developmental process of child psychopathology, protective factors and resilience need to be examined as possible contributors to etiology. Introduction Table 1: Resilience Factors Coded From Observed Behavior Table 2: Risk and Resilience Measures Children with higher resilience (e.g., creativity, options thinking, emotion regulation, positive affect) will be less likely to have symptoms and diagnosis of internalizing and externalizing disorders. Hypothesis