families with children with emotional disorders

8/10/2019 Families With Children With Emotional Disorders

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Families with Children with Emotional Disorders: A Review of the Literature

Early, Theresa J., Poertner, John, o!ial "or#

Thinking of some children as emotionally disordered or disturbed is a recent phenomenon. Before the 1920swhen children's behavioral and emotional problems first received attention with the establishment of childguidance clinics needy children in the !nited "tates generally were thought of as dependent or delin#uent $%etr& "pano 1990. (rom the 19)0s to the 19*0s the number of children in !.". mental hospitals and residential

treatment centers tripled $%etr & "pano 1990. This trend went almost unnoticed by the public as the needs ofchildren with emotional problems were largely ignored $+nit,er 19-2 in spite of federal studies such as thereport of the oint /ommission on the ental ealth of /hildren $oint /ommission 1993 eyers 19-). 4twas not until the publication of !nclaimed /hildren $+nit,er 19-2 that public attention was drawn to theneeds of children with serious emotional disorders.

5s %etr and "pano $1990 pointed out social work has demonstrated ambivalence about whether toinstitutionali,e children or keep them with their families. +nowing what to do for or with children withemotional disorders and designing social work interventions for them is a comple6 problem. %art of thiscomple6ity is in defining the role of parents in interventions. +nit,er $19-2 pointed out that many parentsreported being blamed by the professionals and the public for causing their children's problems7 8The

persistence of this attitude is a tragic legacy of early efforts to e6plain children's problems as resulting frompoor parenting8. This blaming of parents is primarily 8motherblaming.8 4n a review of clinical :ournal articlesfrom 19*0 19* and 19-2 in which the etiology of someone's emotional problems was discussed /aplan andallc/or#uodale $19-) concluded that the overwhelming picture in all :ournals for more than ; items ahl $19-9 studied nineabnormal psychology te6tbooks published in 19- 19-* and 19-- to determine the treatment of the concept of8schi,ophrenogenic parenting8 the notion that parental behavior causes schi,ophrenia. 5lthough research hasfailed to establish causal links between parent behavior and schi,ophrenic development and although a recent

publication of the ?ational 4nstitute of ental ealth states that most researchers now agree parents do notcause schi,ophrenia most of the te6tbooks did not accurately reflect current thought. 4n fact some of thete6tbooks implied that parental causation of schi,ophrenia is likely and as yet has not been proved because of

inade#uate research. 5 recent review of the literature on the parentprofessional relationship found that thisliterature has focused on parents' perceptions of their relationship with professionals and that parents perceivethey are e6cluded alienated and blamed $/ollins & /ollins 1990.

4t is evident from the work of /aplan and allc/or#uodale $19-) and >ahl $19-9 that families parents ingeneral and mothers in particular are 8blamed8 for their children's mental and emotional disorders. 5s well

parents of children with emotional disorders indicate that they e6perience many practices of and encounterswith professionals as e6clusionary and blaming $/ollins & /ollins 19903 +nit,er 19-2. 4n light of the

blaming nature of much research and many practices and with an eye to designing social work interventions forfamilies with children with emotional disorders a review of recent literature $19-) to 1990 was undertaken todiscover empirical knowledge about families with children with emotional disorders that is of use in designing

interventions for these families and their children and to identify ways in which research may be blaming ofparents and families. The authors sought to answer these two #uestions7 $1 >hat do we empirically knowabout families with children with emotional disorders@ and $2 ow does this information help us design social

policy and social work interventions for families and children@


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Because both the literature and public policy lack clear definition of what constitutes a serious emotionaldisorder $+nit,er 19-2 drawing boundaries around the literature is difficult. "tudies were included in the

present review if they met two criteria7 $1 The research focused on families with children under the age of 1-or at least provided betweengroup comparisons of some aspect of family structure or interaction in familieswith children under the age of 1- and $2 the children who were sub:ects were identified as having a seriousemotional or behavioral disorder $that is by psychiatric diagnosis or scoring in the clinical range of aclassification measure. "tudies that described an intervention or compared interventions were specificallye6cluded. "earches of "ocial >ork Aesearch & 5bstracts %sychological 5bstracts and ducational Aesources

4nformation /enter $A4/ and inde6es of selected :ournals for the years anuary 19-) through 5ugust 1990yielded CC articles that met these criteria.

(our types of study emerged in the literature. Dne body of studies e6amined the rates of identifiable mental oremotional disorder in close relatives of children or adolescents diagnosed with particular disorders. The secondcategory concerns the use of behavior checklists or other evaluation instruments. 5nother group has the generalformat of correlating some aspect of family structure or interaction with a child's emotional mental or

behavioral problems. The final group of studies may be categori,ed as ecological in nature because theyconsider the wider conte6t of the behavioral or emotional problems e6amining such issues as factorsdiscriminating which children are referred for psychiatric services3 what parents hope to gain from seeking helpfor their children3 and family perspectives on their problems needs and e6periences in relation to their child

with an emotional disorder.

Because the volume of the literature is large and because of our interest in information useful to frontline socialworkers intervening with families and children this review is limited to research that studies correlations of thechild's disorder with family structure or interaction and ecological factors.

Correlations of Child$s Disorder with Family tru!ture or %ntera!tion

The ma:ority of the literature identified for this review $2- of ;2 articles concerns the correlation of a child'semotional mental or behavioral problem with particular actions $or inaction of the parent or with a moregenerali,ed measure of family interaction $nine studies some aspect of the child's perception of the family or

the parents' perception of the child $seven studies or characteristics of the child's parents $12 studies. Thefollowing sections summari,e findings of each of these categories of correlational studies.

%arental 5ction or (amily 4nteraction

?ine studies may be categori,ed as correlating some measure of parents' functioning $ohnson & D'Eeary19-*3 >ebster"tratton 19-) mothers' functioning $(ield et al. 19-*3 Fardner 19-93 c(arlane 19-*3"anders Gadds & Bor 19-93 >ebster"tratton 19-) or family functioning $Bernstein "vingen & Farfinkel19903 /unningham Benness & "iegel 19--3 uffington & "evitt 19-93 c(arlane 19-* with the emotionalor behavioral problems of a child in the family. Table 1 lists authors sample characteristics familyrelatedvariables studied and ma:or results of these studies. $Tables 1 to C follow the reference list.

"everal studies found significant relationships between measures of mothers' functioning and the presence ofbehavioral or emotional problems in their children. "pace does not allow for indepth reporting here of allresults. "elected e6amples follow.

Fardner $19-9 found a relationship between mothers' inconsistency and episodes of angry conflict with theirchildren with conduct problems. (ield et al. $19-* found mothers of normal children and children who aredepressed reported themselves to be significantly more nurturant than mothers of children with conductdisorders. 5lso mothers of normal children and children who are depressed were observed to e6press moreapproval toward their children than mothers of children with conduct disorder and mothers of children who are

depressed and children with conduct disorders e6pressed more disapproval toward their children than didmothers of normal children. (inally mothers of children with conduct disorders were found to engage insignificantly more aversive behavior than mothers of normal children during observations of usual parenting

practices in the home $"anders et al. 19-9.


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Dther studies revealed no relationship between children's behavioral or emotional problems and measures ofmothers' functioning. "pecifically no significant differences were found between abusive families andnonabusive families in mothers' reports of use of forceful and nonforceful methods of discipline $>ebster"tratton 19-). (actors that were found to discriminate abusive families from nonabusive families weremothers being significantly more depressed in abusive families abusive families reporting significantly moreabuse as children and partner abuse significantly more abusive families headed by a single mother andsignificantly lower income in abusive families.

Two studies in this group measure fathers' behavior separately from generic parental behavior. Dne found thatfathers of girls with conduct disorders used a more aggressive response style than fathers of control sub:ects$ohnson & D'Eeary 19-*3 the other found that fathers reported significantly poorer affective responsivenessthan their wives $/unningham et al. 19--.

%erceptions of the /hild or the %arents

The research reporting on perceptions of the child or parents $seven articles e6amined relationships betweenchildren's perceptions of their families or parents' perceptions of their children with serious emotional disorders.Table 2 lists authors sample characteristics familyrelated variables studied and ma:or results of these studies.

Two articles e6plored parents' perceptions of their children $Brody & (orehand 19-3 Frotevant cAoy &enkins 19--. "pecifically Brody and (orehand measured mothers' perceptions of their children's behavior asmalad:usted along with depression of the mother and child's compliance3 Frotevant et al. e6amined parents'

perceptions of compatibility between child's personality and parents' behavioral style. The remaining fivearticles e6plored children's perceptions of family members' conflict resolution styles $+ashani Burbach &Aosenberg 19-- family environment $5sarnow /arlson & Futhrie 19-*3 argalit >eisel eiman &"hulman 19-- and parental bonding $Burbach +ashani & Aosenberg 19-93 +ashani et al. 19-*.

5 few results from these studies illustrate the content of these works. The ma:ority of these studies consideredthe family as the unit of analysis not separating mothers' perceptions from fathers' or children's perceptions oftheir mothers from perceptions of their fathers. 6ceptions to this considered mothers' and fathers' conflict

resolution tactics separately $+ashani et al. 19-- and only mothers' perceptions of their children's behavior$Brody & (orehand 19-.

others' higher scores of perception of child malad:ustment were associated with high maternal depression andwith low child compliance especially in interaction with high maternal depression $Brody & (orehand 19-.

"ignificant relationships were found between children's perceptions of different aspects of their familyenvironments and their emotional problems. /hildren classified as suicide attempters saw their families as lesscohesive and higher in conflict than did nonsuicidal sub:ects $5sarnow et al. 19-*.

"ignificant relationships also were found between children's perceptions of parental bonding and children'sdisorders. 5dolescents determined to be 8in need of treatment8 reported their parents as significantly less caringthan did adolescents not in need of treatment $+ashani et al. 19-*3 adolescents who were nondepressed

psychiatric sub:ects reported significantly less parental care and more parental overprotection than adolescentswith no diagnosis $Burbach et al. 19-9.

/haracteristics of the %arents

"tudies reported in this section $12 articles measured characteristics of mothers only $four articles7 (rickEahey artdagen & ynd 19-93 Foodyer >right & 5ltham 19--3 Eahey Ausso >alker & %iacentini19-93 outon & Tuma 19-- both parents separately $si6 articles7 Brown Borden /lingerman & enkins

19--3 /lark & Bolton 19-)3 amdan5llen "tewart & Beeghly 19-93 odges +line Barbero & >oodruff19-)3 +aslow Aehm %ollack & "iegel 19--3 >ebster"tratton 19-9 or parents in the generic sense $twoarticles7 5arkrog 19-)3 Tompson 5sarnow Foldstein & iklowit, 1990. ?o articles concerned thecharacteristics of fathers only. Table ; lists authors sample characteristics parent and familyrelated variablesstudied and ma:or results of these studies. 6amples of results from the studies follow.


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?ot surprisingly because 10 of the studies measured something about mothers and only si6 measuredsomething about fathers the greatest number of significant results concerned characteristics of mothers. 4nstudies that concerned only mothers children's an6ious or depressive emotional disorders were found to beassociated with mothers' poor confiding relationships maternal distress and recent stressful life events$Foodyer et al. 19--.

"tudies that measured characteristics of both mothers and fathers found significant results for fathers'

characteristics as well as mothers' characteristics. amdan5llen et al. $19-9 found the greatest number ofsignificant relationships between boys with pervasive aggressive conduct disorder $%5/G and their parents'characteristics7 others had higher rates of alcoholism and drug abuse than mothers of boys with a situationalaggressive conduct disorder $"5/G or mothers of boys in the comparison group3 antisocial behavior was more

prevalent for fathers. 5lso fathers of boys with both %5/G and "5/G abused alcohol at rates significantlyhigher than fathers of boys in the comparison group.

"everal studies failed to show significant results. +aslow et al. $19-- rebutted the notion that cognitivedistortions of parents lead to cognitive deficits and depression in their children. 5lthough significantly moremothers of children who were depressed were themselves depressed no betweengroup differences weredetected in parents' attributional style and selfcontrol behavior $the cognitive functioning dimensions studied

and no relationship was found between children's and parents' cognitive functioning. Tompson et al. $1990found no significant differences in disordered communication or thought disorder between parents of childrenwith schi,ophrenia spectrum disorders and children with ma:or depression.

cological (actors

The remainder of the empirical literature reviewed $four articles moves in a different direction from the effortsdescribed earlier. 4nstead of seeking to identify aspects of the family that may be correlated with children'sdisorders this literature has identified needs of parents and families in regard to their children with emotionaldisorders $Bailey & Farralda 19-93 (riesen 19-9 and identified factors that were related to children beingreferred for mental health services $Gulcan et al. 19903 Farralda & Bailey 19--. Table C lists authors sample

characteristics family and ecological variables studied and ma:or results of these studies.

Both studies of factors affecting referral for mental health services involved researchers' completing diagnosticinterviews for all children with their parents. 5lthough both studies found pediatricians had identified andreferred fewer children than were determined by researchers to receive Giagnostic and "tatistical anual ofental GisordersThird dition $G"444 $5merican %sychiatric 5ssociation 19-0 diagnoses $labeled8disturbed8 by researchers 0 percent of disturbed children had been referred in the Farralda and Bailey$19-- study and only 1* percent had been referred in the Gulcan et al. $1990 study. There was greateragreement between the two studies in the percentages of children referred but determined not to be disturbed720 percent $Farralda & Bailey 19-- and 1 percent $Gulcan et al. 1990.

(actors found to be associated with referral in the Farralda and Bailey $19-- study included high totalantisocial scores on the child behavior #uestionnaire filled out by parents high parental concern about theirability to control their child and disadvantaged social class. (urther results from the same study reported in adifferent article $Bailey & Farralda 19-9 e6amined doctors' statements of their reasons for referral of childrenin the referred sample. 4n more than half the cases doctors gave as a main referral reason parental an6iety or

parental re#uest3 the severity of the child's problem was a main reason for referral in slightly less than half thecases3 and family disturbance was a main reason in about onethird of the cases. %arental concern about thechild's problems also was associated with referral in the Gulcan et al. $1990 study. (or children determined to

be disturbed identification by the pediatrician was 1; times more likely when the parent had consulted thepediatrician about the child's emotional and behavioral problems and was not significantly increased for

children determined not to be disturbed.

%arents were hesitant to discuss emotional and behavioral problems with pediatric staff. Gulcan et al. $1990reported that more than half of the parents in their study e6pressed a concern about their child's emotional and

behavioral problems to the researchers but only 2; percent reported having discussed their concerns with the


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health maintenance organi,ation pediatric staff. Dften parents' concerns about their children's emotional andbehavioral problems were supported by the diagnostic process of the research7 -) percent of parents whosechild met G"444 criteria for diagnosis e6pressed concern about the child's problems to the researchers andonly C) percent of parents whose child did not meet diagnostic criteria did so. /ontrolling for the presence ofdiagnosis factors that significantly predicted parents' e6pressing concern about their child's problems to theresearchers were distress in the mother and a family history of mental problems. These same factors had thegreatest effect on parents' reporting having consulted the pediatrician about the child's problems.

>hen their child was referred for psychiatric services parents reported e6pecting to obtain help for the childdesiring to have an e6planation for the child's behavior and problems and e6pecting to receive advice on howto deal with the child's difficulties $Bailey & Farralda 19-9.

4n (riesen's $19-9 study services parents indicated they received included support groups $;- percentadvocacy services $20 percent and financial assistance $; percent. 5ll respondents reported currently usingone or more services for their children with emotional disorders. "ervices being used for children includedspecial education $* percent psychiatric hospitali,ation $11 percent and residential treatment $2) percent.

"ources of support included formal and informal sources such as spouses other relatives and friends.motional support was listed by more than *0 percent of respondents as the most helpful type of help to receive

from informal sources. ?early half the respondents affirmed involvement with religion and involvement withother parents as helpful to them in coping with raising their children with emotional disorders3 these were theactivities chosen first or second across parents from all income categories e6cept the overH)0000 category$(riesen 19-9.

5lthough very small percentages of parents reported positive effects of their children's emotional problems onthe family's relationships with others relationships among family members effects on other children andhealth of the parents one#uarter of the parents did report a positive effect of the child's problems oninvolvement by both parents in the care of the child $(riesen 19-9. ore than )0 percent of respondentsreported a negative effect of the child's problems on family life in areas such as parents' opportunity to havetime away from their children3 effects on other children in the family3 amount of attention parents provide to

other children3 the ability to plan and participate in social activities as a family3 and the family's relationshipswith other family members friends and neighbors.

"ocial >ork !se of >hat 4s +nown

The ma:or #uestions this review seeks to answer are what social workers know about families with childrenwith emotional disorders and how this helps social workers respond to the needs of these families and childrenon policy program and practice levels. The summary of this research presents a substantial challenge inanswering these #uestions.

any of the studies are aimed at investigating factors associated with various emotional disorders in childrenand adolescents presumably to understand something about the causes of such disorders. Fiven that the

primary methodology is one of correlation there is the danger of confusing cause and effect. The temporalorder of the variables studied remains uninvestigated. Thus for the significant relationship demonstrated

between mothers' an6iety and their children's recurrent abdominal pain or behavior disorders it is not possibleto know whether mothers' an6iety preceded their children's problems or is a response to parenting children withsuch difficulties or whether both factors are related to some other unidentified variable.

4f one takes this view of the findings it may make more sense and be more helpful to keep in mind that an6ietydepression and a number of other affective responses may be e6pected and not dysfunction on the part of

parents. This makes a difference in the ways social workers engage with families and in the focus of their

interventions. 4f family factors or parent characteristics are thought to cause children's emotional problems thensocial workers' work with families with children with emotional disabilities may overtly or covertly blame thesefamilies for their children's problems.


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>hen families are assumed to be at fault for their children's problems families are not considered to be aresource for their children3 rather they are something to be 8fi6ed8 or removed from their children's livesthrough placing the children out of their homes. Dn the other hand if social workers accept that parenting achild with an emotional disorder is stressful for the family they are in a better position to create policies and

practices that relieve some of the stress to enable families to better care for their children and that emphasi,e apreference for serving children and their families.

4f mothers' distress and family history of mental problems predict parents' e6pressing concern about their child's

emotional problems and if these factors also predict parents' having consulted a medical doctor about suchproblems $Gulcan et al. 1990 it may be that the referred or treatment samples of parents studied are notrepresentative of the general population of parents of children with emotional and behavioral disorders. 4f socialworkers base policy and programs on information collected from biased samples then these policies and

programs may not be useful to the wider population of families and their children with emotional disorders.

5nother way in which the correlational literature fails to be useful is in the e6tent to which consistent with themotherblaming identified by /aplan and allc/or#uodale $19-) the ma:ority of conclusions focus onmothers' emotional states actions or inaction at rates far greater than those with which fathers' contributionsare e6amined. 5s /aplan and allc/or#uodale observed

/hild rearing is still primarily considered the mother's responsibility. The increasing number of singlemothers ... means that above all mothers are there. They are there for the professionals who assess and treattheir children3 they are there to be identified studied and #uestioned by these professionals3 and they are therefor the general public to see raising their children. Thus they more than the absent fathers are easy targets for

blame.

Aesearch that singles out the relationship between an action or trait of mothers and their children's disordersthat fails to consider the influence of fathers perpetuates mothers being held solely responsible for theirchildren's development.

%erhaps some of the most useful information one may glean from the correlational studies is unrelated to the

#uestions being studied. (or instance it is known that children with conduct disorders are from families that arenonabusive as well as from families that are abusive and that both adoptive and nonadoptive families havechildren with emotional disturbances. This is useful information for social workers and other professionals as itchallenges stereotypes and myths7 Dne must not assume the presence of one trait based on the e6istence ofanother trait.

5 limitation of the ma:ority of the studies identified in all categories is the lack of race and socioeconomicstatus $"" information on the samples of families and children. 4n all only 12 studies reported the races andeight studies discussed the ""s of sub:ects. ven the studies that describe sample racial and socioeconomiccharacteristics usually fail to consider the effect of race or "" on the other variables under study or havesample si,es insufficient for such comparisons to be meaningful.

4nformation that is most useful to practitioners policymakers and planners primarily is found in the ecologicalstudies. (rom the studies of factors associated with referrals of children for mental health services one findsthat general medical practitioners make errors of C0 percent to -; percent in underreferral and 1 percent to 20

percent in overreferral.

5ssuming that the researchers in these studies accurately identified children in need of mental health servicesattention needs to be focused on reaching the C0 percent to -; percent of disturbed children not identified bycommunity professionals. "ome policy and research issues are raised7 Go current mental health systems havethe capacity to find and serve these children@ >hat about the 20 percent of children referred but found not to be

disturbed@ ow are these children different@ >hat do they need rather than mental health services@ ow maytheir parents get the assistance they are seeking@ 5re some children receiving mental health services who do notneed them@ 5lthough the research presented in this review does not answer these #uestions it brings up lines ofin#uiry that may lead human services professionals in useful directions.


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Fiven possible difficulties of accurate assessment and the stigma of a mental illness label we suggest thatsocial workers take a normali,ation approach. 4f they work toward normal living and educational arrangementsfor the child it may be possible to reduce stigma divert children from the mental health system and hasten thee6it from the system of children inaccurately identified.

The ecological literature also yields useful information about the parent perspective. %arents want ane6planation of the behavior or problem3 advice on how to handle the problem3 special education services thatmeet their children's needs3 emotional support from spouses relatives and friends3 time to get away3 and

normal relationships with other children in the family as well as with friends. (rom a practice point of view it isclear that social workers can and should focus their efforts on meeting these selfe6pressed needs. ost of theseneeds are well within the realm of usual social work practice. %olicy implications are clear as well. (amiliesre#uire supportive services to care for their children with emotional disorders and to maintain their family unit.

%roviding e6planations for children's problems or behavior may be problematic because it is likely that onecannot reliably identify the cause. Iet even this information is useful to parents. The drive for an e6planationmay be related to blame placed by family friends and professionals as well as selfblame. 5 parent may askhimself or herself 8Gid 4 do something as a parent to cause this@8 Fiven professionals' inability to answer this#uestion in a valid and reliable manner the most useful approach might be to recogni,e the comple6ity of andlack of knowledge of the cause of emotional problems. %ractitioners' attention then shifts to helping families

focus their resources on the current solution. 4n our view the most appropriate role for social work is to countersome of the forces that have blamed families in general and mothers in particular. "ocial workers enablemothers and families to be released from selfblame when they identify their strengths and build on them tomeet the needs of caring for their child. 4t must be social work's role to ask the #uestion 8Fiven your child's

behavior what is it you need to provide care@8 "ocial work can then :oin with parents to get these needs met.

4t is our position that the research literature reported as ecological studies is the hope for the future for socialwork policy practice and research. The profession is :ust beginning to reali,e that a different approach tofamilies of children with emotional disturbances is needed. Aesearch on referral and parents' e6pressedcaregiving needs is not a sufficient research agenda however. 4n addition researchers need to e6amine areasand outcomes of intervention that assist families in meeting their caregiving needs. Aesearch is needed on how

caregivers cope and on the conse#uences of caring for a child with an emotional disturbance. Aesearch of thistype holds promise for developing social work practice and policy to address this difficult problem.

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+ashani . . Burbach G. . & Aosenberg T. +. $19--. %erception of family conflict resolution anddepressive symptomatology in adolescents. ournal of the 5merican 5cademy of /hild and 5dolescent%sychiatry 2* C2C-.

+ashani . . oeper . >. Beck ?. /. /orcoran /. . (allahi /. c5llister . Aosenberg T..+. &Aeid . /. $19-*. %ersonality psychiatric disorders and parental attitude among a community sample ofadolescents. ournal of the 5merican 5cademy of /hild and 5dolescent %sychiatry 2 -*9--).

+aslow ?. . Aehm E. %. %ollack ". E. & "iegel 5. >. $19--. 5ttributional style and selfcontrol behaviorin depressed and nondepressed children and their parents. ournal of 5bnormal /hild %sychology 1 1;1*).

+nit,er . $19-2. !nclaimed children. >ashington G/7 /hildren's Gefense (und.

Eahey B. B. Ausso . (. >alker . E. & %iacentini . /. $19-9. %ersonality characteristics of the mothersof children with disruptive behavior disorders. ournal of /onsulting and /linical %sychology )* )12)1).

argalit . >eisel 5. eiman T. & "hulman ". $19--. "ocial skills and family climate of behaviorallydisordered adolescents. Behavioral Gisorders 1; 2);22.

c(arlane 5. /. $19-*. The relationship between patterns of family interaction and psychiatric disorder inchildren. 5ustralian and ?ew Kealand ournal of %sychiatry 21 ;-;;90.

outon %. I. & Tuma . . $19--. "tress locus of control and role satisfaction in clinic and control mothers.ournal of /linical /hild %sychology 1* 21*22C.

%etr /. F. & "pano A. ?. $1990. volution of social services for children with emotional disorders. "ocial>ork ;) 22-2;C.

"anders . A. Gadds . A. & Bor >. $19-9. /onte6tual analysis of child oppositional and maternalaversive behaviors in families of conductdisordered and nonproblem children. ournal of /linical /hild%sychology 1- *2-;.

Tompson . /. 5sarnow . A. Foldstein . . & iklowit, G. . $1990. Thought disorder andcommunication problems in children with schi,ophrenia spectrum and depressive disorders and their parents.ournal of /linical /hild %sychology 19 1)91-.

>ahl D. (. $19-9. "chi,ophrenogenic parenting in abnormal psychology te6tbooks. Teaching of %sychology1 ;;;.


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>ebster"tratton /. $19-). /omparison of abusive and nonabusive families with conductdisordered children.5merican ournal of Drthopsychiatry )) )99.

>ebster"tratton /. $19-9. The relationship of marital support conflict and divorce to parent perceptionsbehaviors and childhood conduct problems. ournal of arriage and the (amily )1 C1*C;0.

Theresa . arly "> is a doctoral candidate and research assistant and ohn %oetner G"> is professor!niversity of +ansas "chool of "ocial >elfare Twente all Eawrence +" 0C). This paper was supported

paper was supported in part by the Aesearch and Training /enter on (amily "upport and /hildren's entalealth ?4GAA Frant ?o. 122B9000*90. This article does not necessarily reflect the views or policies ofthese organi,ations. The authors thank Beth Thompson for her contribution of library research which wascritical to the completion of this article.

families with children with emotional disorders

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