Socioeconomic Status and Internalizing Symptoms in Chilean Children: Does Reserve Capacity Matter

¹University of California at San Diego, 9500 Gilman Dr. 0927, La Jolla, CA 92093-0927, USA

²University of Chile; 5524 Macul, Santiago de Chile, Santiago, Chile

³University of Michigan, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI 48109-2029, USA

*Corresponding Author:

Martinez SM, PhD
University of California at San Francisco
3333 California Street, Suite 245
San Francisco, CA 94118, USA
Tel: 415-476-8273
Fax: 415-476-6106
E-mail: suzanna.martinez@ucsf.edu

Received Date: October 02, 2015 Accepted Date: October 14, 2015 Published Date: October 21, 2015

Citation: Martinez SM, Castillo M, Lozoff B, Gahagan S (2015) Socioeconomic Status and Internalizing Symptoms in Chilean Children: Does Reserve Capacity Matter?. J Child Adolesc Behav 3:254. doi:10.4172/2375-4494.1000254

Copyright: © 2015 Martinez SM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Child and Adolescent Behavior

Abstract

Informed by the reserve capacity model, we examined pathways between socioeconomic status (SES) and internalizing symptoms (IS) in 1119 Chilean 10-year-olds. Mediators included parental disciplinary style and reserve capacity resources (RCR), namely home environment, parent-child engagement, and self-esteem, and conduct problems. Using structural equation modeling, the model was stratified by gender. For boys, the SES-IS relationship was mediated by the home environment and parental disciplinary style. For girls, the SES-IS relationship was mediated by the home environment, parent-child engagement, self-esteem, and conduct problems. Findings suggest different RCR may protect against IS in a sample of Chilean children.

Keywords

Reserve capacity; Parental discipline; Internalizing symptoms; Conduct; Self-esteem; Socioeconomic status

Introduction

Children experience emotional issues characteristic of internalizing symptoms (IS) in both developing and developed countries [1,2]. Preadolescent girls and boys are affected equally, but during adolescence, girls experience more emotional problems than boys [3]. It is therefore important to understand the risk and protective factors for IS for boys and girls separately, particularly in developing countries. Moreover, developing countries in economic transition, such as Chile, are particularly vulnerable to depression compared with other developing and developed countries [4,5].

Chile has undergone dramatic socio-demographic and health changes in the last 40 years [6]. Life expectancy, maternal and infant mortality and malnutrition have improved [7], yet depression is one of the most commonly reported health conditions among Chileans [5], making it a public health priority especially among children [8].

In a study of adolescents (ages 13 to 15 years), Fleming and Jacobsen reported that 30% of a sample of Chilean adolescents reported feeling sad or hopeless every day in a 2-week period [9], which is similar U.S. incidence (26%) in a nationally representative sample of adolescents [10]. Despite the high prevalence of IS in Chilean youth, factors related to IS remain poorly understood in this population.

Socioeconomic status (SES) is a well-known social determinant of adult depression [11], yet research findings for children are inconsistent [12,13]. The impact of lower SES on IS among children may depend on contextual factors such as home-environmental attributes [14]. Furthermore, the quality of parenting and the parentchild relationship are known to be important and protective factors of children’s IS [15].

The current study used the reserve capacity model (RCM; [16]) to help inform the pathways between SES and children’s IS. The model articulates three processes underlying the relationship between social inequities and health disparities: (a) via stressful events, (b) through emotional and cognitive coping, and (c) by intermediate pathways that involve health behavior.

“Reserve capacity” is conceptualized as intrapersonal and interpersonal resources that mediate the relationship between stresses and one’s positive coping ability. The model posits that individuals of low SES may experience more stress, and in turn be more emotionally reactive to stress due to their lower reserve capacity. In turn, intermediate health behaviors and functioning are impacted, which ultimately contributes to morbidity and mortality. Informed by empirical evidence, the three processes were adapted to examine mechanisms between SES and children’s IS (Table 1).

Via stressful events

Children of lower SES may experience more stressors, conceptualized here as harsh disciplinary parenting [17,18], compared to those higher of SES. Low SES is associated with harsh parental discipline [19] and could be a precursor to depression or IS [20,21]. When parents experience economic hardship, their ability to use positive parental discipline is undermined, resulting in high levels of harsh discipline [22].

The importance of parents’ disciplinary style for children’s emotional and mental well-being is well established [23,24]. Parenting style and children’s emotional and mental well-being may differ by gender [25], with studies showing that parents are less punitive with their daughters than their sons [26,27]. Just as parental discipline may differ depending on the child’s gender, children’s response to disciplinary styles might also vary by gender [28].

Reserve capacity resources

The level of parent-child engagement and the home environment were conceptualized as a child’s reserve capacity. These factors are associated with higher maternal education [19,29,30], a common proxy for SES. Home-environmental attributes (clean, uncluttered) are important for children’s favorable developmental outcomes [31,32]. In contrast, a less optimal home environment has been shown to result in parent-child conflict and children’s behavioral problems [33].

Through emotional and cognitive coping. Parent-child engagement may protect children from depression [21,34] as it is believed to impact both children’s reactivity to stress and their cognitive and emotional coping ability [35]. Children’s self-esteem was used as a proxy for positive emotional and cognitive coping.

Previous research suggests that parent-child engagement helps build children’s self-esteem [36,37]. Others have also found that children’s low self-esteem relates to children’s emotional wellbeing [38,39], yet mediators of this relationship remain unclear. We examined (1) if the relationship between parent-child engagement and children’s coping, behavioral functioning differed for boys and girls, and (2) whether the home environment and parent-child engagement mediated the relationship between SES and children’s IS through children’s emotional and cognitive coping.

By intermediate pathways that involve health behavior. Children’s self-esteem may impact IS through intermediate paths related to children’s behavioral functioning, such as the incidence of conduct problems [31]. Studies suggest that children who are more engaged with their parents [40,41] and have higher self-esteem [42] are less likely to have behavioral conduct problems [43], which is associated with lower risk for IS [39].

Thus, we postulated that children’s conduct problems acted as a mediator between children’s self-esteem and IS. The purpose of this study was to examine the simultaneous relationships between children’s SES, home environment, parent-child engagement, and children’s self-esteem, conduct problems, and IS in the sequence of the RCM to better understand the contextual origins of childhood depression in Chilean 10-year-olds. We hypothesized that: (1) higher SES would be related to less frequent IS through a less negative parental disciplinary style; (2) higher SES would be related to positive reserve capacity, and in turn would be related to less frequency of IS through a less negative parental disciplinary style, higher self-esteem and fewer conduct problems; and (3) the pathways linking SES to children’s IS would differ by gender.

Method

Study population

The study sample included 1,119 10-year-old Chilean children and their mothers (or primary caregiver). Detailed description of infancy study methods have been previously described in detail [44]. Children and their mothers were participants in an ongoing longitudinal cohort study, which began as an iron-deficiency anemia (IDA) preventive trial in working-class urban communities of Santiago, Chile [44]. Participants were enrolled as infants between 1991 and 1996. Extensive data were collected on the developmental and behavioral outcomes and on family background, including maternal education in infancy and at a 10-year follow-up. Participants were assessed at the Institute of Nutrition and Food Technology (INTA), University of Chile. Data were obtained by research psychologists via interviewer-administered surveys, conducted separately for parent and child. For the purposes of this secondary data analysis, we included children with complete data for SES and IS. The current study was approved by the Institutional Review Boards at INTA, the University of Michigan, and the University of California, San Diego.

Measures

For the current study, we used cross-sectional data from the 10-year follow-up. Items from the Home Observation for Measurement of the Environment inventory (HOME) [45] and the Child Health and Illness Profile survey (CHIP) [46] were selected. The items from the HOME inventory are based on parental report whereas items from the CHIP survey are based on child report. Given that these measures were developed for the general population, confirmatory factor analysis (CFA) was used to identify which items explained the constructs as described in the RCM (Table 1). Study measures are presented below.

Table 1: Adapting the reserve capacity model for children’s depressive symptoms.

Maternal education

Mothers reported years of education completed (continuous variable).

Negative parental disciplinary style

Five items from the HOME scale assessed parental discipline. Each item had a no (0) or yes (1) response option, which was reverse coded, with yes representing a more negative disciplinary style. Using confirmatory factor analysis (CFA), we created a latent construct using three items (factor loadings ranged from 31-63): ‘parent has not lost patience with the child’, ‘child was not physically punished more than once in the past month’, and ‘child is able to express negativity toward parents without severe consequences’. Items that did not load onto this construct were ´child has a special place to keep belongings’ and ´parent uses an endearing term to address child.´

Home environment

Eight items from the HOME inventory pertaining to the home’s physical environment for nurturing. Items were based on parental report, with each item having a no (0) or yes (1) response option. Using CFA, we created a latent construct using eight items (factor loadings ranged from .40-.57). The items used to describe the home environment included attractiveness of the child’s room, cleanliness, lighting, clean floors, structural safety of the home, surface area available per person, level of noise, and risk-free outside environment.

Parent-child engagement

Six items from the CHIP survey assessed the frequency of positive parent-child engagement, with response options ranging from no days (1) to every day (5). Using CFA, we created a latent construct using six items (factor loadings ranged from .32-.55): “How often do…”, 1) ‘you get along well with parents’, 2) ‘your parents listen to your ideas’, 3) ‘parents eat meals with you’, 4) ‘your parents spend time with you doing something fun’, 5) ‘you go to an adult with a problem’, 6) ‘you talk to your parents about the next day?’

Self-esteem

Five items from the CHIP survey assessed self-esteem, with response options ranging from never [1] to always [5]. Using CFA, we created a latent construct using five items (factor loadings ranged from .49-.70): ‘h/o do you like yourself,’ ‘how often do you feel happy,’ ‘h/o are you proud of yourself,’ ‘h/o do you feel loved and wanted,’ and ‘h/o do you like the way you look?”

Conduct problems

Six items from the CHIP survey assessed poor behavioral functioning, with response options ranging from never (1) to always (5). Using CFA, we created a latent construct using six items (factor loadings ranged from .38-.58): ‘h/o do you get in trouble,’ ‘h/o do you pick on other kids,’ ‘h/o do you hang around troublemakers,’ ‘h/o do you try to get away with rule-breaking,’ ‘h/o do you try to do something dangerous’ and ‘h/o have you told someone that you will hurt them.”

Children’s internalizing symptoms (IS)

Mood, anxiety and emotional wellbeing were assessed by 6 of 11 items identified in the CHIP survey, with response options ranging from never (1) to always (5). Items did not equate with a validated depression risk scale, but have been used to assess emotional-related quality of life such as IS. Using CFA, we created a latent construct using six items (factor loadings ranged from .37-.65): ‘h/o are you sad,’ ‘h/o do you cry,’ ‘h/o do you worry,’ ‘h/o are you grouchy,’ ‘h/o are you afraid’, and ‘h/o are you too sick to play?’ The five items that did not load onto this construct included somatic complaints such as sore throat, stomachache, and pain.

Demographics

Birthdate and sex were obtained through medical records in infancy. Mothers’ birthdate was obtained by parent report. Child’s age was used to describe our participant sample, but was not included in the main analysis as there was little variability.

Covariates

We examined iron assignment and IDA during infancy as possible covariates, since participants were originally part of an IDA preventive trial, and maternal depression risk, measured by CES-D at the 10-year wave, as a child stress factor.

Analytic plan

We used PASW (Version 18; Chicago, IL) for descriptive statistics. Latent constructs were estimated using CFA. CFA and structural equation models were estimated using MPlus software. Overall model fit was assessed using the following fit indices: confirmatory fit index (CFI ≤ .90), root mean square error of approximation (RMSEA approximating .06) and standardized root mean square residual (SRMR ≤ .08) [47,48]. Pathways were considered significant at t>1.96 (equivalent to p<0.05). The full information maximum likelihood function was used to account for missing data. We first tested the model for the full sample and then used multiple group analysis to examine gender differences.

Results

Participant characteristics are displayed in Table 2. Only conduct problems differed by gender: 15% of boys vs. 11% of girls reported “almost always” or “always” reported getting into trouble (p<0.05). Overall 15% reported that they “almost always” or “always” experienced IS.

Table 2: Descriptive characteristics of Chilean 10-yr olds (N=1119).

Structural equation model

The a priori multiple group analysis model fit the data well (CFI=. 89, RMSEA=.03). As hypothesized, SES showed a negative and indirect path to IS in boys and girls, but through different mechanisms. We present the gender stratified model (Figure 1) as we were interested in gender differences.

Figure 1: Gender stratified models with mediated pathways from socioeconomic circumstance to depressive symptoms in a cohort of Chilean 10-year olds. All paths are significant at p<.05.

For boys, SES was negatively and indirectly related to IS through a nurturing home environment and harsh parental discipline. As hypothesized, higher SES related to a more positive home environment (B=.24, p<.001). In turn, a more positive home environment was related to a less negative parental disciplinary style (B=.50, p<.001), which related to more frequent IS (B=.31, p<.001). The model explained 35% of the variance in boys’ IS.

For girls, SES was indirectly related to IS through the presence or absence of reserve capacity resources. As hypothesized, higher SES was positively associated with a more positive home environment (B=.24, p=.01), which in turn, was related to greater parent-child engagement (B=.30, p=.01). Greater parent-child engagement was related to girls’ higher self-esteem (B= .73, p<.001), which related to less frequent conduct problems (B=-.35, p<.01). More frequent conduct problems were related to more frequent IS (B=.56, p<.001). Self-esteem was directly, but marginally related to less frequent IS (B=-.13, p=.05). The model explained 47% of the variance for girls’ IS.

For boys and girls, higher maternal education was directly related to less frequent IS (B=-.10, p<.001; B=-.10, p=.06; respectively). Neither iron assignment, IDA during infancy, maternal age nor maternal depression significantly related to IS. These covariates were excluded from the analysis for more parsimonious models.

Discussion

The current study analyzed the role of SES in childhood IS in a large cohort of Chilean 10-year olds of low- to middle-income backgrounds. In our sample, higher SES directly related to lower risk for IS, and lower SES related to IS through processes involving reserve capacity that differed by gender. For boys, SES related to IS through the home environment for nurturing and less harsh parental discipline, sequentially. For girls, SES related to IS through home environment, parental engagement, self-esteem and conduct problems, sequentially. The key findings are presented in the sequence of the reserve capacity model.

SES matters for children’s socioemotional adjustment [31], which our findings support. SES also matters for parents’ harsh disciplinary practices [24], yet our findings did not support this relationship. Our sample was of low to middle income and therefore the narrow range of may have limited our ability to detect a relationship.

We found an indirect relationship between SES and children’s IS. Higher SES was linked with a more optimal home environment for boys and girls. Interestingly, though, harsh parenting was related to IS for boys only, and an indirect relationship surfaced for boys between lower SES and parents’ harsher parenting by way of a less nurturing home environment. This may reflect the fact that mothers who were able to provide a more nurturing home atmosphere were less likely to engage in harsh disciplinary practices. Lower SES mothers may have been more reactive to a less nurturing and disorderly home atmosphere, and in this way, more likely to use harsh discipline with their sons. Long term, undue stress for mothers resulting from life in lower SES settings may hinder mothers’ ability to provide hands-on, authoritative, and nurturing parenting [22]. Parenting stress has been postulated as one possible mediator between SES and favorable child development [18,49]. Our study validates this mechanism in Chilean boys, but not girls. Perhaps mothers parented their daughters differently [46,47] or girls reacted differently to harsh discipline [48,49].

As expected, higher SES related to a more nurturing home environment. In turn, the home environment related to more engaged parent-child relations for girls only. Both home environment and parent-child engagement mediated the pathway between SES and IS and thus appear to be protective factors against IS for girls. Parentchild engagement was not related to harsh parenting but, rather, was strongly related to girls’ feelings of self-esteem. This pattern is similar to that found in U.S. girls, with family economic stress negatively affecting adolescent girls’ adjustment through less nurturing and less involved parenting [50]. While the association between self-esteem and family relationships has been observed during adolescence in boys and girls [51,52], others have that it is stronger for girls [53]. Girls place more emphasis on relationships than boys [54], making it is possible that positive parent-child interactions are more central to girls’ self-esteem. In our sample, girls who reported engaging with their parents on most days might have had more opportunity to receive parental support and approval, which promoted greater self-esteem [20].

For girls, children’s emotional and cognitive coping/self-esteem and behavioral functioning/conduct problems were found to mediate the relationship between parent-child engagement and IS among girls in our sample, but not boys. To our knowledge, there are no published studies of this pathway from self-esteem to IS in early and middle childhood. While similar pathways between other parenting factors and IS have been observed in both boys and girls [55], we found similar associations between parent relationships, self-esteem and IS in girls only. It could be that parent-child engagement does not affect boys’ self-esteem or emotional adjustment in the same way as girls, particularly when accounting for parental discipline [56].

Unlike Kim and Cicchetti, we only found a marginally significant relationship between self-esteem and IS in girls [57]. This finding suggests that boys and girls follow different developmental pathways in terms of coping mechanisms, particularly when considering reserve capacity resources. Also, internalizing problems differ by gender, with girls being more prone to depression beginning in adolescence [58]. Conduct problems are generally correlated with internalizing behavior among youth [59]. Our finding echoes this relationship and suggests that low self-esteem may be a precursor to poor behavioral functioning, and in turn, may be a risk factor for IS in Chilean girls [60].

Interpretation and generalizability of these findings may be limited, as participants were of low- to middle-income backgrounds. Other findings may have emerged if our sample included upper-income families. This was a cross-sectional study; therefore, we cannot make inferences about temporal precedence or causality. Third, parental discipline was based on maternal report, based on their perceptions, which may be different than what would be reported by their children or fathers. Lastly, our data were limited to IS as opposed to a validated depression risk scale or diagnostic criteria. Nonetheless, childhood IS should be a priority as it is a precursor to later depression [61] and the lack of categorical distinction between clinical depression and other degrees of IS [62].

Despite these limitations, the current study has several strengths. This is the first application of the RCM in children, in both developed and developing countries. Findings provide a comprehensive description of the mechanisms linking SES to child emotional wellbeing. Given the high rates of depression and rapid economic transition experienced in Chile, our results are timely. Additionally, the large sample size allowed us to examine a range of factors related to IS by gender.

These findings describe how SES may contribute to children’s IS differently among boys and girls, particularly in countries that have undergone rapid economic change. Given our findings here, it would be important for future research to examine gender differences in the links between children’s self-esteem, conduct problems, and emotional wellbeing. Future studies are needed to corroborate whether these pathways are present for children in other contexts, especially in countries, such as Chile, where depression is common. Likewise, longitudinal studies should be used to consider age and development more carefully, since contextual factors such as parent-child engagement and parents’ disciplinary tactics may change with children’s development [63]. Further studies of the RCM would be strengthened by using a longitudinal design to test the across-time relationships outlined in this framework.

Acknowledgements

The authors are especially grateful for the careful review made by Dr. Patricia East, the support of Estela Blanco, as well as the ongoing participation of the participants.

Funding

This research was funded by grants from the National Heart, Lung, and Blood Institute and the National Institute of Child Health & Human Development(1R01HL088530, PI: Gahagan; R01HD14122, PI: Lozoff).

References

1. Mojtabai R (2006) Serious emotional and behavioral problems and mental health contacts in American and British children and adolescents. J Am Acad Child Adolesc Psychiatry 45: 1215-1223.
2. Morris J, Belfer M, Daniels A, Flisher A, Villé L, et al. (2001) Treated prevalence of and mental health services received by children and adolescents in 42 low-and-middle-income countries. J Child PsycholPsychiatr 52: 1239-1246.
3. Kessler RC, McGonagle KA, Nelson CB, Hughes M, Swartz M, et al. (1994) Sex and depression in the national comorbidity survey. Cohort effects. J Affect Disord 30: 15-26.
4. Araya R, Rojas G, Fritsch R, Acuña J, Lewis G (2001) Common mental disorders in Santiago, Chile: prevalence and socio-demographic correlates. Br J Psychiatry 178: 228-233.
5. Vicente PB, Kohn R, Saldivia BS, Rioseco SP (2007) Burden of psychiatric diseases in Chile. Rev Med Chil 135: 1591-1599.
6. http://www.ine.cl/canales/menu/indice_tematico_eng.php?lang=eng
7. Albala C, Vio F, Kain J, Uauy R (2001) Nutrition transition in Latin America: the case of Chile. Nutr Rev 59: 170-176.
8. Araya R, Alvarado R, Minoletti A (2009) Chile: an ongoing mental health revolution. Lancet 374: 597-598.
9. Fleming LC, Jacobsen KH (2009) Bullying and symptoms of depression in chilean middle school students. J Sch Health 79: 130-137.
10. Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, et al. (2010) Youth risk behavior surveillance - United States, 2009. MMWR SurveillSumm 59: 1-142.
11. Lorant V, Deliège D, Eaton W, Robert A, Philippot P, et al. (2003) Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 157: 98-112.
12. Goodman E, Huang B, Wade TJ, Kahn RS (2003) A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter? J Pediatr 143: 451-456.
13. Leech SL, Larkby CA, Day R, Day NL (2006) Predictors and correlates of high levels of depression and anxiety symptoms among children at age 10. J Am Acad Child Adolesc Psychiatry 45: 223-230.
14. Lau JY, Rijsdijk F, Gregory AM, McGuffin P, Eley TC (2007) Pathways to childhood depressive symptoms: the role of social, cognitive, and genetic risk factors. DevPsychol 43: 1402-1414.
15. Graham CA, Easterbrooks MA (2000) School-aged children's vulnerability to depressive symptomatology: the role of attachment security, maternal depressive symptomatology, and economic risk. DevPsychopathol 12: 201-213.
16. Gallo LC, Matthews KA (2003) Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull 129: 10-51.
17. McLoyd VC, Kaplan R, Hardaway CR, Wood D (2007) Does endorsement of physical discipline matter? Assessing moderating influences on the maternal and child psychological correlates of physical discipline in African American families. J FamPsychol 21: 165-175.
18. Mistry RS, Vandewater EA, Huston AC, McLoyd VC (2002) Economic well-being and children's social adjustment: the role of family process in an ethnically diverse low-income sample. Child Dev 73: 935-951.
19. Bradley RH (2002) Environment and parenting. In M. Bornstein (edn.), Handbook of Parenting. Hilllsdale, Erlbaum 2: 281-313.
20. Messer SC, Gross AM (1995) Childhood depression and family interaction: A naturalistic observation study. J Clin Child Psychol 24: 77.
21. Sheeber L, Sorensen E (1998) Family relationships of depressed adolescents: a multimethod assessment. J Clin Child Psychol 27: 268-277.
22. McLoyd VC (1990) The impact of economic hardship on black families and children: psychological distress, parenting, and socioemotional development. Child Dev 61: 311-346.
23. Aunola K, Nurmi JE (2005) The role of parenting styles in children's problem behavior. Child Dev 76: 1144-1159.
24. Gallagher B, Cartwright-Hatton S (2008) The relationship between parenting factors and trait anxiety: mediating role of cognitive errors and metacognition. J Anxiety Disord 22: 722-733.
25. Hankin BL, Oppenheimer C, Jenness J, Barrocas A, Shapero BG, et al. (2009) Developmental origins of cognitive vulnerabilities to depression: review of processes contributing to stability and change across time. J ClinPsychol 65: 1327-1338.
26. Leaper C (2002) Parenting girls and boys. In M. Bornstein (ed), Handbook of parenting. Children and parenting. Mahwah 1: 189-225.
27. Calvete E, Gamez-Guadix M, Orue I (2010) The Dimensions of Discipline Inventory (DDI) - Child and adolescent version: Analysis of the parental discipline from a gender perspective. An Psicol 26: 410-418.
28. Sorbring E, Rodholm-Funnemark M, Palmerus K (2003) Boys' and girls' perceptions of parental discipline in transgression situations. Infant Child Dev 12: 53-69.
29. Bornstein M, Bradley R (2003) Socioeconomic status, parenting, and child development. Routledge: 305.
30. Currie J, Moretti E (2002) Mother's education and the intergenerational transmission of human capital: Evidence from college openings and longitudinal data. National Bureau of Economic Research Working Paper Series: 9360.
31. Gershoff ET, Aber JL, Raver CC, Lennon MC (2007) Income is not enough: Incorporating material hardship into models of income associations with parenting and child development. Child Devel 78: 70-95.
32. Bradley RH, Corwyn RF (2002) Socioeconomic status and child development. Annu Rev Psychol 53: 371-399.
33. Evans GW1, Maxwell LE, Hart B (1999) Parental language and verbal responsiveness to children in crowded homes. DevPsychol 35: 1020-1023.
34. Herman KC, Lambert SF, Ialongo NS, Ostrander R (2007) Academic pathways between attention problems and depressive symptoms among urban African American children. J Abnorm Child Psychol 35: 265-274.
35. Vandeleur CL, Jeanpretre N, Perrez M, Schoebi D (2009) Cohesion, satisfaction with family bonds, and emotional well-being in families with adolescents. J Marriage Fam 71: 1205-1219.
36. Ackard DM, Neumark-Sztainer D, Story M, Perry C (2006) Parent-child connectedness and behavioral and emotional health among adolescents. Am J Prev Med 30: 59-66.
37. Bruce AE, Cole DA, Dallaire DH, Jacquez FM, Pineda AQ, et al. (2006) Relations of parenting and negative life events to cognitive diatheses for depression in children. J Abnorm Child Psychol 34: 321-333.
38. Hammen C, Shih JH, Brennan PA (2004) Intergenerational transmission of depression: test of an interpersonal stress model in a community sample. J Consult ClinPsychol 72: 511-522.
39. Rudolph KD, Clark AG (2001) Conceptions of relationships in children with depressive and aggressive symptoms: social-cognitive distortion or reality? J Abnorm Child Psychol 29: 41-56.
40. Herman-Stahl M, Petersen AC (1999) Depressive symptoms during adolescence: Direct and stress-buffering effects of coping, control beliefs, and family relationships. J Applied Develop Psychol 20: 45-62.
41. Taylor LC, Clayton JD, Rowley SJ (2004) Academic socialization: Understanding parental influences on children's school-related development in the early years. Rev Gen Psychol 8: 163-178.
42. Wang F, Veugelers PJ (2008) Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obes Rev 9: 615-623.
43. McCarty CA, Vander Stoep A, McCauley E (2007) Cognitive features associated with depressive symptoms in adolescence: directionality and specificity. J Clin Child AdolescPsychol 36: 147-158.
44. Lozoff B, De Andraca I, Castillo M, Smith JB, Walter T, et al. (2003) Behavioral and developmental effects of preventing iron-deficiency anemia in healthy full-term infants. Pediatrics 112: 846-854.
45. Bradley RH, Caldwell BM, Rock SL, Hamrick HM, Harris P (1988) Home observation for the measurement of the environment - Development of a home inventory for use with families having children 6 to 10 years old. ContempEducPsychol 13: 58-71.
46. Starfield B, Bergner M, Ensminger M, Riley A, Ryan S, et al. (1993) Adolescent health status measurement: development of the Child Health and Illness Profile. Pediatrics 91: 430-435.
47. Enders CK, Bandalos DL (2001) The Relative Performance of Full Information Maximum Likelihood Estimation for Missing Data in Structural Equation Models. StrucEqu Modeling 8: 430 - 457.
48. Hu L, Bentler P (1999) Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. StrucEqu Modeling 6: 1-55.
49. Mistry RS, Biesanz JC, Taylor LC, Burchinal M, Cox MJ (2004) Family income and its relation to preschool children's adjustment for families in the NICHD Study of Early Child Care. DevPsychol 40: 727-745.
50. Conger RD, Conger KJ, Elder GH Jr, Lorenz FO, Simons RL, et al. (1992) A family process model of economic hardship and adjustment of early adolescent boys. Child Dev 63: 526-541.
51. Donnellan MB, Trzesniewski KH, Robins RW, Moffitt TE, Caspi A (2005) Low self-esteem is related to aggression, antisocial behavior, and delinquency. PsycholSci 16: 328-335.
52. Laible DJ, Carlo G, Roesch SC (2004) Pathways to self-esteem in late adolescence: the role of parent and peer attachment, empathy, and social behaviours. J Adolesc 27: 703-716.
53. Lau S, Kwok LK (2000) Relationship of family environment to adolescents' depression and self-concept. SocBehavPers 28: 41-50.
54. Maccoby EE (1998) Two sexes: Growing up apart, coming together. Harvard University Press, Cambridge, MA:1998.
55. Behnke AO, Plunkett SW, Sands T, Bámaca-Colbert MY (2011) The relationship between Latino adolescents' perceptions of discrimination, neighborhood risk, and parenting on self-esteem and depressive symptoms. J Cross-Cult Psychol 42: 1179-1197.
56. McKinney C, Milone MC, Renk K (2011) Parenting and late adolescent emotional adjustment: mediating effects of discipline and gender. Child Psychiatry Hum Dev 42: 463-481.
57. Kim J, Cicchetti D (2006) Longitudinal trajectories of self-system processes and depressive symptoms among maltreated and nonmaltreated children. Child Dev 77: 624-639.
58. Twenge JM, Nolen-Hoeksema S (2002) Age, gender, race, socioeconomic status, and birth cohort differences on the Children's Depression Inventory: A meta-analysis. J AbnormPsychol 111: 578-588.
59. Card NA, Stucky BD, Sawalani GM, Little TD (2008) Direct and indirect aggression during childhood and adolescence: A meta-analytic review of gender differences, intercorrelations, and relations to maladjustment. Child Dev 79: 1185-1229.
60. Wolff JC, Ollendick TH (2006) The comorbidity of conduct problems and depression in childhood and adolescence. Clin Child FamPsychol Rev 9: 201-220.
61. Georgiades K, Lewinsohn PM, Monroe SM, Seeley JR (2006) Major depressive disorder in adolescence: the role of subthreshold symptoms. J Am Acad Child Adolesc Psychiatry 45: 936-944.
62. Lewinsohn PM, Klein DN, Durbin EC, Seeley JR, Rohde P (2003) Family study of subthreshold depressive symptoms: risk factor for MDD? J Affect Disord 77: 149-157.
63. Maddox SJ, Prinz RJ (2003) School bonding in children and adolescents: conceptualization, assessment, and associated variables. Clin Child FamPsychol Rev 6: 31-49.