Joseph P Allen, Ph.D. - US grants

The proposed study examines family contributions to adolescent social development using developmentally-sensitive, observational measures of family interactions and relating these to state-of-the-art indices of adolescent social development. This study further refines and applies a newly developed system for assessing interactions that promote or inhibit autonomy and relatedness in families with adolescents, which was designed to take advantage of a rich available longitudinal data set. Autonomy and relatedness have been frequently characterized as central dimensions of adolescent social development, although these dimensions have not previously been studied over time using observational data. This study assesses these dimensions longitudinally in adolescents' and parents' interactions with each other and examines their connection with current and future aspects of adolescent social development. Existing data will be used for 75 adolescents and their two-parent families for year 1 of the study and 65 adolescents and families at year 3. Adolescents were approximately evenly distributed between males and females and between psychiatrically hospitalized, non-psychotic, non-organically impaired adolescents and a demographically matched group of adolescents in a public high school. The Autonomy and Relatedness Coding System will be applied to audiotaped, transcribed family interaction data generated each year using a revealed differences task, and related to existing data on adolescent ego development, self-esteem and self-image complexity, also collected longitudinally. This study addresses four major research goals: 1) to enhance and further demonstrate the reliability and validity of the Autonomy and Relatedness Coding System; 2) to examine the concurrent relationship of parents' behaviors which promote or inhibit autonomy and relatedness and their adolescents' levels of ego development, self-esteem and self-image complexity; 3) to examine the change and stability in autonomy and relatedness in family interactions over a two-year period; and, 4) to examine links between parental behaviors in interactions with their adolescent and that adolescent's psychosocial development over the following two years.

DESCRIPTION (Adapted from applicant's abstract): This investigation is designed to increase our understanding of the linked development of family and peer relationships from early to mid-adolescence as these in turn predict adaptive and maladaptive psychosocial functioning. Family and peer relationships are conceptualized in terms of adolescents' progress in the developmental tasks of establishing autonomy in social relationships while maintaining and developing attachment and affiliative bonds. An intensive, longitudinal, observation, and multi-reporter design is used to pursue three conceptually-bounded studies. Study 1: Normative Development of Peer Relationships, assesses development over time in autonomy and attached affiliative processes in peer relationships, considering linkages between these two processes. Study 2: Family Interactions as Predictors of Peer Relationships, considers ways in which autonomy and attachment processes in adolescent-parent interactions set the stage for the emergence of similar processes (e.g., resistance to peer pressure and formation of supportive friendships) in developing peer relationships. Study 3: Sequelae of Developing Peer Relationships, considers ways in which important aspects of adolescent psychosocial functioning (e.g., depressive symptoms, externalizing behavior problems, changing relationships with parents, and sexual risk-taking) can be understood as outcomes of developing peer relations. This investigation will address these questions using intensive, observational and multi- reporter data from a socio-demographically heterogeneous sample of 172 families with early adolescents, along with three peers of these adolescents who will be assessed in for waves spaced annually. Assessments will included attachment interviews, and observation and interview sessions with parents, adolescents, and peers. Important socio-demographic factors that may influence the development of peer relationships are also incorporated into models as appropriate. This investigation is designed to yield information that can inform: (a) remedial and preventative psychosocial interventions targeting peer influences; (b) efforts to assess social functioning in adolescence; and (c) efforts to understand the development of critical social relationships across the lifespan as these are linked to psychosocial functioning.

[unreadable] DESCRIPTION (provided by investigator): This is a competing continuation application to study the development and consequences of adolescents' efforts to resist maladaptive peer pressure while still learning to form strong, supportive peer relationships. This investigation extends theories about adolescents' developing autonomy and relatedness with parents to explore parallel processes that occur as adolescents strive to demonstrate resiliency in the face of inappropriate peer pressure (e.g., establish autonomy with peers) and form adaptive peer relationships in three conceptually-bounded studies: [unreadable] [unreadable] Study I. Development of Autonomy and Relatedness in Peer Relationships. We first seek to sharpen our understanding of the construct of peer pressure, which we conceptualize as a normatively occurring threat to adolescent autonomy. We distinguish peer pressure from other forms of peer influence that do not threaten adolescent autonomy, and then test the hypothesis that adolescents' success vs. failure in avoiding pressuring relationships while developing autonomy maintaining relationships will predict levels of social adaptation across adolescence.Study II. Family Interactions As Predictors Of Developing Peer Relationship Qualities. In this study, we address the question: To what extent and in what ways does the family serve as a staging ground for the adolescent to develop social skills and expectations that will determine the quality of their peer interactions. We will also examine the conditions under which peer relationships may buffer the negative mental health effects of problematic family interactions.Study Ill. The Relation Of Peer Processes To Critical Adaptational Outcomes. In this study, we consider how the developing peer relationship qualities that we have observed and predicted in the first two studies predict critical adaptational outcomes including hostility with peers, risky sexual behavior, externalizing problems, depression, social isolation, and difficulty establishing successful romantic relationships. We address these questions using intensive, observational, and multiple-reporter data from a socio-demographically heterogeneous final sample of 172 adolescents, their parents, and peers, with adolescents ultimately being followed annually from ages 13 to 21.

[unreadable] DESCRIPTION (provided by applicant): This competing continuation application examines a developmental model of adolescents' peer and family experiences as predictors of long-term psychosocial outcomes in adulthood. We propose to follow a diverse community sample of 172 adolescents, their parents, peers, and romantic partners from ages 13 to 27. We focus upon two stage-salient tasks of adolescence establishing autonomy and maintaining and building social bonds and hypothesize that the resolution of these tasks will be fundamental to understanding qualities of adult psychosocial functioning. We also assess important cognitive, affective, and contextual factors that may mediate continuities and discontinuities from adolescent to adult relationship quality and that may potentially serve as targets for intervention efforts. We organize our efforts into three primary Aims: Aim 1: Parent and Peer Predictors of Adult Relationship Quality: We begin by seeking to identify critical continuities in adolescent relationship qualities that persist into early adulthood. We focus upon predictors of aspects of adult relationships particularly social isolation and hostility known to be closely linked to both mental and physical health. Aim 2: Mediators & Moderators of Continuities and Discontinuities from Adolescence to Adulthood: We next examine several processes that potentially mediate the continuities or account for the discontinuities identified in Aim 1. We focus on three specific factors: the individual's attachment organization, rejection sensitivity, and major developmental/contextual transitions. Aim 3: Early Adult Adaptational Outcomes: Direct & Mediated Pathways from Adolescence: Finally, we consider adolescent-era predictors of internalizing and externalizing symptoms in adulthood and of the development of functional autonomy the capacity to manage one's own career, financial, and residential needs. We assess both direct predictions from adolescent relationship qualities across this fifteen-year span, as well as predictions mediated via adult relationship qualities (Aim 1) and intervening factors (Aim 2). This study builds on the vast body of research that has examined relational predictors of functioning within adolescence but now seeks to extend and ground this research by determining which of the many qualities of social relationships that have been identified as important within adolescence are actually predictive of long-term, life outcomes in adulthood. As such, it seeks to inform: a) parents, educators, and clinicians working with adolescents and early adults; b) interventions targeting parenting behaviors and/or peer influences (e.g., delinquency, aggression, and substance abuse prevention and treatment programs); and c) developing theories of the links between social relationships and functional outcomes across this critical portion of the lifespan. PUBLIC HEALTH RELEVANCE: This study seeks to identify essential qualities of adolescents' relationships with peers and parents that predict long-term success or failure in adult psychological functioning. It is designed to provide knowledge that will ultimately reduce the incidence of both externalizing symptoms (e.g., delinquency, aggression, substance abuse) and internalizing symptoms (e.g., depression, anxiety, social isolation) in late adolescence and early adulthood by informing: a) parents, educators, and clinicians working with adolescents and early adults; b) interventions targeting parenting behaviors and/or peer influences (e.g., delinquency, aggression, and substance abuse prevention and treatment programs); and c) developing theories of the links between social relationships and functional outcomes across this critical portion of the lifespan. [unreadable] [unreadable] [unreadable]

DESCRIPTION (provided by applicant): Within only hours of meeting unfamiliar peers, children with Attention-Deficit/Hyperactivity Disorder (ADHD) are typically disliked by the majority of the peer group. These findings are concerning because children with ADHD are already at high risk for developing depression, criminal behavior, substance abuse, and school failure in adolescence, and if they have peer relationship problems as well, the likelihood of poor outcomes multiplies. Developing effective interventions for the peer difficulties of children with ADHD has the potential to reduce their suffering and to diminish societal burden, carrying high public health significance relevant to the mission of NIMH. Unfortunately, existing medication, behavioral contingency management, and social skills training interventions have shown modest success to date on improving the peer acceptance and friendship of children with ADHD. In contrast to existing interventions that primarily focus on remediating deficits within children with ADHD that contribute to their social difficulties, this application assesses the feasibility of a novel intervention approach to increase the inclusiveness and the tolerance of the peer group that typically rejects the child with ADHD. I attempt to alter the stigma that a peer group may attach to ADHD symptoms and the negative cognitive biases the peer group may hold against a child with ADHD that perpetuates that child's negative reputation, even when the child with ADHD may display positive behavior change. Because elementary school-age children's social status is predominately determined by their classroom peers, this application tests the possibility that the teacher may be able to encourage a peer group that is more likely to be accepting of students with ADHD. I will develop the manualized treatment, appropriate procedures to assess fidelity of implementation, and pilot test an innovative approach to increase the inclusiveness and tolerance of the peer group in a controlled summer program setting. By attending to the understudied influence of the peer group on children's rejection and friendship, this research will ideally lead to the development of an improved treatment for social problems, and inform the submission of a follow-up study to assess intervention efficacy in community schools. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page Continuation Format Page PUBLIC HEALTH RELEVANCE: Children with ADHD have severe problems getting along with peers, and these difficulties increase their risk for depression, delinquency, and school failure in adolescence. Peer relationship problems have proved refractory to existing treatments that focus on remediating deficits within the child with ADHD. This proposal tests a novel psychosocial treatment that trains elementary school teachers to increase the tolerance and acceptance of the peer group towards children with ADHD.

DESCRIPTION (provided by applicant): The proposed study tests the hypothesis that relationship qualities in adolescence ultimately have substantial implications for two important domains of adult physical health: cardiovascular health and metabolic functioning. We address these questions using repeated assessments with multi-reporter, multi-method data from a demographically diverse final sample of 172 individuals followed from age 13 to 32. We focus on two key social relationship pathways that we hypothesize to have substantial long-term physical health ramifications: 1. from the adolescent struggle to establish autonomy adaptively when negotiating disagreements to hostile conflict in future relationships; and, 2. from failure to establish supportive social connections in family and peer relationships to future social isolation We will pursue the following aims: Aim 1: Direct Prediction of Adult Health Indicators from Adolescent Relationship Characteristics We begin with the most basic, yet important epidemiological task of seeking to identify adolescent relational qualities that may directly predict substantial future risks for long-term health difficulties. Aim 2: Intervening Psychosocia Mediators of Links from Adolescence to Adult Health - After identifying key adolescent psychosocial risk factors, we next examine the hypothesized intervening pathways that may explain these risks and can thus suggest further potential arenas for intervention. To properly temporally assess these mediated pathways, we assess direct predictions from adolescence to adult social functioning and cross-lagged predictions between social functioning and health outcomes in adulthood. Aim 3: The Role of Temporal and Contextual Effects - We next seek to distinguish the long-term effects of chronic vs. intermittent social functioning difficulties (e.g. are there lingering effects when a prior pattern of social isolation or hostile conflict eventually resolves?) as well as considering the mediating and moderating roles of key contextual transitions and demographic factors. Aim 4: Interplay of Relational Functioning, Mental Health, and Physical Health - Finally, we assess the interplay of social functioning and mental health in predicting physical health outcomes both from adolescence to adulthood and within adulthood, considering both unique and conjoint effects of relational factors and mental health symptoms as they work together to predict health outcomes. Overall, the proposed study has the potential: a. to open up an entirely new arena for potential screening tools and preventive interventions to improve lifelong health outcomes and suggest specific relational characteristics to target; b. to provide guidance to parents, educators, and clinicians seeking to distinguish transient adolescent relationship difficulties from difficulties with greatest long-term import for health; ad c. to dramatically advance developing theories of the link between adolescent social relationship qualities and major health outcomes into this critical, relatively unexplored portion of the lifespan.

Project Summary Public health efforts in adolescence aimed at life course physical health promotion have to date focused almost exclusively on addressing physiological risk factors and health behaviors (e.g., weight, smoking, etc.). This proposal examines a far-reaching hypothesis with the potential to open up new venues for intervention: that social relationship qualities established in adolescence have an integral, long-term relationship to life course physical health and aging processes. The proposed study will clarify both the existence and the mechanisms by which two specific relationship qualities in adolescence?experience of hostile conflict and absence of supportive relationships?are linked to midlife health and aging outcomes. It uses uniquely rich longitudinal data on peer, romantic partner, and family relationship qualities across a 25-year span, to address four overarching aims: 1) direct prediction of midlife health & aging from adolescent social relationship qualities; 2) assessment of mediational vs. weathering explanations of links from adolescence to midlife health & aging outcomes; 3) examination of mediation of adolescent-midlife linkages via mental health and health behaviors; and 4) examination of biologic and contextual mediators and moderators of observed adolescent-midlife linkages. The proposed study addresses each of these Aims with a uniquely intense combination of repeated interviews, sociometric assessments, and direct observations of interactions with parents, peers, and romantic partners, with the new addition in midlife of an array of highly valid physiological indicators of health and aging?all obtained from a socio-demographically diverse final sample of 172 individuals (with 97% sample retention to date), followed across a 25-year span, from age 13 into midlife (ages 33 ? 37). The proposed study has significance in allowing: a. identification of several entirely new arenas within adolescence for potential interventions to promote lifelong health and healthy aging; b. suggest specific relational characteristics to target across this period in screening and preventive interventions; c. distinguish social processes in adolescence that directly predict accelerated aging (and are thus critical to address within adolescence) from those that lead to mediated chains of risk (which would suggest multiple promising points of intervention); and d. dramatically advance overall theoretical understanding of the ways in which early relationship difficulties are linked to and potentially affect physical health and aging outcomes well into midlife.