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Parenting and conduct problems : moderation by child empathy. Miller, Natalie; Pasalich, David; Johnston, Charlotte 2013

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Child empathy  1 Running head: CHILD EMPATHY AS MODERATOR         Parenting and conduct problems: Moderation by child empathy. Natalie Miller, David Pasalich, & Charlotte Johnston  AUTHORS’ PREPUBLICATION DRAFT    Child empathy  2  Abstract Child empathy was examined as a moderator of the relations between positive and negative parenting behavior and child conduct problems. Participants were 56 mother-child dyads (child age M = 10.8 years; 64% male) and children were recruited with a range of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. Parenting was assessed by direct observations of mothers’ praise and criticism during parent-child interactions and child empathy was measured with mother report. Child conduct problems were assessed via observation and mother-report measures, and a composite variable was created. In regression analyses, child ADHD symptoms were uniquely related to child conduct problems. Second, as hypothesized, child empathy moderated the relations between parenting and conduct problems. Mother praise was negatively related to child conduct problems at lower levels of child empathy, but this relation was not significant at higher levels of child empathy. On the contrary, mother criticism was positively related to child conduct problems at high levels of child empathy, but this relation was not significant at low levels of empathy. The results suggest that different types of parenting behavior may be differentially beneficial to children, depending on their level of empathy.  Keywords: empathy, positive parenting, negative parenting, ADHD    Child empathy  3 Parenting and conduct problems: Moderation by child empathy Conduct problems, ranging from noncompliance and defiance to aggression and severe/violent antisocial behavior, are one of the most common sources of child referrals to mental health services (e.g., Briggs-Gowan, Horwitz, Schwab-Stone, Leventhal, & Leaf, 2000), and are a risk factor for negative outcomes across adolescence and early adulthood (e.g., Fergusson & Horwood, 1998; Lahey, Gordon, Loeber, Stouthamer-Loeber, & Farrington, 1999). Understanding factors that contribute to child conduct problems is thus a priority in children’s mental health. This study addresses both environmental variables (i.e., parenting) and child characteristics that are associated with elevated levels of child conduct problems. Importantly, we also examine how the relations between positive and negative parenting and child conduct problems vary across children with higher and lower levels of empathy.   Ineffective parenting practices have been identified as a risk factor for the development of conduct problems. Indeed, numerous longitudinal studies have demonstrated a significant relation between ineffective parenting practices and the development or escalation of child conduct problems (e.g., Dodge, Greenberg, & Malone, 2008; Kilgore, Snyder, & Lentz, 2000; Shaw, Bell, & Gilliom, 2000; Smith & Farrington, 2004). These parenting practices include low levels of positive parenting, including lack of warmth or praise, and high levels of negative parenting, such as harsh or critical behavior. Although it is acknowledged that the relation between child conduct and parenting contains bidirectional influences and evolves in a transactional manner over time (Lansford et al., 2011; Pardini, Fite, & Burke, 2008), we focus in this paper on the unique association of parenting with child conduct problems. A better understanding of Child empathy  4 the kinds of parenting practices that may exacerbate child conduct problems is of obvious value in enhancing intervention and prevention efforts.    Although much research has focused on the main effects of parenting on the development of child conduct problems, there is limited understanding regarding particular child characteristics, such as temperament or personality, that may moderate the relation between parenting and conduct problems. For instance, it is possible that children with particular dispositions or sensitivities are more susceptible to the effects of ineffective parenting practices than are other less sensitive children (Belsky & Pluess, 2009). In this paper we focus on child empathy as one such possible moderating factor.   Empathy is defined as the “ability to understand and share in another’s emotional state or context” (Cohen & Strayer, 1996 cited in Jolliffe & Farrington, 2004). Empathy promotes prosocial and altruistic behavior, and is considered a factor that protects children from developing serious conduct problems (Schonert-Reichl, Smith, Zaidman-Zait, & Hertzman, 2012). Children with higher levels of empathy are better attuned to the emotional state of others, and this sharing of emotional state is thought to inhibit harmful behavior towards others (Davis, 1994). Specifically, a child who experiences the distress of a victimized peer is less likely to aggress against that peer than a child who does not experience such empathic distress in response to the peer (e.g., Jolliffe & Farrington, 2006).  Despite an overall protective effect of empathy on the development of conduct problems, it also is possible that, because empathy emotionally invests individuals in the actions of others (Eisenberg, Fabes, & Spinrad, 2006), children with higher levels of empathy are more susceptible to both the positive and negative aspects of others’ Child empathy  5 behavior, including behaviors of their parents. In this light, it can be argued that children who are more empathetic may benefit from optimal parenting (i.e., a high level of positive parenting behaviors, and a low level of negative parenting behaviors), but also, at the same time, be more vulnerable to the influence of poor parenting compared to children with lower levels of empathy who may be less attuned to these differences in parenting behavior. That is, children with high levels of empathy may not only show increased compliance or prosocial behavior when reared in homes with high levels of parental praise and warmth, but also may be particularly sensitive to and emotionally hurt by negative parental actions, and may react in negative or disruptive ways when exposed to undesirable parenting actions (e.g., increasing oppositional behavior as an emotional reaction to harsh criticism from their parent). Thus, we would predict that child empathy plays a role in moderating the relation between parenting and conduct problems, such that the link between parenting and conduct problems is stronger among children with high levels of empathy and weaker in children with low levels of empathy.    To our knowledge, only two studies have examined the moderating role of child empathy on the relation between parenting behavior and child conduct problems (de Kemp, Overbeek, de Wied, Engels, & Scholte, 2007; Van der Graaff, Branje, de Wied, & Meeus, 2012). In the first study, de Kemp and colleagues examined a sample of 823 Dutch adolescents (11 to 14 years; 49% male) and employed youth-report measures to assess the moderating role of youth empathy on the longitudinal relation between positive parenting, defined by supportiveness, affection, and companionship, and youth aggression. Positive parenting and youth aggression were assessed at time 1 (T1) and 6 months later at time 2 (T2), whereas youth empathy was only measured at T2. The Child empathy  6 authors used structural equation modeling to test the longitudinal association between T1 parent support and T2 youth aggression, and the moderating role of youth empathy on this association, controlling for T1 youth aggression. As expected, high levels of positive parenting were predictive of lower levels of youth aggression 6 months later; however, this relation was only significant among girls. Further, and contrary to their prediction, youth empathy did not moderate the relation between positive parenting and aggression for either gender.   In the second study, Van der Graaff and colleagues (2012) replicated the analyses of de Kemp et al. (2007) in another sample of 323 Dutch adolescents (M = 14.30 years; 49% male), with youth-report measures of aggression, empathy, and positive parenting (also defined by parent supportiveness, affection, companionship), and a longitudinal design with a 1-year interval. In contrast to the results of de Kemp et al., the authors reported a significant interaction between T1 youth empathy and T1 positive parenting in the prediction of T2 youth aggression, controlling for T1 aggression. Specifically, at extremely high levels of child empathy (i.e., nearly +2SD from the mean), T1 positive parenting was negatively related to T2 child aggression. Unexpectedly, at extremely low levels of youth empathy (i.e., almost -2SD from the mean), T1 positive parenting was positively related to T2 youth aggression. This latter finding is surprising, as theoretically one would predict no relation between parenting and aggression at low levels of empathy. In explanation of this result, the authors suggested that youth with low levels of empathy perceive positive parenting as condoning misbehavior, and consequently increase their rates of aggressive behavior in response. However, for this explanation to hold parents would have to specifically reinforce youth for misbehavior rather than demonstrate Child empathy  7 higher overall levels of positive parenting – a possibility that was not explored by these authors. Thus, in light of these counter-intuitive results, the authors acknowledged that this finding was difficult to interpret, and may have been spurious or attributable to methodological limitations. Taken together, these studies provide inconsistent evidence regarding the role of youth empathy within the context of parent and youth behavior. Clearly, further research is needed to better understand the interplay between parenting and child empathy in relation to child conduct problems.   The inconsistencies in the de Kemp et al. (2007) and the Van der Graaff et al. (2012) studies may be linked to the limitations of each study. First, both studies relied on child-report measures of parenting, conduct problems, and empathy; thus, it is important to examine whether these results are robust using observational and parent-report measures of the constructs. Second, these studies only examined positive aspects of parenting. Negative parenting is at least as strongly linked to child conduct problems as positive parenting (Patterson, 1982). Therefore it would enhance our understanding of the role of child empathy in the development or escalation of child conduct problems to incorporate measures of both positive and negative parenting behaviors. Lastly, the above-mentioned studies were restricted to samples of adolescents. Past research suggests that conduct problems in adolescence are more strongly influenced by peer processes as opposed to parenting behavior (e.g., Ary et al., 1999). Therefore, it is important to examine the relations among child empathy, parenting behavior, and conduct problems in a sample of younger children, when parenting behavior exerts a stronger influence, and perhaps offers greater potential for altering problematic developmental trajectories.    Given existing gaps within the literature, the primary goal of the current study was Child empathy  8 to examine whether child empathy moderates the relation between parenting and conduct problems in children. We aimed to extend the findings of past research in several ways. First, we incorporated a multi-method approach to measuring our main constructs, which included direct observations of mother parenting behavior and child conduct problems, and maternal reports of child characteristics. Second, we examined both positive (i.e., praise) and negative (i.e., criticism) dimensions of parenting behavior. Third, we used a sample of school-aged children. Lastly, we included child Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in the models, given the status of ADHD as a risk factor for conduct problems (e.g., Lee, Lahey, Owens, & Hinshaw, 2008), and the associations between comorbid ADHD/conduct problems and ineffective parenting practices (Deault, 2010; Johnston & Mash, 2001).  Considering the research reviewed above and our expectation that some children are temperamentally predisposed to be more sensitive to their parents’ behavior, we expected that child empathy would moderate the relations between positive parenting behavior and child conduct problems, controlling for child ADHD symptoms. Specifically, we expected that the strength of the negative relation between mothers’ positive behavior and child conduct problems would increase as levels of child empathy increased. Similarly, we predicted that child empathy would also moderate the relations between negative parenting behavior and child conduct problems, such that the strength of the relation between mothers’ negative behavior and child conduct problems would increase as levels of child empathy increased.  Methods Participants  Child empathy  9  Fifty-six mother-child dyads were recruited from the community (28%), elementary schools (21%), an ADHD clinic at a children’s hospital (8%), and from a registry of participants in previous research studies (43%). Approval from the University’s ethics review board was obtained for the study’s procedures, and consent/assent were provided by mothers and their children prior to participation. Sixty-four percent of children were male, and children ranged in age from 9 to 12 years (M = 10.8; SD = 1.2). Children were predominantly European-Caucasian (45%) or Asian (29%), with other ethnicities including Native American, East Indian, and African. One child was adopted and the remainder were the biological children of their mothers. Ninety-three percent of mothers reported completing at least some university education, and 68% reported being married. Hollingshead (1975) socioeconomic status scores were derived using information about mother and father education, occupation, and family income (M = 52.50; SD = 10.80).  Procedures  Mother-child interaction. Mothers and their children participated in a 10-minute structured interaction in which mothers directed their children through a series of eight tasks. These tasks, in order of presentation, were: 1) lacing a pair of shoes, 2) handwriting, 3) sorting toys, 4) solving math problems, 5) folding laundry, 6) sorting paper dots, 7) not interrupting the mother while she completed a questionnaire, and 8) capturing balls from a toy that spits out balls. These tasks were selected to evoke mild frustration for the child, and because they simulated day-to-day tasks children might complete with their mothers. These tasks also provided mothers many opportunities to interact with their child; for instance, mothers had plenty of opportunities to praise their child for engaging in or completing the tasks. Mothers wore audio receivers, similar to Child empathy  10 hearing aids, from which they received instructions about each task. Interactions were video-recorded through a one-way mirror, and prior to these tasks, the mother and child had participated in 10 minutes of free play. Mothers completed questionnaire measures before and after these interactions, and the order of questionnaires was counter-balanced across participating families.  Measures  Mother parenting behavior. Behavioral indicators of negative and positive parenting were observed and recorded during the 10-minute structured mother-child interaction. Positive parenting was measured as the frequency of praise or approval related to a specific behavior, activity, or product of the child. Negative parenting was assessed as the frequency of critical or discouraging verbalizations directed toward the child. These behaviors are defined within the Dyadic Parent-Child Interaction Coding System 3rd edition (DPICS) (Eyberg, Nelson, Duke, & Boggs, 2005), a behavioral observation system used to code parent-child social interactions. The DPICS has been used in previous research with children aged 2 to 12 (Deskins, 2005; Eyberg et al., 2005).  The first author and two other coders, who were blind to the study’s main hypotheses, independently evaluated child and mother behavior using the DPICS system. One third of the mother-child interactions were randomly assigned to each coder. Additionally, one third of the mother-child interactions were blindly double-coded. Coders were partially blind to levels of ADHD symptoms of the children (i.e., coders sometimes were involved in gathering data from families and were in contact with information about child ADHD symptoms). During coding of the study’s tapes, coders met weekly to discuss discrepancies, coding issues, and review the coding manual (i.e., 8 Child empathy  11 weeks of 1 to 2 hour meetings). Using criteria specified by LeBreton and Sentor (2008), the inter-rater reliabilities for the frequency of mother praise and criticism were strong (Praise ICC = .95; Criticism ICC = .95). We renamed the DPICS category ‘negative talk’ into ‘criticism’ for ease of interpretation.    ADHD symptoms. Child ADHD symptoms were measured using mother-report on the ADHD Rating Scale-IV (ADHD-IV) (DuPaul, McGoey, Eckert, & VanBrakle, 2001). The ADHD-IV is an 18-item questionnaire corresponding with DSM-IV criteria for ADHD. Each item assesses the frequency of a symptom and is rated on a 4-point Likert scale (0 = never; 3 = very often). Mean scores on this questionnaire were used in the analyses. The internal consistency coefficient for this scale has been reported to be .92 (Cronbach alpha) (DuPaul, Power, Anastopoulos, & Reid, 1998). The ADHD-IV also has demonstrated construct and predictive validity (DuPaul et al., 1998). In this study, levels of child ADHD symptoms were reflected by the average of frequency ratings across all symptoms. The internal consistency for the ADHD-IV was good within the current sample (Cronbach alpha = .95).  Forty-one percent of the children scored above the 90th percentile on this measure.  Child empathy. Mother-reports on the Empathy scale of the Social Skills Improvement System – Rating Scale (SSIS-RS) (Gresham & Elliot, 2008) were used to assess child empathy. Items on this scale predominantly focus on the child’s reactions to others distress, and include asking about the extent that the child helps others when they are sad, or feels bad when others feel bad. As the original Empathy scale focuses primarily on children’s social functioning among peers, we modified the wording of this scale’s items to reflect social skills demonstrated within the family context (e.g., “others” Child empathy  12 was replaced with “others in our family”). For instance, “my child tries to make others in our family feel better” or “my child is nice to others in our family when they are feeling bad.” These modifications reflected the context in which mothers would be most familiar with child behavior. Mothers rated 46 items on a 4-point Likert scale (0 = never; 3 = almost always) for the frequency the child demonstrated each empathy-related social skill within the family, and mean scores were used in analyses. The original parent-report Empathy scale has good reliability (test-retest = .78; over 6 week interval) (Gresham & Elliot, 2008). The internal consistency for the modified form of the Empathy scale used in this study was .87 (Cronbach alpha). Scores on the mother-report Empathy scale positively correlated with mother-report and child-report of child social skills using the Appropriate Social Skills scale of the Matson Evaluation of Social Skills for Youngsters (Matson, Rotatori, & Helsel, 1983), r(54) = .60, p < .001 and r(50) = .31, p = .02 respectively. This pattern of correlations suggests that the modified Empathy scale has reasonable construct validity. Finally, scores in this sample reflected a range of child empathy; empathy scores one standard deviation below the sample mean parallel scores of children with behavioral problems found in previous samples, and empathy scores one standard deviation above the sample mean correspond to scores of children within normative samples (Gresham & Elliot, 2008).   Child conduct problems. Child conduct problems were assessed using two methods: direct observations and mother-report. Observed child conduct problems were assessed using a composite of child behaviors coded using the DPICS. These behaviors included verbalizations (i.e., neutral/prosocial talk and criticism) and response to commands (i.e., compliance, noncompliance, and no opportunity for compliance). Child Child empathy  13 responses to commands were coded considering both child and mother behavior during and immediately after commands. If the child did not have an opportunity to begin to comply with a command within 5 seconds of the mother issuing it, the child’s response was coded as ‘no opportunity for compliance.’   Using the total frequency for each child micro-level behavioral category within the mother-led play interaction, two ratio scores were calculated: 1) instances of child noncompliance/total number of commands, and 2) instances of child criticism/total amount of child talk. The outcome variable, child conduct problems, was represented by the average of these ratio scores. Higher scores on this variable reflect a greater degree of problematic child behavior within the mother-child interaction. The same coders described in the observations of mother behavior were used to assess child behavior. Inter-rater reliability for child conduct problems was strong (ICC = .91) and this measure was positively correlated with mother-reports of child conduct problems (Table 2), suggesting good construct validity.   Conduct problems also were assessed through mother-report on the Aggressive Behavior scale of the Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2001). This scale contains 18 items that describe quarrelsome, oppositional, and disruptive behavior, which mothers rated on a three-point Likert scale (0 = not true; 2 = very true). Mean scores on this measure were used in the analyses. This scale has well established psychometric properties (Achenbach & Rescorla, 2001), and the internal consistency of this scale was good for our sample (Cronbach alpha = .91). Thirteen percent of children in our sample scored within the clinical range on this measure (T-scores ≥ 70; mean T-score = 57.25; SD = 8.06). Child empathy  14  Scores on observational and mother-report measures of child conduct problems were   positively correlated, r(54) = .46, p < .001. Both sets of scores were converted into T-scores, and a composite variable was created by summing T-scores for each participant.   Results  There were no missing data across the measures, excepting the CBCL Aggressive Behavior scale, which had missing data for one participant. The mean score on the original scale was assigned to the missing value, and the participant’s T-score and composite conduct problems variable score were calculated using the mean score. No demographic variables were significantly related to the child conduct problems composite variable: child age, r(54) = .05, p = .69; mother age, r(54) = -.03, p = .80; and family socioeconomic status, r(40) = .11, p = .51. Further, there were no significant differences on child conduct problems based on child gender, t(54) = -1.39, p = .17; child ethnicity F(3, 52) < 1; or mother education level, t(54) = -.03, p = .97. However, married mothers reported significantly lower levels of child conduct problems compared to unmarried mothers, t(54) = 2.16, p = .04 (married: M = 96.70, SD = 13.26; unmarried: M = 106.96, SD = 22.12). Therefore, mother marital status was included in analyses as a covariate.  Table 1 contains descriptive statistics for the predictor and outcome variables and bivariate correlations among these variables are presented in Table 2. As expected, child ADHD symptoms and mother criticism were each positively correlated with child conduct problems. Contrary to predictions, mother praise was not significantly related to child conduct problems at the bivariate level. Similarly, child empathy was not significantly correlated with child conduct problems.   Child empathy  15  Using RStudio - Version 0.95.263, linear regression modeling was used to examine the moderating role of child empathy on the relation between parenting behavior and child conduct problems. Child ADHD symptoms, child empathy, mother criticism, mother praise, and mother marital status were entered as predictors in the analyses, in addition to the interaction terms between child empathy and mother behavior. Scores on mother praise, mother criticism, and child empathy were centered before creating the interaction terms. For ease of interpretation, separate models were created to examine each interaction: 1) mother praise × child empathy as predictors of child conduct problems; and 2) mother criticism × child empathy as predictors of child conduct problems. Significant interactions were examined using simple slope analysis.  Moderation of child empathy on relation between mother praise and child conduct problems   As seen in Table 3, child ADHD symptoms were significantly related to child conduct problems, which was the only significant main effect. Although neither child empathy nor mother praise were significantly related to child conduct problems, the interaction term between these variables was a significant predictor. A closer inspection of this interaction using simple slope analysis revealed that mother praise was a strong negative predictor of child conduct problems among children with a relatively low level of empathy (i.e., 1 standard deviation below the mean on child empathy), β = -.56 with CI.95 [-1.46, -.11], t(49) =-2.49, p = .02. In contrast, and contrary to our prediction, mother praise was not significantly related to child conduct problems at a higher level of child empathy (i.e., 1 standard deviation above the mean on child empathy), β = .22 with CI.95 [-.11, .52], t(49) = 1.67, p = .10. These results are illustrated by Figure 1. Child empathy  16 Moderation of child empathy on the relation between mother criticism and child conduct problems   Parallel to the results of the previous model, only child ADHD symptoms were significantly related to child conduct problems as a main effect (Table 4). The interaction term between child empathy and mother criticism also was significant, indicating that the strength of the relation between mother criticism and child conduct problems varied across levels of child empathy. Consistent with our prediction, mother criticism was positively related to child conduct problems at a higher level of child empathy, β = .47 with CI.95 [.11, .84], t(49) = 3.04, p = .004. Further, mother criticism was not significantly related to child conduct problems at a lower level of child empathy, β = -.10 with CI.95 [-.66, .20], t(49) = -.71, p = .48. Figure 2 illustrates these results.  Discussion  This study examined the moderating role of child empathy on the relation between observed parenting and child conduct problems among elementary school-aged children with a range of ADHD symptom severity. As expected, we found that child empathy moderated the relation between two dimensions of mother parenting behavior and child conduct problems, even after controlling for child ADHD symptoms and relevant demographic variables. However, contrary to our prediction and past research, the inverse relation between positive parenting behavior and child conduct problems weakened with higher levels of child empathy. In other words, we expected the strongest relation between positive parenting and child conduct problems to occur among children with higher levels of empathy, however we observed the strongest relation among children with lower levels of empathy. We also examined the interaction between child empathy Child empathy  17 and negative parenting behavior in the prediction of child conduct problems. In accordance with our hypothesis, we found that negative parenting behavior was positively related to child conduct problems, and this relation was strengthened at higher levels of child empathy. Positive parenting behavior  We theorized that children with higher levels of empathy would be more sensitive or receptive to the positive behaviors of their parents, and consequently parental praise would serve to encourage child behaviors that would be incompatible with conduct problem behavior (e.g., comply with parent’s request). Following this argument, higher levels of positive parenting should be more strongly related to lower levels of conduct problems among children with higher levels of empathy. However, contrary to previous research (Van der Graaff et al., 2012) and our expectation, in this study mother praise was significantly and negatively related to child conduct problems only at lower levels of child empathy, and this relationship weakened as child empathy increased. This suggests that it was the children with lower levels of empathy who were are most likely to benefit from positive parenting behaviors, while this aspect of parenting may be less important among children who are already high in empathic behavior. There are several reasons we believe our results are contrary to Van der Graaff and colleagues (2012), including methodological issues and developmental considerations. First, the Van der Graaff et al. study, which found youth empathy strengthened the relation between positive parenting and youth conduct problems, focused on a community adolescent sample. In contrast, in our study, the sample was school-aged children, and included children with and without elevations in ADHD Child empathy  18 symptoms. Thus, the broader range of child functioning in our sample, and the fact that ADHD symptoms were controlled in analyses, may account for interactions that emerged between positive parenting and child empathy. In addition, there are likely to be important developmental differences in the relation between positive parenting and child conduct problems. At younger ages, positive parenting may be more focused on praise or other positive reinforcement offered as the child acquires or demonstrates behaviors such as compliance or prosocial skills. In contrast, during adolescence, the important positive aspects of parenting may shift more to open communication with the adolescent and a general over-sight or support of the youth’s activities. Consistent with such developmental differences, the Van der Graaff et al. study assessed positive parenting using a youth-report measure of perceived parent support, whereas we employed an observational measure of mothers’ use of praise. In addition, the influence of peer behavior may obscure effects of positive parenting on child conduct problems in adolescence, compared to childhood. Thus, either the difference in measures used or the developmental period assessed in the Van der Graaf and our study may offer an explanation for the different results. Van der Graaff et al. also included the youth’s perceptions of both mother and father parenting in their measure, whereas we only examined mothers’ behavior. It is possible that there are differential relations among parenting behavior, child empathy, and child conduct problems across mothers and fathers. Clearly, future research is needed to disentangle developmental and parental gender effects in the interaction between child empathy and parenting as predictors of child conduct problems.  Interestingly, while our results are in contrast to those of Van der Graaf et al. Child empathy  19 (2012), they parallel research examining parenting and conduct problems among children with callous-unemotional traits (CU), a defining feature of which is lack of empathy (Kroneman, Hipwell, Loeber, Koot, & Pardini, 2011; Pasalich, Dadds, Hawes, & Brennan, 2011). Both Kronenman et al. and Pasalich et al. reported an inverse relation between positive parenting and child conduct problems, which was moderated by child CU traits. In a longitudinal study of girls from low-income neighborhoods, Kroneman and colleagues found that high levels of positive parenting (i.e., warmth, closeness) were related to a greater decrease in conduct problems among girls with higher levels of CU traits (and presumably low levels of empathy). Pasalich and colleagues reported similar results using a male sample and cross-sectional design. Thus, our results dovetail with a growing consensus that children predisposed towards a lack of empathy may be particularly likely to benefit from warm, responsive parenting in terms of their development of prosocial behavior and avoidance of conduct problems (e.g., Kochanska, 1997).  Negative parenting behavior As predicted, mother criticism was positively correlated with child conduct problems, but only at higher levels of child empathy. This result is consistent with the argument that children with a higher level of empathy are more sensitive to the environmental effects of negative parenting, relative to children with a lower level of empathy. In contrast, the conduct problems of children with lower levels of empathy were not related to negative parenting in this sample. This result suggests that the conduct problems of children with higher levels of empathy may be more directly linked to negative parenting compared to the conduct problems of children with lower levels of Child empathy  20 empathy. In addition to being consistent with empathy as a marker for increased sensitivity to the effects of negative parenting, our results also correspond well to findings within the CU traits literature demonstrating a moderating role of child CU traits on the relation between negative dimensions of parenting and child conduct problems (Oxford, Cavell, & Hughes, 2003; Pasalich et al., 2011). For instance, using a sample of boys (n = 95; 4 to 12 years), Pasalich and colleagues reported a significant positive relationship between observations of coercive parenting behavior (e.g., criticism) and child conduct problems, but only at low levels of child CU traits (most akin to high levels of empathy in our study). Therefore, our result converges with evidence indicating that certain children are less affected by negative parenting compared to others, and may demonstrate conduct problems regardless of experience with negative parenting.  Taken together, our results provide mixed support for our hypothesis that the conduct problems of children with higher levels of empathy are more strongly linked to parenting behavior relative to the conduct problems of children with lower levels of empathy. Although sensitivity to parenting among high empathy children could account for the stronger positive relation of negative parenting to conduct problems, this relation did not emerge for positive parenting where it was low empathy children who benefitted most from positive parenting in terms of fewer conduct problems. These results are somewhat inconsistent with the idea of empathy as a marker for increased child sensitivity to parental influence, however, our unexpected findings do fit with studies of the relation of parenting to child behavior problems among children with CU traits, and confirm that empathy is an important component of CU traits. Child empathy  21 Strengths and Limitations  This study has several notable strengths. To our knowledge, this is the first study to examine the moderating role of child empathy on the relation between parenting and child conduct problems using observational measures. Moreover, this study extends the results of previous research (de Kemp et al., 2007; Van der Graaff et al., 2012) by including school-aged children. Lastly, our participants were recruited from various sources (e.g., community, school, and clinic) and had varying levels of ADHD symptoms; thereby representing a continuum of risk for conduct problems. Further, we demonstrated a moderating effect for child empathy on parenting behavior, even in models that accounted for child ADHD symptoms, indicating that our results were independent of child ADHD symptoms. Notwithstanding these strengths, the current study has several limitations. First, as our observational measure of conduct problems focused on adult-directed defiance (i.e., talking back, noncompliance), it is important to replicate these findings using a more comprehensive measure that would include other aspects of conduct problems such as peer aggression or rule violations. Nonetheless, the construct validity of our measure of child conduct problems is strengthened by the incorporation of both observational and mother-report measures into a composite variable. Second, our measure of positive parenting, praise, was contingent on children’s behavior. Therefore, some mothers may have had more opportunities for praise relative to others based on the extent that their children were compliant and engaged in the tasks. However, observations of mother praise and child negative behavior were not significantly correlated (r = -.03, p = .82), suggesting that mothers found opportunities to praise their children regardless of their Child empathy  22 child’s negative behavior. Third, our sample was restricted to school-aged children and their mothers. As previously mentioned, it is likely that different processes operate within the mother-child relationship to promote or mitigate the development of conduct problems across different developmental periods (Bierman et al., 2007). Future research should expand to include both younger and older children, ideally using longitudinal designs to track changes in both parenting and child conduct problems over time. Fourth, in contrast to mothers’ parenting, much less is known regarding the influence of father behavior on child conduct problems. For instance, there is emerging evidence that father behavior is an important consideration in the development of conduct problems among children with CU traits (Pasalich et al., 2011), but these patterns require replication among children with low empathy. Finally, our measure of empathy was not specific to affective empathy, and included items that reflect components of both affective and cognitive empathy. As affective empathy is most strongly linked to conduct problems (e.g., Jones, Happe, Gilbert, Burnett, & Viding, 2010), it would be useful in the future to use a measure that was more specific to the affective components of empathy, where one might anticipate even larger effects.   In summary, our study extends the findings of previous research by examining the moderating role of child empathy on the relation between parenting behavior and child conduct problems using observational data, and including measures of positive and negative parenting behaviors. Contrary to previous research, we found a stronger inverse relationship between positive parenting and conduct problem among children with lower rather than higher levels of empathy. However, this finding parallels results of studies examining relationships between parenting and conduct problems among children with Child empathy  23 CU traits (Kroneman et al., 2011; Pasalich et al., 2011), and suggests that children with low levels of empathy are not uniformly less responsive to environmental influences but may show particular benefit in response to positive parenting behaviors. Furthermore, our results replicate studies of negative parenting and conduct problems within the CU literature, in that we found the conduct problems of children with low levels of empathy were unrelated to negative parenting behavior. It is possible that children with lower levels of empathy are less sensitive to the negative parent behavior relative to children with higher levels of empathy. Consequently, their conduct problems are less dependent on parent negative behavior, whereas children with higher levels of empathy may act out in response to negative parenting. Our results also are consistent with the idea that empathy is an important child characteristic influencing the outcomes of parent-child interactions, and that its absence may signal a child who is relatively less motivated to behave appropriately in order to avoid negative consequences from parents.     Our research provides the first evidence that child empathy is an important consideration for understanding the development and/or escalation of child conduct problems within the family context. Parent training interventions targeting child conduct problems might benefit by incorporating measures of child empathy, and tailoring treatment to optimize child outcomes. For instance, children with high levels of empathy may benefit from parent training programs emphasizing appropriate disciplinary strategies, whereas a program emphasizing positive parenting might fit better for families of children with lower levels of empathy. Furthermore, research should continue to examine the interplay between child characteristics and parenting behavior as they contribute to child conduct problems. The valence of various child characteristics, as risk Child empathy  24 or protective factors for conduct problems, may be dependent on the type and intensity of parental or environmental effects to which the child is exposed (e.g., harsh discipline). Our research suggests that child empathy may be both a risk and protective factor depending on the type of parenting environment the child experiences. Future longitudinal research is needed to better understand the interplay between child empathy and parenting behavior in the development of conduct problems.     Child empathy  25 References Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families. Ary, D. V., Duncan, T. E., Biglan, A., Metzler, C. W., Noell, J. W., & Smolkowski, K. (1999). Development of adolescent problem behavior. 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Development of a rating scale to measure social skills in children: The Matson Evaluation of Social Skills with Youngsters (MESSY). Behaviour Research and Therapy, 21, 335-340. doi: 10.1016/0005-7967(83)90001-3 Oxford, M., Cavell, T. A., & Hughes, J. N. (2003). Callous/unemotional traits moderate the relation between ineffective parenting and child externalizing problems: A partial replication and extension. Journal of Clinical Child and Adolescent Psychology, 32, 577-585. doi: 10.1207/s15374424jccp3204_10 Pardini, D. A., Fite, P. J., & Burke, J. D. (2008). Bidirectional associations between parenting practices and conduct problems in boys from childhood to adolescence: The moderating effect of age and African-American ethnicity. Journal of Abnormal Child Psychology, 36, 647-662. doi: 10.1007/s10802-007-9162-z Pasalich, D. S., Dadds, M. R., Hawes, D. J., & Brennan, J. (2011). Do callous-unemotional traits moderate the relative importance of parental coercion versus Child empathy  30 warmth in child conduct problems? An observational study. Journal of Child Psychology and Psychiatry, 52, 1308-1315. doi: 10.1111/j.1469-7610.2011.02435.x Patterson, G. R. (1982). A social learning approach to family interventions: III. Coercive family process. Eugene, OR: Castalia. Patterson, G. R., DeGarmo, D. S., & Knutson, N. (2000). Hyperactive and antisocial behaviors: Comorbid or two points in the same process? Development and Psychopathology, 12, 91-106. doi: 10.1017/s0954579400001061 Schonert-Reichl, K. A., Smith, V., Zaidman-Zait, A., & Hertzman, C. (2012). Promoting children's prosocial behaviors in school: Impact of the 'Roots of Empathy' program on the social and emotional competence of school-aged children. School Mental Health, 4, 1-21. doi: 10.1007/s12310-011-9064-7 Shaw, D. S., Bell, R. Q., & Gilliom, M. (2000). A truly early starter model of antisocial behavior revisited. Clinical Child and Family Psychology Review, 3, 155-172. doi: 10.1023/a:1009599208790 Smith, C. A., & Farrington, D. P. (2004). Continuities in antisocial behavior and parenting across three generations. Journal of Child Psychology and Psychiatry, 45, 230-247. doi: 10.1111/j.1469-7610.2004.00216.x Van der Graaff, J., Branje, S., de Wied, M., & Meeus, W. (2012). The moderating role of empathy in the association between parental support and adolescent aggressive and delinquent behavior. Aggressive Behavior, 38, 368-377. doi: 10.1002/ab.21435   Child empathy  31 Table 1. Descriptive statistics  M SD Minimum Maximum Skewness Kurtosis Mother - observed praise 3.16 3.56 0 19 2.03 6.00 Mother - observed criticism 1.75 2.38 0 10 1.58 1.99 Child - mother-reported ADHD symptoms 1.22 .75 0 3 .62 -.53 Child - mother-reported empathy 2.00 .73 0 3 -.63 -.19 Child - observed conduct problems .09 .14 0 .75 3.13 10.98 Child - mother-reported conduct problems 6.64 6.17 0 23 .83 -.11  Table 2. Bivariate correlations  Variables Mother Criticism Child ADHD Symptoms Child Empathy Child Conduct Problems a Mother – observed praise -.03 .03 .15 -.03 Mother - observed criticism  .16 -.20 .24+ Child – mother-reported ADHD symptoms   -.14 .53*** Child - mother-reported empathy    -.19 + p < .10, *p < .05, ** p < .01, *** p < .001 a Composite variable of observed and mother-reported child conduct problems  Table 3. Hierarchical regression testing the moderating role of child empathy on the relationship between mother praise and child conduct problems a   β  SE p CI 95% β b Mother praise -.17 .12 .18 -.46 to .05 Mother criticism .15 .11 .17 -.13 to .41 Child ADHD symptoms .58 .12 <.001 .34 to 1.00 Child empathy -.05 .11 .64 -.38 to .21 Child empathy x Mother praise .39 .14 .006 .07 to 1.02 R2adj = .38, F(6, 49) = 6.55, p < .001 a Marital status included as covariate b Based on 5,999 bootstrapped samples; bias-corrected and accelerated confidence intervals    Child empathy  32 Table 4. Hierarchical regression testing the moderating role of child empathy on the relationship between mother negative talk and child conduct problems a   β  SE p CI 95% β b Mother praise .03 .11 .81 -.25 to .42 Mother criticism .18 .11 .10 -.09 to .43 Child ADHD symptoms .37 .12 .002 .16 to .61 Child empathy -.21 .12 .08 -.65 to .05 Child empathy x Mother criticism .29 .10 .007 .09 to .71 R2adj =  .38, F(6, 49) = 6.54, p < .001 a Marital status included as covariate b Based on 5,999 bootstrapped samples; bias-corrected and accelerated confidence intervals     Child empathy  33     Child empathy  34   

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