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1.  Annotation: Methodological and Conceptual Issues in Research on Childhood Resilience 
Recent advances in research on childhood resilience have yielded valuable insights on protective processes in adjustment. At the same time, however, as with any growing discipline, the rapid accrual of data has led to the identification of additional important questions, many of which are currently inadequately resolved. The focus of this paper is on salient methodological and conceptual issues that merit further scrutiny in research on resilience. The discussion focuses in turn on definitions of competence, measurement of risk, terminology used to describe protective mechanisms, main effect and interaction effect models of resilience, and processes underlying “buffering” or “moderating” effects.
PMCID: PMC4269552  PMID: 8509489
Resilience; social competence; risk
2.  Social Competence in the School Setting: Prospective Cross-Domain Associations among Inner-City Teens 
Child development  1995;66(2):416-429.
Luthar, Suniya S. Social Competence in the School Setting: Prospective Cross-Domain Associations among Inner-City Teens. Child Development, 1995, 66, 416–429. In this 6-month prospective study of 138 ninth-grade inner-city students, associations among different aspects of school-based social competence were examined. In addition, links between initial emotional adjustment and subsequent social competence at school were explored. Aspects of social competence examined included academic achievement, peer reputation, and teacher-rated classroom behaviors. Emotional adjustment was measured based on self-reported internalizing and externalizing symptoms. Consonant with views positing continuity and coherence of development, high temporal consistency was found within each social competence domain. In addition, superior adjustment in one domain was sometimes associated with subsequent improvements in other spheres as well. Exceptions found to this pattern were that (a) both as an antecedent and as a consequent variable, peer-rated sociability was negatively linked with other indices of school-based functioning, and (b) among girls, high anxiety was related to improved performance at school over the year. Ecological influences in adolescent adjustment are discussed, and implications of the findings for future research are explored.
PMCID: PMC4235606  PMID: 7750374
3.  Vulnerability and Resilience: A Study of High-Risk Adolescents 
Child development  1991;62(3):600-616.
Factors that allow children to maintain socially competent behaviors despite stress were examined among 144 inner-city ninth-grade students with a mean age of 15.3 years. Stress was operationalized by scores on a negative life events scale, and definitions of social competence were based on peer ratings, teacher ratings, and school grades. Moderator variables examined included intelligence, internal locus of control, social skills, ego development, and positive life events. Following theoretical models by Garmezy and Rutter, distinctions were made between compensatory factors (which are directly related to competence) and protective/vulnerability factors (which interact with stress in influencing competence). Ego development was found to be compensatory against stress. Internality and social skills proved to be protective factors, while intelligence and positive events were involved in vulnerability processes. This study also revealed that children labeled as resilient were significantly more depressed and anxious than were competent children from low stress backgrounds.
PMCID: PMC4235608  PMID: 1914628
4.  VULNERABILITY AND COMPETENCE: A Review of Research on Resilience in Childhood 
The developmental psychopathology literature addressing issues of children's resilience and vulnerability in dealing with life stresses is reviewed. The contribution and methodological limitations of research on stress and competence are examined, theoretical concepts of resilience are discussed, and findings with respect to protective mechanisms, as well as data from longitudinal studies, are presented. Directions for further research are outlined.
PMCID: PMC4224324  PMID: 2006679
5.  “I can, therefore I must”: Fragility in the upper-middle classes 
Development and psychopathology  2013;25(4 0 2):1529-1549.
We review evidence on a group recently identified as “at risk,” that is, youth in upwardly mobile, upper-middle class community contexts. These youngsters are statistically more likely than normative samples to show serious disturbance across several domains including drug and alcohol use, as well as internalizing and externalizing problems. Extant data on these problems are reviewed with attention to gender-specific patterns, presenting quantitative developmental research findings along with relevant evidence across other disciplines. In considering possible reasons for elevated maladjustment, we appraise multiple pathways, including aspects of family dynamics, peer norms, pressures at schools, and policies in higher education. All of these pathways are considered within the context of broad, exosystemic mores: the pervasive emphasis, in contemporary American culture, on maximizing personal status, and how this can threaten the well-being of individuals and of communities. We then discuss issues that warrant attention in future research. The paper concludes with suggestions for interventions at multiple levels, targeting youth, parents, educators, as well as policymakers, toward reducing pressures and maximizing positive adaptation among “privileged but pressured” youth and their families.
PMCID: PMC4215566  PMID: 24342854
6.  Dynamic of Change in Pathological Personality Trait Dimensions: A Latent Change Analysis Among at-Risk Women 
This study explores longitudinally a four-factor structure of pathological personality trait dimensions (PPTDs) to examine both its structural stability and intra-individual changes among PPTDs over time. Personality Disorder (PD) scales of the Millon Clinical Multiaxial Inventory-III were administered to 361 low-income women with various psychiatric conditions (drug dependence, depression), who were followed in a two-wave study over 5-years. Cross-sectional and longitudinal factor analyses outlined a robust factorial structure of PPTDs, extrinsically invariant over time, representing Negative Emotionality, Introversion, Antagonism and Impulsivity. Despite moderate rank-order stability in the PPTDs, results also indicated substantial intra-individual variability in the degree and direction of change, consistent with trajectories of change in participants’ clinical diagnoses. Results are discussed in light of current debates on the structure and dynamic of pathological personality.
PMCID: PMC3661293  PMID: 23710108
Pathological Personality; Personality Disorders; MCMI; Longitudinal Factor Analysis
7.  Academic Risk Among Inner-City Adolescents: The Role of Personal Attributes 
Journal of school psychology  2000;38(3):277-298.
In this 3-year prospective study, we explored antecedents of school-based adjustment among 134 inner-city high-school students. We examined the role of freshman-year risk and protective factors in relation to dropout status and senior-year adjustment indices among those who remained in school, including academic performance, psychological symptoms, and drug use. Although each single attribute included in this study has been linked to poor academic performance in previous investigations, the primary goal in this study was to determine which attributes were strongly related to academic problems when considered together. In addition, we sought to establish whether risk factors associated with dropout were the same as those that predicted academic problems among students who remained in school. Findings indicated that freshman-year attendance and demographic indices were most strongly predictive of dropout. Among adolescents who remained in school, freshman academic success was robustly linked to senior-year competence. Implications for identifying inner-city high-school students at high risk for academic problems are discussed.
PMCID: PMC4023637  PMID: 24839305
Risk; Adolescence; Dropout; Ethnicity; Low SES; Academic adjustment
8.  Childhood adversity and DNA methylation of genes involved in the hypothalamus–pituitary–adrenal axis and immune system: Whole-genome and candidate-gene associations 
Development and psychopathology  2012;24(4):1417-1425.
In recent years, translational research involving humans and animals has uncovered biological and physiological pathways that explain associations between early adverse circumstances and long-term mental and physical health outcomes. In this article, we summarize the human and animal literature demonstrating that epigenetic alterations in key biological systems, the hypothalamus–pituitary–adrenal axis and immune system, may underlie such disparities. We review evidence suggesting that changes in DNA methylation profiles of the genome may be responsible for the alterations in hypothalamus–pituitary–adrenal axis and immune system trajectories. Using some preliminary data, we demonstrate how explorations of genome-wide and candidate-gene DNA methylation profiles may inform hypotheses and guide future research efforts in these areas. We conclude our article by discussing the many important future directions, merging perspectives from developmental psychology, molecular genetics, neuroendocrinology, and immunology, that are essential for furthering our understanding of how early adverse circumstances may shape developmental trajectories, particularly in the areas of stress reactivity and physical or mental health.
PMCID: PMC3755948  PMID: 23062307
9.  Risky Behavior in Affluent Youth: Examining the Co-occurrence and Consequences of Multiple Problem Behaviors 
Children of affluent parents are often excluded in psychological research as they are considered to be at “low risk”; however, research is beginning to suggest that this previously under-studied population may be at risk for developing multiple problem behaviors, including substance use and externalizing problems. The current study aimed to extend the application of Problem Behavior Theory (PBT) to a sample of affluent adolescents by examining the extent to which these behaviors co-occurred and were associated with negative outcomes. Data were collected from 1,147 high school students living in an affluent community via anonymous questionnaires regarding their engagement in various problem behaviors. PBT was supported in this sample, and youth who engaged in multiple problem behaviors reported experiencing more negative outcomes than youth who did not engage in these behaviors. The findings of this study support the generalizability of PBT and also highlight the importance of continuing to study affluent youth in addition to traditionally high-risk populations.
PMCID: PMC3614372  PMID: 23559845
Affluent youth; Adolescent risk behavior; Problem Behavior Theory; Externalizing behaviors; Substance use
10.  Sensation Seeking, Coping With Stress, and Readiness to Engage in Therapy: Does Ego Development Influence the Psychosocial Functioning of Substance-Abusing Mothers? 
Ego development, the capacity to derive coherent, nuanced meaning from one’s life experiences, often has significant impact on psychosocial adjustment during adulthood. Research with nonclinical populations has indicated links between higher ego development and healthy emotional coping and interpersonal relationships. Emerging research with substance-abusing mothers suggests that higher levels of ego development are associated with improved parenting but also with increased rates of psychopathology. Less is known about how ego development is related to other psychosocial factors important for substance-abusing mothers’ functioning and capacity to parent, including the proclivity to engage in risky behaviors, adaptive coping behaviors, and readiness to engage in psychotherapy. The present study examines these links. Participants included 182 methadone-maintained women who expressed interest in a randomized clinical trial testing the efficacy of a relational parenting intervention for substance-abusing mothers (Luthar, Suchman, & Altomare, 2007). Data were analyzed using a series of MANCOVAs and ANCOVAs controlling for maternal IQ and depression. Mothers with higher levels of ego development reported more adaptive coping techniques and greater readiness to engage in psychotherapy but also reported a heightened desire for strong sensations. Findings are discussed in light of mothers’ psychological processes and parenting capacities. The significance of findings for developing parenting interventions for substance-abusing mothers is also discussed.
PMCID: PMC3349349  PMID: 22506525
substance-abusing mothers; substance-using mothers; ego development; parenting; parenting intervention; sensation seeking; coping
11.  Patterns and Correlates of Substance Use Among Affluent, Suburban High School Students 
Despite ongoing concern about substance use during adolescence, very little is known about alcohol and drug use among teens living in affluent social settings. In this longitudinal study, cluster analysis was used to characterize patterns of substance use and change in other dimensions of psychosocial adjustment within a cohort of 292 high school students (54% girls) living in an affluent, suburban community. When compared with a cluster of students reporting minimal use, clusters reporting escalating, declining, and persistently high use consistently demonstrated relatively poorer psychosocial adjustment. Moreover, other dimensions of psychosocial adjustment remained relatively stable despite changes in substance use, and there were relations involving substance use and other aspects of psychosocial adjustment that may be specific to this social setting. The findings highlight the need for preventive intervention grounded in a clear understanding of developmental process occurring within populations of affluent, suburban teens.
PMCID: PMC3538812  PMID: 16390304
12.  Contextual factors in substance use: A study of suburban and inner-city adolescents 
Development and psychopathology  1999;11(4):845-867.
Objectives in this research were to examine contextual differences in correlates of substance use among high school students. The focus was on two broad categories of adjustment indices: personal psychopathology (internalizing and externalizing problems) and behaviors reflecting social competence (academic achievement, teacher-rated classroom behaviors, and peer acceptance or rejection). Associations between drug use and each of these constructs were examined in two sociodemographically disparate groups: teens from affluent, suburban families (n = 264), and low socioeconomic status adolescents from inner-city settings (n = 224). Results indicated that suburban youth reported significantly higher levels of substance use than inner-city youth. In addition, their substance use was more strongly linked with subjectively perceived maladjustment indices. Comparable negative associations involving grades and teacher-rated behaviors were found in both groups, and among suburban males only, substance use showed robust positive associations with acceptance by peers. Results are discussed in terms of developmental perspectives on adolescent deviance, contextual socializing forces, and implications for preventive interventions and treatment.
PMCID: PMC3535189  PMID: 10624729
A Parental Values scale, in which students ranked the top 5 of 10 items in terms of how important they perceived the items as being to their parents, was analyzed using a latent class ranking model. A model with three latent classes was considered adequate, based on the Bayesian information criterion and the interpretability of the results. The three classes were interpreted as consisting of students who perceive their parents as valuing personal happiness, those who perceive their parents as valuing concern for others, and those who perceive their parents as valuing academics and attending a good college. Some evidence as to the validity of the latent classes was obtained by comparing scores on a Parental Expectations scale; the scores were higher for the academic latent class as compared to the other two classes. The analysis suggests which items might be useful in a revised version of the scale.
PMCID: PMC3535190  PMID: 23293379
14.  Multiple jeopardy: Risk and protective factors among addicted mothers' offspring 
Development and psychopathology  1998;10(1):117-136.
Objectives of this study were to ascertain risk and protective factors in the adjustment of 78 school-age and teenage offspring of opioid- and cocaine-abusing mothers. Using a multimethod, multiinformant approach, child outcomes were operationalized via lifetime psychiatric diagnoses and everyday social competence (each based on both mother and child reports), and dimensional assessments of symptoms (mother report). Risk/protective factors examined included the child sociodemographic attributes of gender, age, and ethnicity, aspects of maternal psychopathology, and both mother's and children's cognitive functioning. Results revealed that greater child maladjustment was linked with increasing age, Caucasian (as opposed to African American) ethnicity, severity of maternal psychiatric disturbance, higher maternal cognitive abilities (among African Americans) and lower child cognitive abilities (among Caucasians). Limitations of the study are discussed, as are implications of findings for future research.
PMCID: PMC3526890  PMID: 9524811
15.  Privileged but Pressured? A Study of Affluent Youth 
Child development  2002;73(5):1593-1610.
The purpose of this study was to build on preliminary findings of unusually high internalizing symptoms and substance use among suburban high school students. The sample consisted of 302 sixth- and seventh-grade students in an affluent, suburban community. Findings corroborated expectations regarding several domains of vulnerability, showing (1) high rates of clinically significant depressive symptoms among older girls, (2) significant links between various internalizing symptoms and substance use among both boys and girls, and (3) peers’ approval of substance use among older boys. In exploring potential causes of distress in this suburban sample, associations were found for achievement pressures (particularly excessive perfectionistic strivings), and isolation from parents (particularly low perceived closeness to mothers). Findings of this study are discussed in terms of widespread stereotypes about affluent families, as well as implications for future research and preventive interventions for a subgroup of youth typically viewed as being at “low risk.”
PMCID: PMC3524830  PMID: 12361321
16.  Social–Emotional Factors Affecting Achievement Outcomes Among Disadvantaged Students: Closing the Achievement Gap 
Educational psychologist  2010;37(4):197-214.
Despite concentrated efforts at improving inferior academic outcomes among disadvantaged students, a substantial achievement gap between the test scores of these students and others remains (Jencks & Phillips, 1998; National Center for Education Statistics, 2000a, 2000b; Valencia & Suzuki, 2000). Existing research used ecological models to document social–emotional factors at multiple levels of influence that undermine academic performance. This article integrates ideas from various perspectives in a comprehensive and interdisciplinary model that will inform policy makers, administrators, and schools about the social–emotional factors that act as both risk and protective factors for disadvantaged students’ learning and opportunities for academic success. Four critical social–emotional components that influence achievement performance (academic and school attachment, teacher support, peer values, and mental health) are reviewed.
PMCID: PMC3523355  PMID: 23255834
17.  Children With Co-Occurring Anxiety and Externalizing Disorders: Family Risks and Implications for Competence 
This study used data from 340 mother–child dyads to examine characteristics of children with co-occurring diagnoses of anxiety and externalizing disorders and compared them with children with a sole diagnosis or no diagnosis. Comparisons were made using 4 child-diagnostic groups: anxiety-only, externalizing-only, co-occurrence, and no-problem groups. Most mothers were characterized by low income and histories of psychiatric diagnoses during the child’s lifetime. Analyses using multinomial logistic regressions found the incidence of co-occurring childhood disorders to be significantly linked with maternal affective/anxiety disorders during the child’s lifetime. In exploring implications for developmental competence, we found the co-occurrence group to have the lowest level of adaptive functioning among the 4 groups, faring significantly worse than the no-problem group on both academic achievement and intelligence as assessed by standardized tests. Findings underscore the importance of considering co-occurring behavior problems as a distinct phenomenon when examining children’s developmental outcomes.
PMCID: PMC3490217  PMID: 20099944
co-occurring psychiatric disorders; anxiety disorders; externalizing disorders
18.  Socioeconomic Context and Emotional-Behavioral Achievement Links: Concurrent and Prospective Associations Among Low- and High-Income Youth 
Temporal associations in the relationship between emotional-behavioral difficulty and academic achievement were explored in 2 samples followed from 6th through 8th grade. The first sample comprised 280 students entering an economically disadvantaged urban middle school and the second comprised 318 students entering an affluent suburban middle school. Among disadvantaged youth, emotional indices were concurrently associated with poorer achievement while prospective associations between substance use and achievement were evident. For privileged adolescents, only a significant concurrent relationship emerged between social anxiety and achievement, although nonsignificant trends in the data suggest other, albeit weak, associations. The findings are discussed in terms of similarities and differences in these temporal associations across 2 samples representing extremes of the socioeconomic continuum.
PMCID: PMC3488273  PMID: 23129975
19.  Conceptual Issues in Studies of Resilience 
We begin this article by considering the following critical conceptual issues in research on resilience: (1) distinctions between protective, promotive, and vulnerability factors; (2) the need to unpack underlying processes; (3) the benefits of within-group experimental designs; and (4) the advantages and potential pitfalls of an overwhelming scientific focus on biological and genetic factors (to the relative exclusion of familial and contextual ones). The next section of the article is focused on guidelines for the selection of vulnerability and protective processes in future research. From a basic science standpoint, it is useful and appropriate to investigate all types of processes that might significantly affect adjustment among at-risk individuals. If the research is fundamentally applied in nature, however, it would be most expedient to focus on risk modifiers that have high potential to alter individuals’ overall life circumstances. The final section of this article considers conceptual differences between contemporary resilience research on children versus adults. Issues include differences in the types and breadth of outcomes (e.g., the tendencies to focus on others’ ratings of competence among children and on self-reports of well-being among adults respectively).
PMCID: PMC3480733  PMID: 17347344
resilience; protective processes; risk modifiers; interventions
20.  Defining Characteristics and Potential Consequences of Caretaking Burden Among Children Living in Urban Poverty 
Parentification of children has not been the focus of much empirical research. Consequently, this study was designed to explore the defining characteristics and potential consequences of caretaking burden in a sample of 356 children living in urban poverty. In a series of multivariate analyses, characteristics of the children, vocational-educational status of their mothers, and family structure correlated with caretaking burden more consistently than psychiatric, substance use, or personality problems in the mothers. Moreover, responsibility to care for mother, more so than responsibility for household chores or the care of siblings, consistently correlated with the psychosocial adjustment of the children. However, even the highest levels of caretaking burden were not consistently associated with clinically significant compromise of psychosocial adjustment.
PMCID: PMC3471375  PMID: 17535125
parent-child relations; caregiver burden; dysfunctional family; childhood development
21.  Developmental themes in women’s emotional experiences of motherhood 
Development and Psychopathology  2001;13(1):165-182.
In this study, women’s levels of ego development and their psychological difficulties were examined in relation to feelings in the maternal role. The sample consisted of 91 mothers from diverse socioeconomic backgrounds. Ego development was assessed by the Washington University Sentence Completion Test, and psychological difficulties were operationalized by self-reported global symptomatology, maternal substance abuse, and expressed anger. Outcome variables included feelings of satisfaction, distress, and support in the maternal role, as well as the degree to which negative and positive emotions were integrated in response to hypothetical vignettes of challenging everyday child-rearing experiences. Hypotheses were that women at high levels of ego development would show greater deterioration in the presence versus absence of self-reported adjustment problems than would those at lower levels. A series of interaction effects each indicated trends consistent with the hypotheses. These results add to accumulating evidence that tendencies toward self-examination, characteristic of high developmental levels, do not inevitably serve protective functions but may be linked with heightened reactivity to negative intrapsychic forces.
PMCID: PMC3314384  PMID: 11346050
22.  Drug dependence, parenting responsibilities, and treatment history: why doesn’t mom go for help? 
Drug and Alcohol Dependence  2002;65(2):105-114.
Despite longstanding concern that the presence of children deters drug-dependent women from entering treatment, there have been few empirical tests of the relationship between parenting responsibilities and treatment-seeking behavior. In this study, the relationship between number of biological children and treatment history was examined in a cohort of 153 women seeking methadone maintenance treatment. In a standard multiple regression analysis that also allowed for the potential influence of (a) age, (b) education, (c) ethnic minority status, (d) cohabitation with a sexual partner, (e) chronicity of opioid use, and (f) knowledge of HIV infection, there was a significant, negative relationship between number of children and number of earlier contacts for drug abuse treatment. Ethnic minority status and cohabitation with a sexual partner were also associated with fewer earlier contacts; greater chronicity and knowledge of HIV infection were associated with more earlier contacts. Moreover, there was significant moderation of the negative relationship between parenting responsibilities and treatment history by (a) ethnic minority status, (b) cohabitation, and (c) chronicity of use. Within a cross-sectional research design, the findings highlight ways parenting responsibilities may interact with other factors over time to influence the treatment-seeking behavior of drug-dependent women.
PMCID: PMC3314385  PMID: 11772472
Opioid dependence; Methadone maintenance; Women; Parenting; Drug treatment history; Pharmacotherapy
23.  Relational Psychotherapy Mothers’ Group: A developmentally informed intervention for at-risk mothers 
Development and Psychopathology  2000;12(2):235-253.
The Relational Psychotherapy Mothers’ Group (RPMG), a developmentally informed, supportive psychotherapy designed to serve heroin-addicted mothers with children up to 16 years of age, aims at addressing psychosocial vulnerabilities, and facilitating optimal parenting, among at-risk mothers. We present preliminary evidence on the efficacy of RPMG as an “add on” treatment in comparison with standard methadone counseling alone. At the end of the 24-week treatment period, mothers receiving RPMG plus standard methadone counseling demonstrated lower levels of risk for child maltreatment, greater involvement with their children, and more positive psychosocial adjustment than women who received methadone counseling alone. Children of RPMG participants also reflected fewer problems in multiple areas. At 6 months posttreatment, RPMG recipients continued to be at a relative advantage, although the magnitude of group differences was often attenuated. Notably, urinalyses indicated that RPMG mothers showed greater improvements in levels of opioid use over time than comparison mothers.
PMCID: PMC3313648  PMID: 10847626
24.  Discrepancies in Perceptions of Maternal Aggression: Implications for Children of Methadone-Maintained Mothers 
Despite a long history of documenting discrepancies in parent and child reports of parental care and child psychopathology, it has only been in recent years that researchers have begun to consider these discrepancies as meaningful indicators of parent–child relationship quality and as predictors of long-term child adjustment. Discrepancies in perceptions of parenting may be particularly important for the children of mothers with a history of substance abuse who may be less aware of the impact of their behavior on their child and of their child’s internalizing symptoms. This study examined associations between (a) mother–child discrepancies in reports of maternal aggression, and (b) mother and child reports of child internalizing and externalizing symptoms. Data collected from 99 mother–child dyads (with children 4–16 years of age) during the baseline phase of a randomized clinical trial testing a parenting intervention were used in this study. Measures included parent and child versions of the Parental Acceptance–Rejection Questionnaire and the Behavioral Assessment Scale for Children. Findings indicated that as children viewed their mothers as increasingly more aggressive than mothers viewed themselves, children reported more internalizing and externalizing symptoms but mothers only reported more child externalizing symptoms. Mother–child discrepancies in reports of parenting behavior have potentially meaningful implications for child emotional and behavioral problems.
PMCID: PMC3308352  PMID: 20636946
mothers; children; adolescents; Connecticut; interrater discrepancies; substance abuse; emotional disturbance; depression; aggression; parent–child relations; parent groups
25.  Ego Development, Psychopathology, and Parenting Problems in Substance-Abusing Mothers 
The authors examined maternal ego development in relation to psychopathology and parenting problems in a sample of substance abusing mothers. Given predilections at higher levels of ego development for introspection and guilt, the authors expected mothers at higher levels to report more psychopathology. Given predilections at lower levels of ego development for dichotomous perceptions and limited conceptions of causation, the authors expected mothers at low levels to report more problematic parenting behaviors. Intelligence was expected to correlate but not overlap with ego development. Subjects were 182 mothers who expressed interest in a randomized clinical trial for a new parenting intervention. Measures included the Washington University Sentence Completion Task—Short Form, the Parental Acceptance-Rejection Questionnaire, the Brief Symptom Inventory and the Kaufman Brief Intelligence Test. Results of correlation and multivariate analyses of variance confirmed predictions. Implications for future development of interventions for substance abusing mothers are discussed.
PMCID: PMC2729054  PMID: 18444723
ego development; drug abuse; parenting style; psychopathology

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