Considering parents’ stress and child gender

Parents’ problem solving with preadolescents and its association with social withdrawal at school: considering parents’ stress and child gender

Scott R. Miller

The early adolescent years are a critical period for social skill development, especially for children at risk for social failure. Data from the Adolescent Development Research Program (ADRP) were used to examine the interrelationship of parents’ stress, problem solving with their adolescent child, and youths’ social withdrawal. Data were collected from 231 families in the rural South, each of which included an 11- or 12-year-old child. Fathers’ but not mothers’ constructive problem solving with children was negatively associated with teachers’ reports of youths’ social withdrawal, with the association for fathers being especially strong for sons. Neither parents’ self-reported stress was associated with self-reported problem solving with children, nor was parents’ stress associated with children’s social withdrawal. Interventions with fathers that teach and encourage problem solving with children may benefit children’s social development, a benefit that may be especially helpful for socially withdrawn sons.

Keywords: fathering, fathers’ problem solving, social withdrawal, shyness, parental stressors


The first few years of a child’s life are critical in the development of social skills and attitudes toward social interaction. Infants and young children who feel confident in exploring their social environments are able to learn positive communication skills through social interactions (Shiner, 2000), but those who are reluctant to explore their social environments are less likely to have this learning opportunity (Rubin, 1993). Individuals born with varying predispositions toward sociability may show variations in development that are associated with exposure to a variety of caregiving environments. Furthermore, children who are more sociable may evoke responsive caregiving that reinforces their sociability, whereas children who are less sociable may not evoke as positive a reaction from caregivers (Scarr & McCartney, 1983). Parents who are responsive to their socially inhibited children, however, may help to encourage greater sociability in their children. Fox and Calkins (1993), for example, reported that infants who had been unsociable and nonreactive at five months of age did not necessarily display the same type of behavior at 24 months. This finding led them to hypothesize that caregiver responsiveness may modify a child’s behaviorally inhibited temperament.

According to Rubin and Krasnor (1986), social withdrawal may begin to engender negative outcomes when children are between the ages of eight and 10 years, because mutual respect for peers’ opinions and values becomes more important during this time. During middle childhood, self-isolation may lead to peer rejection because other children perceive social withdrawal to be a nonnormative behavior. According to Bowlby (1969), during middle childhood youngsters are expected to build a working model of social interactions based on their social exploration with peers. This expectation, coupled with high demands for conformity to group norms, may lead to increasingly poorer social outcomes for those children who do not engage in social exploration. Furthermore, children whose classmates perceive them as withdrawn may be at risk for social anxiety, poor self-concept, and depression (Strauss, Forehand, Smith, & Frame, 1986) during middle childhood, which may translate to continued anxiety, depression, and poor social competence during later adolescence (Rubin & Mills, 1988).

Prior studies have made significant contributions to enhancing our understanding of social skill development and possible links between patterns of social withdrawal and children’s interactions with peers (La Greca & Lopez, 1998; Rubin & Krasnor, 1986; Rubin & Mills, 1988). What is missing from this body of research, however, is the consideration of ways in which family contexts, including stressors experienced by caregivers, may remediate or exacerbate social withdrawal during the transition to early adolescence. Also, although prior studies have shown differential effects of parenting styles on social development (Baumrind, 1995), the cumulative effect of environmental stressors on childrearing practices among parents of socially withdrawn children has not been sufficiently addressed.

The purpose of the present study is to examine the role of family context in inhibiting or fostering social withdrawal tendencies among young adolescents. Specifically, the extent to which parental stress may inhibit positive parental involvement with the child and how these factors interrelate with preadolescent social withdrawal, will be examined. Consideration of how stress influences caregiving may be especially useful to parents who are not aware of the negative effects that chronic stress can have on their children’s social development.


Bowlby (1969) proposed that normative child development depends on caregiver responsiveness, which helps children to develop a sense of security from interactions with caregivers. Secure children, in turn, feel confident in exploring their social environments.

For example, authoritative parents who involve their children in discussions about appropriate behavior tend to have children with higher levels of psychosocial maturity (Mantzicopoulos & Oh-Wang, 1998). McClun and Merrell (1998) found the authoritative style to be associated with social competence, friendliness, responsibility, and leadership. Furthermore, Baumrind (1995) reported an association between the authoritative style and social responsibility, and Durbin, Darling, Steinberg, and Brown (1993) found an association between authoritative parenting and the acquisition of a well-rounded peer group, especially in white, middle-class samples.

The accumulation of studies over the past three decades suggests that fathers may play a particularly important role in encouraging their children’s social development (Amato & Gilbreth, 1999) and general well-being (Flouri & Buchanan, 2003). Although socially withdrawn children may experience poor attachment to their fathers (Verschueren & Marcoen, 1999), fathers’ positive involvement with children tends to be associated with better social adjustment (Amato & Gilbreth, 1999). In a meta-analysis of studies between 1970 and 1998 that examined nonresident father involvement and child outcomes (Amato & Gilbreth. 1999), the average effect size for the association of fathers’ authoritative parenting and children’s internalizing problems was -.12 (p < .01). Although youth in the present study were all from intact households, past studies (e.g., Dubowitz et al., 2001) have suggested that the nature of father involvement may be at least as important as father presence in predicting child outcomes (Amato & Gilbreth, 1999). Dubowitz and colleagues (2001) found both father presence and father support to predict child social competence in a sample of children entering first grade. Additionally, data from National Survey of Families and Households (NSFH) found the amount of time fathers reported spending with children, the amount of support reported, and the quality of the father-child relationship all predict fewer behavioral problems in children aged five to 18 (Amato & Rivera, 1999). Although none of the previous studies specifically examined positive problem solving with children, the constructs that were examined (e.g., father involvement, authoritative parenting, and father support) incorporate many of the elements associated with positive problem solving; good listening skills, considering the child's feelings, and being invested in resolving disagreements with the child.

Based on these findings, it was expected that fathers’ report of positive problem solving with their preadolescent children would be negatively associated with teacher-reported child social withdrawal. Because the present sample included both mothers and fathers residing with the child, it was decided to also test the association of mothers’ problem solving with youths’ social withdrawal. This association was also expected to be negative.


Children’s development of social withdrawal can be linked both directly and indirectly to stressful events in parents’ lives. Mills and Rubin (1993) relate that stressful situations may reduce parents’ ability to respond sensitively to child withdrawal, which diminishes parental opportunities to encourage children’s social initiative. For example, Mills and Rubin found that mothers and fathers in families with limited financial resources and little social support were highly directive during interactions with their withdrawn children. Parents under stress, according to these authors, may lack sufficient psychosocial resources to respond to children in ways that foster child sociability and social competence. Based on these considerations, it was hypothesized that higher levels of parent-reported stress would be associated with lower levels of positive problem solving with the child and also associated with higher levels of children’s social withdrawal.

Gender Considerations. Past research suggests that gender may also play a role in parents’ involvement with their socially withdrawn children (Mills & Rubin, 1992). Hastings and Rubin (1999) found that mothers of withdrawn four-year-old girls did not consistently perceive their daughters’ withdrawal to be problematic, whereas Mills and Rubin (1993) found that fathers discouraged withdrawal in kindergarten and fourth-grade boys. Findings from these researchers suggest gender as an important factor in parent-child interactions. Furthermore, theories of gender-role socialization suggest that the father-child relationship is especially important for sons as sons learn sex-appropriate behavior from their fathers (Rossi & Rossi, 1990). Other studies, however, provide evidence that father involvement may benefit daughters as much as sons (Crouter, McHale, & Bartko, 1993; Flouri & Buchanan, 2003). Due to the need for further examination of this issue, gender was included as a potential moderator in all analyses.

To summarize, three specific hypotheses were proposed: (1) parents’ report of positive problem solving with their preadolescent children was expected to be negatively associated with teacher-reported child social withdrawal, (2) parents’ self-reported level of stress was expected to be negatively associated with parents’ positive problem solving with children, and (3) parents’ self-reported level of stress was expected to be negatively associated with teachers’ reports of child social withdrawal. Furthermore, although the analyses with gender were strictly exploratory, there was some evidence (e.g., Fagan, 2000; Mills & Rubin, 1993) to suggest that effects may be stronger for father-son relationships.



As part of the Adolescent Development Research Program (ADRP) at the University of Georgia, data were collected in 1994-1995 from 231 two-parent rural families in Georgia and South Carolina. The sample consisted primarily of White (76%) and African American (23%) families. All parents were biological parents of a target child, with boys and girls equally represented. Age ranges were 30 to 70 for fathers (M = 41.28, SD = 5.60), 28 to 50 for mothers, (M = 38.58, SD = 4.61), and 10 to 13 for target children (M = 12.02, SD = 0.63). Total annual income ranged from $3,522 to $226,032 with a median income of $46,779.

Data were collected from children and parents during visits to families’ homes. Data were gathered from children’s teachers (n = 177) via questionnaires mailed to the schools. Detailed recruitment and data collection procedures are described elsewhere (Brody & Ge, 2001).


Parental Stressors. Total stressful life events and each parent’s perception of the severity of those events were used as a measure of parents’ stress. Fathers and mothers completed Conger and Elder’s (1994) 37-item Stressful Life Events Scale, indicating whether particular stressful events had occurred during the previous year, then rating the impact of the stressors that had occurred on a scale of 1 = very good to 5 = very bad. Scores were summed across all items for a total score. Therefore, a parent who experienced two events, each rated as very bad, would receive a score of 10 (2 x 5) on this measure. Examples of stressful events included changes at work, loss of job, loss of significant others, changes in relationships, changes of residence, and various financial or legal hassles.

Parents Positive Problem Solving. The Positive Problem Solving subscale from the General Parenting Questionnaire, which was developed for ADRP, includes four items rated on a five-point scale. High scores indicate high levels of constructive problem solving with the child. Internal consistency was .62 for fathers’ report and .68 for mothers’ report. Positive problem solving with the child was conceptualized as having good listening skills, considering the child’s feelings, and being able to resolve disagreements.

Social Withdrawal. Social withdrawal was assessed based on reports from teachers using the Shyness subscale of the Early Adolescent Temperament Questionnaire (Capaldi & Rothbart, 1992). The subscale includes nine items rated on a five-point scale. Items tapped the child’s general shyness, quietness, and social initiative with strangers. Alpha from ADRP data was .92 for teachers’ reports. For the present study, the average score across all items was used. Therefore, possible values ranged from one to five with a score of five representing complete agreement with statements indicative of socially withdrawn behavior.


Bivariate correlations provided associations among all study variables. Path analysis via LISREL 8.54 (Joreskog & Sorbom, 2003) was used to assess the relationships of interest among the variables. Fathers’ problem solving, mothers’ problem solving, fathers’ stress, and mothers’ stress were all modeled as predictors of teachers’ report of child social withdrawal. Teacher report of social withdrawal was used as the outcome variable so that possible method bias due to nonindependent reporters could be ruled out as a confounding variable in predicting child outcome. The covariance of fathers’ and mothers’ problem solving with the child, the covariance of fathers’ and mothers’ stress, and the covariance between problem solving and stress for both fathers and mothers were also estimated. The hypothesized model is shown as Figure 1.


LISREL was also used to test the extent to which the hypothesized model fit the model implied by the covariance matrix of all study variables. In the present study the authors used two primary goodness of fit statistics: a full information maximum likelihood chi-square value and the root mean square error of approximation (RMSEA). The chi-square test has been the traditional measure used to test the closeness of fit between the hypothesized model and the implied model. However, because this statistic measures discrepancies from a perfectly fitting model, it tends to be an overly strict test of model fit (Byrne, 1998). The root mean square error of approximation (RMSEA; Hu & Bentler, 1999) represents the discrepancy per degree of freedom between the population data and the proposed model (Byrne, 1998). Some authors have suggested values less than .06 to represent good fit (Hu & Butler, 1999) while other authors have suggested that values up to .08 may be accepted as indicating adequate fit (Vandenberg & Lance, 2000).

To test for gender effects, a two-group model was run in which all paths of interest were held invariant across males and females. The chi-square value for this model provided a baseline value representing how well the model fit under the assumption that relationships among variables were consistent across gender. To test the extent to which gender moderated the path from each of the four predictors to child social withdrawal; four models were tested. In each of these models, the path from one of the four predictors to child social withdrawal was allowed to vary across gender, and the subsequent improvement in fit represented by the decrease in chi-square was noted. Statistically significant decreases in the chi-square value associated with freeing a specific path served as evidence that gender moderated the relationship in question.


Table 1 presents the mean, standard deviation, and range for each study variable for the overall sample and also for males and females separately. Fathers and mothers reported similar levels of problem solving with their children and also reported similar levels of stress. The mean score for teacher-reported social withdrawal (M = 2.47, SD = 0.84) indicates that teachers, on average, tended to slightly disagree with statements indicative of shy behavior. However, there was sufficient variability to suggest the inclusion of children with a wide range of social initiative.

Table 2 presents bivariate correlations for all study variables, also presented for both the entire sample and for males and females separately. When fathers reported more positive problem solving, their children’s teachers described the children as less socially withdrawn, r = -.16, p < .05. Fathers' self reports of problem solving with their children showed a modest positive association with mothers' self-reports of problem solving, r = .17, p < .01, as did fathers' and mothers' stress, r = .17, p < .01. Zero-order correlations revealed no statistically significant associations between parents' stress and either parents' problem solving with their children or teachers' reports of child social withdrawal.

The hypothesized model in which parents’ problem solving and stress were modeled as predictors of child social withdrawal showed good fit, [chi square] (2, N = 231) = 2.50, p = 0.29, RMSEA = 0.033. As hypothesized, fathers’ problem solving with their children was a statistically significant predictor of teachers’ reports of children’s social withdrawal, B = -.16, t = -2.10, p .10. The hypothesized positive association between parents’ stress and children’s social withdrawal was not supported for either mothers, B = .08, t = 1.04, p > .10, or fathers, B = .01, t = 0.13, p > .10. Furthermore, the hypothesized negative covariance (represented by [PHI] in LISREL) between parents’ stress and parents’ problem solving with their children was not supported for either mothers, [PHI] = .02, t = 0.38, p > .10, or fathers, [PHI] = -.02, t = -0.39, p > .10.


The first step in testing for gender as a moderator involved running a two-group model in which all paths of interest were held invariant across males and females. The chi-square value for this model, [chi square] (17, N = 231) = 11.70, p = 0.82, RMSEA = 0.000, indicated that the interrelationships among the variables were similar across males and females. However, it was still important to test how individual paths may differ across gender. Allowing the path from father’s problem solving to child social withdrawal to vary across gender resulted in a marginally significant improvement in the fit of the model, [DELTA][chi square] (1, N = 231) = 3.47, p < .10). It is notable that the 90% confidence interval for the RMSEA ranged from 0.000-0.051 in the baseline model but was narrowed to 0.000-0.017 when this path was freed across gender. Furthermore, when the model was run for males only, the association between father's problem solving and child social withdrawal was highly significant, B = -.28, t = -2.72, p .10. Although chi-square analyses showed no other paths, including the stress-problem solving covariances, to be moderated by gender, the overall model run for males only, [chi square] (2, N = 115) = 1.06, p = 0.59, RMSEA = 0.000, showed better fit than the overall model run only for females, [chi square] (2, N = 116) = 5.04, p = 0.080, RMSEA = 0.11. Figures 3 and 4 show the separate models for males and females, respectively.



The results only partly support the study’s hypotheses. When both father’s and mothers’ problem solving were considered as predictors of teacher-reported child social withdrawal, only fathers’ problem solving was negatively associated with less child social withdrawal. Furthermore, neither fathers’ nor mothers’ stress was associated with teachers’ reports of child social withdrawal, nor was either parent’s stress associated with parent-reported problem solving with their children. Follow-up analyses with gender, however, indicated that the negative association of fathers’ problem solving with child social withdrawal was particularly strong for sons but was negligible for girls.

Findings from the present study extend research on the significance of family context in understanding children’s social behavior. Although some studies have linked parental problem solving to children’s social adjustment (Mantzicopoulos & Oh-Wang, 1998; McClun & Merrell, 1998), and others have suggested a link between parents’ stress and less responsive parenting strategies (Mills & Rubin, 1993), the present study considers the unique role that fathers play in children’s social development. Furthermore, findings from the present study suggest that fathers may become less involved with socially withdrawn children, especially sons. Some of the major findings of the present study are highlighted and discussed below.


The present results suggest that a lack of self-reported positive problem solving by fathers is associated with children’s social withdrawal as reported by teachers. This association is particularly important given that the use of independent reporters across these two variables minimized possible method bias associated with the same individual reporting on both predictor and outcome variables. Baumrind (1995) has suggested that children of unengaged parents typically lack social assertiveness, whereas children of responsive parents tend to be more sociable. Numerous studies have indeed found that positive parental involvement encourages children’s social adjustment (e.g., Baumrind, 1995; Durbin, Darling, Steinberg, & Brown, 1993; Reiss, Neiderhiser, Hetherington, & Plomin, 2000). The question remains, however, to what extent sociable children evoke more social interaction from their parents, a question raised by Scarr and McCartney more than two decades ago (Scarr & McCartney, 1983). Longitudinal analyses would be helpful in further elucidating the direction of effects among these variables. In a sample of rural African-American preadolescents, for example, Brody and colleagues found child competence to predict more involved-supportive parenting one year later and involved-supportive parenting, in turn, to predict less child internalizing behavior one year after that (Brody, Kim, Murry, & Brown, 2004). More studies that consider the possibility of bidirectional effects over time will be helpful in further untangling this issue.


Findings from the present study suggest that fathers’ problem solving with children is not associated with the amount of stress experienced by fathers, nor is mothers’ problem solving with children associated with her self-reported level of stress. Great care should be taken in interpreting these findings, however, given the limited range of values for both fathers’ and mothers’ stress. Future studies in which there is sufficient variability in parents’ stress should continue to examine the extent to which parents are hindered by negative life events in their efforts to interact effectively with their children.


Consonant with previous research findings (Hastings & Rubin, 1999), the present study’s results suggest the relationship between parents’ problem solving with their children and children’s social withdrawal differs according to the parent’s and child’s gender. Mothers’ problem solving was not associated with child social withdrawal, but fathers’ problem solving was negatively associated with child withdrawal. Mothers may not see a need to intervene with their withdrawn children, especially their daughters (Hastings & Rubin, 1999), because they do not perceive withdrawal to be problematic. Fathers, however, may perceive withdrawal as undesirable, especially in sons (Mills & Rubin, 1993). In the present study, boys, but not girls whose fathers engaged in positive problem solving with them were more sociable. Fathers who respond positively to withdrawn sons, however, may break the continuity of the withdrawal-perpetuating cycle by serving as important models of adaptive social behavior for their sons (Rutter, 1996). It is important that future studies examine the extent to which increased problem solving by fathers leads to increased sociability for sons as they transition to adolescence and the extent to which increased sociability evokes even greater positive involvement from fathers.

The lack of association of fathers’ self-reported stress with both sons’ social withdrawal and fathers’ problem solving is a bit puzzling. Again, however, the restricted range of scores on the stressful life events scale completed by fathers prevents a fair test of the hypothesized associations. Almost 90% of fathers reported scores between zero and seven on the stressful life events measure. Since this score represents the number of stressful events multiplied by a severity rating between 1 = very good and 5 = very bad, it follows that most fathers reported very few events, and few were rated as having a severely negative impact. In other words, there’s no evidence to suggest that a majority of these individuals were experiencing the multitude of daily hassles found by Fagan (2000) to inhibit positive father-son interaction. It remains possible that a greater range of scores on fathers’ stress may have resulted in a stronger association between fathers’ self-reported stress and fathers’ problem solving with sons and consequently with teacher-reported child social withdrawal.


Although the present study supports important findings from past research on social withdrawal and suggests new directions, the cross-sectional design used in the present study did not allow evaluation of long-term environmental effects. Social withdrawal in childhood and adolescence follows a developmental path that differs across children depending on the continuous interplay of parent and child behaviors (Rubin & Stewart, 1996). Tracing the quantity and quality of fathers’ involvement with children over time as they negotiate stressors, influence their children, and respond to their children’s social behavior could reveal unique trajectories not anticipated by the present study.

It is also important for future studies to consider how parent-child relationship dynamics and their consequences may differ in family types other than two-parent families. There is some evidence that the nature of father involvement may be an important influence on child outcomes, even when the father does not reside in the home (Amato & Gilbreth, 1999). It is important for future studies to consider how these fathers’ positive interactions with their children are affected by increasing amounts of stress in the fathers’ lives. Furthermore, it is important to learn the extent to which nonresidential fathers may restrict their interaction with sons based on the sons’ social withdrawal.

An additional limitation involves the magnitude of the association between parents’ problem solving with children and children’s social withdrawal, which was modest at best. In other words, much of the variance in children’s social withdrawal remained unexplained. The modest association of parents’ problem solving with children’s withdrawal may be partly explained by the low reliability (alpha = .62) associated with the problem-solving measure. Much of the variability in social withdrawal, however, may have genetic origins, with heritability estimates hovering around 50% (Reiss, Neiderhiser, Hetherington, & Plomin, 2000). Much of the variance in social withdrawal may also be due to parental variables not measured in the present study, such as maternal warmth and support, which may account for as much as a third of the variance in adolescent sociability (Reiss, Neiderhiser, Hetherington, & Plomin, 2000). It is interesting that fathers’ warmth and support accounted for about a quarter of the variance in sociability in the same study. The school environment may also contribute to children’s social development and may indeed be an especially significant influence during the preadolescent years (Eccles, Lord, & Midgley, 1991). Nonetheless, findings from the present study are not insignificant and provide additional insight into factors associated with preadolescent social withdrawal.


The present study has important implications for fathers as they contribute to their children’s social development during the adolescent transition. Fathers may find it challenging to engage in constructive problem solving with their socially withdrawn sons, especially when these sons may fail to evoke positive reactions from fathers (Mills & Rubin, 1993). Fathers who are responsive to their withdrawn children and work with their children to find positive solutions to problems, however, may encourage social initiative and help their children to learn socially appropriate ways of interacting with peers. Furthermore, fathers who constructively solve problems with their sons may be especially helpful in their sons’ development of social initiative.

The nature of a parent’s involvement in a child’s life is important. Involvement that is affectively positive is more likely to benefit the child (Amato & Galbreth, 1999; Flouri & Buchanan, 2003) whereas involvement marked by overly directive or controlling communication may inhibit positive social development, especially in socially withdrawn children (Barber, Olsen, & Shagle, 1994). Although the results of the present study have focused on fathers as a key factor in children’s social development, mothers, other family members, and other community supports may also play a significant role in helping fathers to be more involved with their children, especially their sons. In this way, families and communities can work together to encourage more positive parent-child involvement and healthy social development for children as they enter the adolescent years.

Table 1

Descriptive Statistics for all Measured Variables (N = 232)

Full sample (N = 232) M SD Minimum Maximum

Father’s problem solving 15.39 2.03 9 20

Mother’s problem solving 15.46 2.10 9 20

Father’s stress 4.48 2.72 0 15

Mother’s stress 4.30 3.18 0 20

Child social withdrawal

(Teacher’s report) 2.47 0.84 1.00 4.67

Males only (n = 115)

Father’s problem solving 15.23 2.12 9 20

Mother’s problem solving 15.34 2.01 9 19

Father’s stress 4.74 2.72 0 15

Mother’s stress 4.25 3.09 0 20

Child social withdrawal

(Teacher’s report) 2.60 0.88 1.00 4.67

Females only (n = 117)

Father’s problem solving 15.55 1.93 10 19

Mother’s problem solving 15.58 2.18 9 20

Father’s stress 4.23 2.70 0 13

Mother’s stress 4.35 3.28 0 17

Child social withdrawal

(Teacher’s report) 2.35 0.79 1.11 4.33

Table 2

Correlation Matrix for all Measured Variables (N = 232)

Variable 1 2 3 4 5

Full sample (N = 232)

1. Father’s problem solving —

2. Mother’s problem solving .17 ** —

3. Father’s stress .08 .03 —

4. Mother’s stress -.02 -.07 .17 ** —

5. Child social withdrawal

(Teacher’s report) -.16 * -.06 .07 .04 —

Males only (n = 115)

1. Father’s problem solving —

2. Mother’s problem solving .12 —

3. Father’s stress -.02 .06 —

4. Mother’s stress -.03 -.09 .17 —

5. Child social withdrawal

(Teacher’s report) -.28 * -.03 .07 .02 —

Females only (n = 117)

1. Father’s problem solving —

2. Mother’s problem solving .22 * —

3. Father’s stress .20 * .00 —

4. Mother’s stress -.02 -.05 .17 —

5. Child social withdrawal

(Teacher’s report) .02 -.08 .04 .06 —

Note. Values rounded to 2 decimal places. * p < .05. ** p <.01.


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Data for this project were collected for the Adolescent Development Research Program, directed by Gene Brody at the University of Georgia and funded by a grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This paper is based on the first author’s master’s thesis.

Correspondence concerning this article should be addressed to Scott R. Miller, Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029. Electronic mail:

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