Original ArticleIdentification of Families At Risk for Behavior Problems in Primary Care SettingsLampe, Elissa M. MA; Karazsia, Bryan T. PhD; Wildman, Beth G. PhDAuthor Information From the Department of Psychology, Kent State University, Kent, OH. Bryan T. Karazsia, PhD, is currently at the Department of Psychology at The College of Wooster, Wooster, OH 44691. Received January 30, 2009; accepted August 31, 2009. Address for reprints: Beth G. Wildman, PhD, Department of Psychology, Kent State University, Kent, OH 44242; e-mail: [email protected]. Portions of this paper were presented at the 2008 National Conference in Child Health Psychology, Miami, FL. Journal of Developmental & Behavioral Pediatrics: December 2009 - Volume 30 - Issue 6 - p 518-524 doi: 10.1097/DBP.0b013e3181bf360c Buy Metrics Abstract Objective: Parenting practices and cognitions are associated with child externalizing behavior problems. Parenting programs targeting these areas are effective in improving child behavior but are limited to the extent to which they reach at-risk families. This study compared the parenting practices and cognitions of parents with high and low tolerance for misbehavior to parents of children with clinically significant behavior problems to evaluate the utility of assessing parental tolerance for identifying children at risk for externalizing behavior problems. Methods: Participants were 1014 parents of children between the ages of 2 and 16 years presenting for primary care. Parents completed the Eyberg Child Behavior Inventory, Parenting Scale, and Parenting Sense of Competence Scale. Results: Parents with high and low tolerance resembled the clinically significant problem groups in both parental behaviors and cognitions. Differences regarding parental cognitions were consistent across all age groups assessed. Conclusions: This study demonstrated the clinical utility of interpreting caregiver responses to questions about the intensity of their child's behavior problems and parental tolerance for these problems separately. Results indicated that parents with high or low tolerance for their child's behavior are at risk of having children with clinically significant behavior problems. Parents who are concerned about their child's behavior, even if their child does not currently exhibit clinically significant behavior problems, are likely to profit from early intervention for behavior problems. © 2009 Lippincott Williams & Wilkins, Inc.