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Associations Between Disruptive Behavior Problems, Parenting Factors, and Sleep Problems Among Young Children

Coto, Jennifer MS; Garcia, Alexis MS; Hart, Katie C. PhD; Graziano, Paulo A. PhD

Journal of Developmental & Behavioral Pediatrics: October/November 2018 - Volume 39 - Issue 8 - p 610–620
doi: 10.1097/DBP.0000000000000595
Original Articles

Objective: To examine within an at-risk/clinical sample of preschool-aged children with externalizing problems: (1) which disruptive behavior and attention disorder symptoms (i.e., inattention, hyperactivity/impulsivity, and oppositionality/aggression) and (2) what aspects of parenting (e.g., discipline practices or stress) are related to children's sleep problems (e.g., sleep habit and night waking problems).

Method: The sample consisted of 148 children (meanage = 5.06 years, 82% male) with at-risk/clinically elevated levels of externalizing behavior problems and their primary caregiver. As part of a larger study, parents reported on their stress and parenting practices and their children's behavioral and sleep functioning. Positive and negative parenting behaviors (“do” and “don't” skills, respectively) were also observed during a 15-minute parent-child interaction during play.

Results: Oppositionality/aggression was the only disruptive behavior and attention disorder symptom associated with more sleep habit problems. Higher levels of inconsistent discipline and “don't” skills were also associated with more sleep habit problems. Within a combined model, an interaction emerged such that the association between “don't” skills and elevated sleep habit problems was only evident at low levels of inconsistent discipline. In terms of night waking problems, there was only an association with parenting stress, whereas the other parenting factors and disruptive behavior and attention disorder symptoms were unrelated.

Conclusion: Although the directionality of our associations cannot be ascertained because of the cross-sectional nature of our study, these findings, nevertheless, highlight the importance of parenting factors (e.g., inconsistent discipline and parenting stress) when considering sleep difficulties in young children with disruptive behavior and attention disorders.

Department of Psychology and Center for Children and Families, Florida International University, Miami, FL.

Address for reprints: Jennifer Coto, MS, Department of Psychology and Center for Children and Families, 11200 SW 8th St, AHC-1 123, Miami, FL, 33199; e-mail:

Disclosure: The authors declare no conflict of interest.

Received November 13, 2017

Accepted April 26, 2018

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