Our findings suggest several directions for policy and
intervention. The direct relationship between SES and
adolescent psychopathology implies that poverty and
poverty-related stressors are appropriate targets for youth
internalizing and externalizing problems. For example,
local and federal programs should directly target poverty
and related difficulties (e.g., neighborhood safety, crowding,
nutrition, access to health services) to improve mental
health outcomes for these youth. In addition, clinical
interventions should include coping skills to help youth
manage stressors occurring in low-SES, urban environments
(e.g., exposure to community violence). Similarly,
the results regarding parent positive communication are
consistent with treatment literature on the most effective
interventions for internalizing and externalizing disorders.
Specifically, individual interventions (e.g., cognitive
restructuring) have a significant impact on internalizing
problems (Clarke et al. 2001), while externalizing problems
are treated most effectively with family-based and
multi-systemic interventions, especially for lower-income
urban youth (Henggeler 1999). Our results suggest that
even if parent communication is poor, youth may still
benefit from individual interventions that improve internalizing
problems (e.g., individual cognitive-behavioral
therapy). In contrast, our results suggest that family-based
approaches are integral to treating externalizing problems.
Since our results were significant for parent-report only,
parents may benefit from both positive communication
skills (e.g., non-verbal listening skills, providing clear
explanations) and coping skills to help manage stress
caused by youths’ externalizing behaviors. By helping
parents cope with their teens’ externalizing behaviors, they
may become less distressed and may use more positive
communication, which may ultimately have a positive
impact on youths’ externalizing problems.
Study strengths such as sample characteristics, multiple
and culturally sensitive methodologies, and theory-driven
hypotheses should be considered along with the following
study limitations. First, while we accounted for baseline
symptoms and utilized two waves of data, we did not
examine each process at a different timepoint, as is recommended
to obtain unbiased effect sizes and establish
directionality among processes (Cole and Maxwell 2003;
Maxwell and Cole 2007). Hence, findings do not indicate
that effects will be sustained over time (indeed, effect sizes
may be inflated) nor do they determine directionality
between variables. This study represents an initial step in
examining the family stress model with treatment-seeking,
lower income urban youth. It will be important for future
studies to address the potential transactional relationships