The risk of having at least 1 psychiatric disorder by age 16 years is much higher than point estimates would suggest. Concurrent comorbidity and homotypic and heterotypic continuity are more marked in girls than in boys.
In the general population of children, potentially traumatic events are fairly common and do not often result in PTS symptoms, except after multiple traumas or a history of anxiety. The prognosis after the first lifetime trauma exposure was generally favorable. Apart from PTSD, traumatic events are related to many forms of psychopathology, with the strongest links being with anxiety and depressive disorders.
Context Social causation (adversity and stress) vs social selection (downward mobility from familial liability to mental illness) are competing theories about the origins of mental illness. Objective To test the role of social selection vs social causation of childhood psychopathology using a natural experiment. Design Quasi-experimental, longitudinal study. Population and Setting A representative population sample of 1420 rural children aged 9 to 13 years at intake were given annual psychiatric assessments for 8 years (1993-2000). One quarter of the sample were American Indian, and the remaining were predominantly white. Halfway through the study, a casino opening on the Indian reservation gave every American Indian an income supplement that increased annually. This increase moved 14% of study families out of poverty, while 53% remained poor, and 32% were never poor. Incomes of non-Indian families were unaffected. Main Outcome Measures Levels of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, psychiatric symptoms in the never-poor, persistently poor, and ex-poor children were compared for the 4 years before and after the casino opened. Results Before the casino opened, the persistently poor and ex-poor children had more psychiatric symptoms (4.38 and 4.28, respectively) than the never-poor children (2.75), but after the opening levels among the ex-poor fell to those of the neverpoor children, while levels among those who were persistently poor remained high (odds ratio, 1.50; 95% confidence interval, 1.08-2.09; and odds ratio, 0.91; 95% confidence interval, 0.77-1.07, respectively). The effect was specific to symptoms of conduct and oppositional defiant disorders. Anxiety and depression symptoms were unaffected. Similar results were found in non-Indian children whose families moved out of poverty during the same period. Conclusions An income intervention that moved families out of poverty for reasons that cannot be ascribed to family characteristics had a major effect on some types of children's psychiatric disorders, but not on others. Results support a social causation explanation for conduct and oppositional disorder, but not for anxiety or depression.
In this rural sample, African American and white youth were equally likely to have psychiatric disorders, but African Americans were less likely to use specialty mental health services. School services provided care to the largest number of youths of both ethnic groups.
We examine the role that an exogenous increase in household income due to a government transfer unrelated to household characteristics plays in children's long run outcomes. Children in affected households have higher levels of education in their young adulthood and a lower incidence of criminality for minor offenses. Effects differ by initial household poverty status. An additional $4000 per year for the poorest households increases educational attainment by one year at age 21 and reduces having ever committed a minor crime by 22% at ages 16−17. Our evidence suggests that improved parental quality is a likely mechanism for the change.
Research Summary:The analyses reported in this article are based on data from a longitudinal epidmiologic study of youth from 11 rural counties in North of the children in the population represented in this study had a parent or other parent figure who had been arrested as an adult. Analyses showed that parent risk factors (i.e., substance abuse, mental illness, and lack of education) had a significant direct effect on children's exposure to family risks. These parent risk factors were also associated with greater odds of parental involvement in the criminal justice system (CJS), which in turn, had a significant association with children's likelihood of experiencing two types of family risks (i.e., economic strain and instability), net the effect of parent risk factors. Parent CJS involvement, however, was not significantly associated with family risks related to family structure or quality of care. Exposure to risks in these latter domains was better explained by the direct effect of parental substance abuse, mental health problems, and lack of education.
Policy Implications:These findings provide empirical evidence that parent CJS involvement is significantly related to children's exposure to certain types of family risks independent of the possible confounding effect of parent risks. The fact that the two domains of family risks that were associated with CJS involvement were economic adversity and family stability is noteworthy as these mirror two of the ecological correlates of crime that are thought to be perpetuated by high levels of incarceration-poverty and population mobility. Second, these findings suggest that it is unrealistic to expect correctional programs that focus on inmates' relationships VOLUME 5 NUMBER 4 2006 PP 677-702
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