U.S. Children With Emotional and Behavioral Difficulties:: Data From the 2001, 2002, and 2003 National Health Interview Surveys

Simpson, Gloria; Bloom, Barbara; Cohen, Robin; Blumberg, Stephen J.; Bourdon, Karen

doi:10.1037/e609192007-001

Cited by 66 publications

(71 citation statements)

References 20 publications

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“…Absence of gender differences on this subscale, however, may be attributable to the inability of lay observers to recognize symptoms of internalizing disorders (34). In general, our results are congruent with those of past studies showing that among children in kinship care, boys experience greater behavioral problems and less prosocial behavior than girls (21,26,41).…”

Section: Discussionsupporting

confidence: 82%

“…First, it is unlikely that the SDQ identifies emotionally disturbed youths with the same precision as more extensive interview and diagnostic procedures (36). This is especially true when parent figures are the sole reporters, given that their own psychological distress is likely to bias their observations (34). Second, our SDQ data differed from those of the NHIS in some ways that might have affected the findings.…”

Section: Discussioncontrasting

confidence: 50%

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Risk of Psychological Difficulties Among Children Raised by Custodial Grandparents

Smith¹,

Palmieri²

2007

Psychiatric Services

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Objective-Although custodial grandchildren are believed to be at greater risk of emotional and behavioral problems than children in general, scant research has examined this important public health issue.Methods-This study involves data from 733 custodial grandmothers participating in a study funded by the National Institute of Mental Health on custodial grandparenting and 9,878 caregivers from the 2001 National Health Interview Survey (NHIS) who completed the Strengths and Difficulties Questionnaire (SDQ) in reference to target children between ages four and 17. These two data sets were used to determine if custodial grandmothers report greater emotional and behavioral difficulties, as measured by the SDQ, for custodial grandchildren than do caregivers of children from the NHIS normative sample.Results-Custodial grandchildren fared worse than children from the NHIS sample across all domains measured by the SDQ subscales, regardless of the child's gender and whether reporters were recruited by population-based or convenience sampling methods. Comparisons within the sample of 733 custodial grandmothers showed that higher levels of difficulties were reported when grandmothers were caring for boys, were recruited by convenience versus population-based sampling, and were white. Comparisons of the banded scores computed for each SDQ subscale suggested that custodial grandchildren have different cutoff points than children in the general population for a likely diagnosis of a psychiatric disorder.Conclusions-Similar to other children in kinship care arrangements, custodial grandchildren are reported by their caregivers to have higher levels of behavioral and emotional disturbances than children in the overall U.S. population.Although increasing numbers of grandparents are becoming surrogate parents to grandchildren (1), little is known about how custodial grandchildren fare in these families. Yet there are two major reasons why custodial grandchildren may encounter greater risk of behavioral and emotional difficulties than children in general. One reason is that custodial grandchildren typically receive care from grandparents because of such predicaments among their parents as substance abuse, child abuse and neglect, teenage pregnancy, death, illness, divorce, incarceration, and HIV-AIDS (2). Such predicaments bear numerous risks of psychopathology among custodial grandchildren, including exposure to prenatal toxins, early childhood trauma,The authors report no competing interests.An earlier version of this article was presented at the annual scientific meeting of the Gerontological Society of America, November 16-20, 2006, Dallas. NIH Public Access Another reason why custodial grandchildren may experience higher risk of emotional and behavioral difficulties concerns the numerous challenges that grandparents face as caregivers. For many this role is developmentally off time, unplanned, ambiguous, and undertaken with considerable ambivalence (5-7). Additional challenges to raising custodial grandchildren in...

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Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 50%

Risk of Psychological Difficulties Among Children Raised by Custodial Grandparents

Smith¹,

Palmieri²

2007

Psychiatric Services

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“…Sites were chosen to represent the range of specialties (family practice and pediatrics), payers (private insurance and Medicaid), locations (rural and urban), and practice structures (solo, group, clinic) that provide pediatric primary care in the United States (Freed, Nahra, & Wheeler, 2004;Woodwell & Cherry, 2004) and relate to variation in the prevalence of children's mental health problems (Rushton, Clark, & Freed, 2000;Simpson, Bloom, Cohen, Blumberg, & Bourdon, 2005). Clinics in the Baltimore, MD, Washington, DC and upstate New York areas were chosen based on these criteria.…”

Section: Sample and Proceduresmentioning

confidence: 99%

Identification of Youth Psychosocial Problems During Pediatric Primary Care Visits

Brown

Riley

Wissow

2007

Adm Policy Ment Health

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This investigation applied the Gateway Provider Model (GPM) of child mental health services to investigate whether characteristics of the child, family, visit, and provider were related to the identification of youth psychosocial problems during primary care visits. Data were gathered during 774 visits to 54 primary care providers (PCPs) at 13 clinics. Similar to previous investigations in primary care settings, 42% of youth demonstrated at least a sub-threshold clinical mental health problem. Most PCPs reported high job satisfaction and control, but reported varying access to mental health specialists. PCPs generally had positive attitudes and beliefs about treating psychosocial problems but many reported that doing so was burdensome. Identification was more likely when the visit was for a mental health problem, when issues related to psychosocial problems were discussed during the visit, when the youth demonstrated mental health symptoms, impairment, or burden to the family, and when the youth was older, uninsured, or received Medicaid. Identification was less likely when the PCP reported greater burden associated with treating psychosocial problems and when the PCP reported greater accessibility to mental health specialists. These results suggest that identification is associated with the interaction of multilevel factors and that the GPM is a useful model to investigate points of intervention for improving the identification of children's mental health problems in primary care settings.

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“…National studies demonstrate that ≤3% of children <8 years old have ever used mental health care services or have a significant mental health condition. 5,13 Further, since the prevalence of drug and alcohol use was extremely low among the "Healthy Passages" fifth grade participants (eg, 2% reported ever using marijuana; <1% reported ever using other drugs), most reported utilization was likely for emotional and behavioral problems.…”

Section: Methodsmentioning

confidence: 99%

Racial/Ethnic Disparities in the Mental Health Care Utilization of Fifth Grade Children

Coker¹,

Elliott²,

Kataoka³

et al. 2009

Academic Pediatrics

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Objective-The aim of this study was to examine racial/ethnic differences in fifth grade children's mental health care utilization.Methods-We analyzed cross-sectional data from a study of 5147 fifth graders and their parents in 3 US metropolitan areas from 2004-06. Multivariate logistic regression was used to examine racial/ethnic differences in mental health care utilization.Results-Nine percent of parents reported that their child had ever used mental health care services; fewer black (6%) and Hispanic (8%) children had used services than white children (14%). Fewer black and Hispanic children with recent symptoms of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder, and fewer black children with symptoms of depression had ever utilized services compared with white children. In multivariate analyses controlling for demographic factors, parental mental health, social support, and symptoms of the 4 mental health conditions, we found that black children were less likely than white children to have ever used services (Odds ratio [OR] 0.3, 95% confidence interval [95% CI], 0.2-0.4, P <.001). The odds ratio for black children remained virtually unchanged when the analysis was restricted to children with symptoms of ≥1 mental health condition, and when the analysis was stratified by mental health condition. The difference in utilization for Hispanic compared with white children was fully explained by sociodemographics in all multivariate models.

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U.S. Children With Emotional and Behavioral Difficulties:: Data From the 2001, 2002, and 2003 National Health Interview Surveys

Cited by 66 publications

References 20 publications

Risk of Psychological Difficulties Among Children Raised by Custodial Grandparents

Risk of Psychological Difficulties Among Children Raised by Custodial Grandparents

Identification of Youth Psychosocial Problems During Pediatric Primary Care Visits

Racial/Ethnic Disparities in the Mental Health Care Utilization of Fifth Grade Children

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