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1.
J Immigr Minor Health ; 25(4): 744-754, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36576672

RESUMO

Our study provides nationally-generalizable evidence on the racial/ethnic and socioeconomic disparities in diagnosis and recovery from childhood behavioral or conduct problems. We pooled data from 4 years (2016-2019) of the National Survey of Children's Health (NSCH) for 3 to 17 years old US children (N = 114,476). We performed several logistic regression models using complex survey data analysis statistical methodologies to estimate nationally representative and generalizable results in the Stata MP 16 program. About 20.1% of 3-17 years old US children previously diagnosed with behavioral or conduct problems no longer had the current diagnosis (were recovered). Hispanic children [Odds ratio (OR) 0.77, 95% Confidence Interval (CI) 0.65-0-95], immigrant children or children of immigrant parents (first or second generation immigrant children), and children from high-income families [200-399% Federal Poverty Level (FPL)] were about 23%, 38%, and 21% less likely than non-Hispanic White children, children of US native parents, and children with a family income of below 100% FPL to be currently diagnosed with behavioral or conduct problems, respectively. Conversely, Non-Hispanic Black and Hispanic children were about 50% and 40% more likely than non-Hispanic White children to recover from a past diagnosis. Moreover, children from higher-income families (at or above 300% of FPL) were between 1.59 to 1.79 times more likely than those from low-income families (below 100% FPL) to recover from a past diagnosis. Racial/ethnic and socioeconomic disparities in diagnosing appear to persist in recovering from behavioral or conduct problems.


Assuntos
Grupos Raciais , Adolescente , Criança , Pré-Escolar , Humanos , População Negra , Hispânico ou Latino , Renda , Pobreza , Estados Unidos/epidemiologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/terapia , Brancos , Emigrantes e Imigrantes , Fatores Socioeconômicos , Fatores Raciais
2.
Fam Process ; 59(3): 1094-1112, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31381814

RESUMO

Culturally adapted evidence-based parenting interventions constitute a key strategy to reduce widespread mental health disparities experienced by Latinx populations throughout the United States. Most recently, the relevance of culturally adapted parenting interventions has become more prominent as vulnerable Latinx populations are exposed to considerable contextual stressors resulting from an increasingly anti-immigration climate in the country. The current study was embedded within a larger NIMH-funded investigation, aimed at contrasting the differential impact of two culturally adapted versions of the evidence-based parenting intervention known as GenerationPMTO©. Specifically, a sample of low-income Mexican-origin immigrants was exposed either to a culturally adapted version of GenerationPMTO primarily focused on parent training components, or to an enhanced culturally adapted version in which parenting components were complemented by sessions focused on immigration-related challenges. The sample for the study consisted of 103 Mexican-origin immigrant families (190 individual parents). Descriptive analysis and generalized estimating equations (GEEs) indicated that exposure to the enhanced intervention, which included context- and culture-specific sessions, resulted in specific benefits for parents. However, the magnitude of the impact was not uniform for mothers and fathers and differed according to the type of immigration-related stress being examined (i.e., intrafamilial vs. extrafamilial stress). Overall, findings indicate the relevance of overtly addressing contextual (e.g., discrimination) and cultural challenges in culturally adapted interventions, as well as the need to increase precision according to the extent to which immigration-related stressors impact immigrant mothers and fathers in common and contrasting ways. Implications for family therapy practice and research are discussed.


Las intervenciones basadas en evidencia, dirigidas a padres y adaptadas a la cultura son una estrategia clave para reducir las desigualdades en salud mental generalizadas que las poblaciones de latin@s experimentan en los Estados Unidos. Más recientemente, la relevancia de intervenciones dirigidas a padres adaptadas a la cultura ha adquirido más peso al estar las poblaciones de latin@s expuestas a factores estresantes contextuales considerables como resultado de un ambiente cada vez más contrario a la inmigración en el país. Este estudio fue incluido dentro de una investigación de mayor escala financiada por NIMH cuyo objetivo era contrastar el impacto diferencial de dos versiones adaptadas a la cultura de la intervención basada en evidencia y dirigida a padres conocida como GenerationPMTO© . En específico, se expuso una muestra de inmigrantes de origen mexicano de bajo ingreso, o a una versión de GenerationPMTO adaptada a la cultura y enfocada principalmente en elementos de entrenamiento de padres, o a una versión reforzada adaptada a la cultura en la cual los elementos de padres se complementaron con sesiones enfocadas en retos asociados a la inmigración. La muestra para el estudio consistió de 103 familias inmigrantes de origen mexicano (190 padres individuales). Análisis descriptivos y ecuaciones de estimación generalizadas indicaron que la exposición una intervención reforzada, que incluía sesiones contextual y culturalmente específicas, generaron beneficios específicos para los padres. Sin embargo, la magnitud del impacto no fue uniforme para madres y padres y fue distinta según el tipo de estrés por inmigración examinado (p.ej., estrés intrafamiliar versus estrés extrafamiliar). En general, los hallazgos indican la relevancia de enfrentar abiertamente retos contextuales (p.ej., discriminación) y culturales en intervenciones adaptadas a la cultura, así como la necesidad de aumentar la precisión conforme a cómo los factores estresantes asociados a la inmigración afectan a madres y padres inmigrantes de la misma y diferentes maneras. Se discuten las implicaciones para la práctica e investigación de terapia familiar.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Educação não Profissionalizante/métodos , Terapia Familiar/métodos , Americanos Mexicanos/psicologia , Estresse Psicológico/terapia , Adulto , Criança , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Masculino , México/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pobreza/etnologia , Pobreza/psicologia , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Estados Unidos , Populações Vulneráveis/etnologia , Populações Vulneráveis/psicologia
3.
J Immigr Minor Health ; 22(1): 22-33, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31089910

RESUMO

Refugee children are at risk to develop mental health problems, which have rarely been investigated in educational contexts. We conducted three studies in childcare programs for refugees in Germany. Children's behavior was assessed by educators on site (n = 84) and online (n = 50) using a two-stage-cluster sampling and on site (n = 107) using complete samples. In Study 1 and 2, children showed elevated attention problems ranging from medium to large effect sizes, r = 0.2 and r = 0.5, respectively, and aggressive behavior problems ranging from small to large effect sizes, r = 0.1 and r = 0.5, respectively, when compared to norm data. In Study 3, children showed elevated peer-problems, r = 0.5. Future research needs to investigate whether these problems are a consequence of adapting to a novel context or a precursor of a psychopathology caused by risk factors in the context of forced displacement.


Assuntos
Saúde Mental/etnologia , Refugiados/psicologia , Agressão , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtornos do Comportamento Infantil/etnologia , Pré-Escolar , Emoções , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Fatores de Risco , Comportamento Social
4.
J Am Acad Child Adolesc Psychiatry ; 58(6): 572-581.e1, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30768419

RESUMO

OBJECTIVE: This pragmatic, randomized, non-inferiority trial compared the effectiveness and cost of group-based parent management training with mastery-based individual coaching parent management training in a low-income, predominantly African American sample. METHOD: Parents seeking treatment for their 2- to 5-year-old children's behavior problems in an urban fee-for-service child mental health clinic were randomized to the Chicago Parent Program (CPP; n = 81) or Parent-Child Interaction Therapy (PCIT; n = 80). Consent followed clinic intake and diagnostic assessment and parent management training was delivered by clinicians employed at the clinic. Primary outcome measures were externalizing child behavior problems, assessed at baseline and postintervention follow-up, using the Child Behavior Checklist (CBCL) and average per-participant treatment cost. RESULTS: Data from 158 parents were analyzed. Most were mothers (75.9%), African American (70.3%), and economically disadvantaged (98.7% Medicaid insured). Of children, 58.2% were boys, and mean age was 3.6 years (SD 1.03). Based on CBCL scores, behavior problems improved in the 2 conditions (Cohen d = 0.57 for CPP and 0.50 for PCIT). CPP was not inferior to PCIT (90% CI -1.58 to 4.22) at follow-up, even after controlling for differences in treatment length (90% CI -1.63 to 4.87). Average per-participant treatment cost was higher for PCIT (mean $2,151) than for CPP (mean $1,413, 95% CI -1,304 to -170). CONCLUSION: For parents of young children living in urban poverty, CPP is not inferior to PCIT for decreasing child behavior problems. CPP requires less time to complete and costs a third less than PCIT. CLINICAL TRIAL REGISTRATION INFORMATION: Early Parenting Intervention Comparison (EPIC); https://clinicaltrials.gov/; NCT01517867.


Assuntos
Transtornos do Comportamento Infantil/terapia , Planos de Pagamento por Serviço Prestado/economia , Serviços de Saúde Mental/economia , Poder Familiar/etnologia , Pais/educação , Negro ou Afro-Americano , Baltimore/epidemiologia , Comportamento Infantil , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/economia , Transtornos do Comportamento Infantil/etnologia , Pré-Escolar , Análise Custo-Benefício , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Saúde Mental , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Pobreza/etnologia , Pobreza/psicologia , Avaliação de Programas e Projetos de Saúde
5.
Infant Behav Dev ; 50: 165-173, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29306797

RESUMO

The main aim of the present study was to examine differences in behavioral problems in toddlers born very preterm in Brazil and Italy. The sample comprised 154 toddlers (18-24 months of age) born very preterm, including 76 toddlers from Brazil and 78 toddlers from Italy. The Child Behavior Checklist was used to assess behavioral problems. Specific sociodemographic factors (i.e., maternal age at childbirth and maternal education) and neonatal factors (i.e., gestational age, sex, and length of hospitalization) were tested as potential mediators of country-related differences in behavioral problems. Brazilian toddlers presented more internalizing, externalizing, and total behavioral problems compared with their Italian counterparts. The effect of country on the toddlers' internalizing and total behavioral problems was mediated by maternal age at childbirth and education. Independent effects of country, maternal age at childbirth, and maternal education emerged for externalizing behavioral problems. No significant effect emerged for neonatal variables. These findings suggest that sociodemographic factors, in addition to country-related differences, should be considered when assessing the risk of behavioral problems in preterm toddlers.


Assuntos
Transtornos do Comportamento Infantil/economia , Transtornos do Comportamento Infantil/psicologia , Recém-Nascido Prematuro/psicologia , Comportamento Problema/psicologia , Classe Social , Adulto , Brasil/etnologia , Transtornos do Comportamento Infantil/etnologia , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Itália/etnologia , Idioma , Masculino , Fatores de Risco
6.
Issues Ment Health Nurs ; 38(4): 327-336, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28379743

RESUMO

This contribution proposes an intervention methodology that provides improved access to and effectiveness of mental health care facilities in Brussels, Belgium, for children and their families with a refugee and migration background. Migration is a complex process that involves several potential risk factors, and referral to mental health facilities is often ineffective. Consequently, optimal developmental opportunities for refugee children are hampered. The intervention is underpinned by a broad-based contextual perspective that seeks to bring to the surface and tackles the many challenges faced by these families. It takes into account the unique developmental context of refugee children, as well as the interplay with broader systems.


Assuntos
Acessibilidade aos Serviços de Saúde/organização & administração , Transtornos Mentais/etnologia , Transtornos Mentais/enfermagem , Serviços de Saúde Mental/organização & administração , Refugiados/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/enfermagem , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Competência Cultural , Diversidade Cultural , Etnopsicologia/métodos , Etnopsicologia/organização & administração , Feminino , Humanos , Lactente , Comunicação Interdisciplinar , Colaboração Intersetorial , Deficiências da Aprendizagem/etnologia , Deficiências da Aprendizagem/enfermagem , Deficiências da Aprendizagem/psicologia , Masculino , Transtornos Mentais/psicologia , Relações Profissional-Família , Participação Social/psicologia , Valores Sociais
7.
Compr Psychiatry ; 79: 4-18, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28356192

RESUMO

BACKGROUND: Originating in the 1960s, the Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of instruments for assessing problems and strengths for ages 1½-90+ years. PURPOSE: To provide an overview of the ASEBA, related research, and future directions for empirically based assessment and taxonomy. CONTENT: Standardized, multi-informant ratings of transdiagnostic dimensions of behavioral, emotional, social, and thought problems are hierarchically scored on narrow-spectrum syndrome scales, broad-spectrum internalizing and externalizing scales, and a total problems (general psychopathology) scale. DSM-oriented and strengths scales are also scored. The instruments and scales have been iteratively developed from assessments of clinical and population samples of hundreds of thousands of individuals. Items, instruments, scales, and norms are tailored to different kinds of informants for ages 1½-5, 6-18, 18-59, and 60-90+ years. To take account of differences between informants' ratings, parallel instruments are completed by parents, teachers, youths, adult probands, and adult collaterals. Syndromes and Internalizing/Externalizing scales derived from factor analyses of each instrument capture variations in patterns of problems that reflect different informants' perspectives. Confirmatory factor analyses have supported the syndrome structures in dozens of societies. Software displays scale scores in relation to user-selected multicultural norms for the age and gender of the person being assessed, according to ratings by each type of informant. Multicultural norms are derived from population samples in 57 societies on every inhabited continent. Ongoing and future research includes multicultural assessment of elders; advancing transdiagnostic progress and outcomes assessment; and testing higher order structures of psychopathology.


Assuntos
Diversidade Cultural , Pesquisa Empírica , Transtornos Mentais/classificação , Transtornos Mentais/etnologia , Escalas de Graduação Psiquiátrica/normas , Adolescente , Adulto , Fatores Etários , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/etnologia , Emoções , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pais , Psicopatologia
8.
J Fam Psychol ; 29(3): 405-415, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26053349

RESUMO

African American youth, particularly those from single-mother homes, are overrepresented in statistics on externalizing problems. The family is a central context in which to understand externalizing problems; however, reliance on variable-oriented approaches to the study of parenting, which originate from work with intact, middle-income, European American families, may obscure important information regarding variability in parenting styles among African American single mothers, and in turn, variability in youth outcomes as well. The current study demonstrated that within African American single-mother families: (a) a person-, rather than variable-, oriented approach to measuring parenting style may further elucidate variability; (b) socioeconomic status may provide 1 context within which to understanding variability in parenting style; and (c) 1 marker of socioeconomic status, income, and parenting style may each explain variability in youth externalizing problems; however, the interaction between income and parenting style was not significant. Findings have potential implications for better understanding the specific contexts in which externalizing problems may be most likely to occur within this at-risk and underserved group.


Assuntos
Negro ou Afro-Americano/etnologia , Transtornos do Comportamento Infantil/etnologia , Mães/psicologia , Poder Familiar/etnologia , Família Monoparental/etnologia , Classe Social , Adolescente , Adulto , Criança , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , North Carolina/etnologia
9.
J Health Care Poor Underserved ; 26(2): 410-20, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25913339

RESUMO

BACKGROUND: The relationship between behavioral problems and obesity in early childhood in Latinos is largely unknown. METHODS: Cross-sectional anthropometric and behavioral data of children at three years of age were gathered from a cohort of 174 children of Latina mothers at two San Francisco hospitals. Child behaviors were assessed using the preschool Child Behavior Checklist (CBCL/1½-5). Logistic regression was used to analyze the association between behavior and obesity. RESULTS: At three years, 27.7% were obese. There were no associations between affective (OR = 1.89; 95% confidence interval [CI] 0.42-8.59), anxiety (OR = 1.86; 95% CI 0.53-6.47), pervasive developmental (OR = 0.42; 95% CI 0.13-1.36), attention deficit hyperactivity (OR = 0.58; 95% CI 0.12-2.76), or oppositional defiant (OR = 6.49; 95% CI 0.65-64.49) problems and obesity. CONCLUSIONS: Though psychological problems and obesity are associated among older children and adolescents, there was no association in Latino three-year olds in a low-income sample.


Assuntos
Comportamento Infantil/etnologia , Hispânico ou Latino/psicologia , Obesidade Infantil/etnologia , Pobreza/etnologia , Ansiedade/complicações , Ansiedade/etnologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Lista de Checagem , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/etnologia , Transtornos Globais do Desenvolvimento Infantil/complicações , Transtornos Globais do Desenvolvimento Infantil/etnologia , Pré-Escolar , Estudos Transversais , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/etnologia , Obesidade Infantil/economia , Obesidade Infantil/psicologia , Pobreza/economia , Pobreza/psicologia , São Francisco/epidemiologia
10.
Psychol Bull ; 141(4): 723-46, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25822131

RESUMO

Economic disadvantage is a well-studied risk factor for poorer behavioral and academic functioning in young children. Although the mechanisms by which disadvantage impacts children have long been of interest to researchers, studies to date have predominantly focused on mechanisms that are external to the child (e.g., parental depression, marital conflict). Very few studies have examined the internal, cognitive aspects of the experience of economic disadvantage, and almost none have considered how the effects of disadvantage on children's functioning might be mediated through cognitive processes. This article provides a framework for research into cognitive and social-cognitive mediators of economic disadvantage operating in early-to-middle childhood. The initial section of the article briefly reviews and summarizes the extant literature on childhood poverty and its effects. The second section reviews the evidence that preschool-aged children have the requisite cognitive abilities to recognize social inequality in their environments, to be aware of stereotypes related to social class, and to connect these social concepts to their own experience. The third section reviews and evaluates the small literature on children's appraisals, attributions, stereotypes, and perceptions of or about poverty and inequality. The fourth section defines and evaluates the literature on 2 social-cognitive processes-stereotype threat and status anxiety-that are hypothesized to mediate the effects of economic disadvantage on children's functioning. The article concludes with a series of proposed questions and hypotheses for future research, and elaborates on the potential implications of the proposed area of research. (PsycINFO Database Record


Assuntos
Cognição , Pobreza/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/etiologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Economia , Feminino , Humanos , Masculino , Pais/psicologia , Classe Social , Percepção Social , Estados Unidos , Adulto Jovem
11.
Trials ; 15: 70, 2014 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-24581245

RESUMO

BACKGROUND: Untreated behavioral and mental health problems beginning in early childhood are costly problems affecting the long-term health and wellbeing of children, their families, and society. Although parent training (PT) programs have been demonstrated to be a cost-effective intervention modality for treating childhood behavior problems, they have been less effective for children from low-income and underserved racial and ethnic populations. The purpose of this randomized trial is to compare the effectiveness, cost, and social validity of two manualized evidence-based PT programs that were developed and tested on different populations and employ different delivery models: (1) The Chicago Parent Program (CPP), a group-based program developed in collaboration with a community advisory board of African-American and Latino parents; and (2) Parent-Child Interaction Therapy (PCIT), an individualized parent-child coaching model considered to be 'the gold standard' for parents of children with externalizing behavior problems. METHODS: This trial uses an experimental design with randomization of parents seeking behavioral treatment for their 2- to 5-year-old children at a mental health clinic in Baltimore, MD (80% African-American or multi-racial; 97% receiving Medicaid). Using block randomization procedures, 262 parents are randomized to CPP or PCIT. Clinicians (n=13) employed in the mental health clinic and trained in CPP or PCIT are also recruited to participate. Primary outcomes of interest are reductions in child behavior problems, improvements in parenting, perceived value of the interventions from the perspective of parents and clinicians, and cost. Parent distress and family social risk are assessed as modifiers of treatment effectiveness. We hypothesize that CPP will be at least as effective as PCIT for reducing child behavior problems and improving parenting but the programs will differ on cost and their social validity as perceived by parents and clinicians. DISCUSSION: This is the first study to compare the effectiveness of a PT program originally designed with and for parents from underserved racial and ethnic populations (CPP) against a well-established program considered to be the 'the gold standard' (PCIT) with a high-risk population of parents. Challenges related to conducting a randomized trial in a fee-for-service mental health clinic serving urban, low-income families are discussed. TRIAL REGISTRATION: NCT01517867.


Assuntos
Transtornos do Comportamento Infantil/terapia , Pesquisa Comparativa da Efetividade , Educação não Profissionalizante/métodos , Planos de Pagamento por Serviço Prestado , Serviços de Saúde Mental , Poder Familiar , Pais/educação , Pobreza , Projetos de Pesquisa , Baltimore/epidemiologia , Comportamento Infantil , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/economia , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Análise Custo-Benefício , Educação não Profissionalizante/economia , Planos de Pagamento por Serviço Prestado/economia , Custos de Cuidados de Saúde , Humanos , Saúde Mental , Serviços de Saúde Mental/economia , Relações Pais-Filho , Poder Familiar/etnologia , Poder Familiar/psicologia , Pais/psicologia , Pobreza/economia , Pobreza/etnologia , Pobreza/psicologia , Avaliação de Programas e Projetos de Saúde , Fatores de Tempo , Resultado do Tratamento
12.
Soc Psychiatry Psychiatr Epidemiol ; 49(5): 733-42, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24077635

RESUMO

BACKGROUND: Empirical research on mental health care use and its determinants in young school-aged children is still scarce. In this study, we investigated the role of ethnicity, socioeconomic position (SEP) and perceived severity by both parents and teachers on mental health care use in 5- to 8-year old children with emotional and/or behavioural problems. METHODS: Data from 1,269 children with a high score([P90) on the Strengths and Difficulties Questionnaire (SDQ) in the school year 2008­2009 were linked to psychiatric case register data over the years 2010­2011. Cox proportional hazards models were used to predict mental health care use from ethnicity, SEP and perceived severity of the child's problems. RESULTS: During the follow-up period, 117 children with high SDQ scores (9.2 %) had used mental health care for the first time. Ethnic minority children were less likely to receive care than Dutch children (HR Moroccan/Turkish:0.26; 95 % CI 0.13-0.54, HR other ethnicity: 0.26; 95 %CI 0.12-0.58). No socioeconomic differences were found.After correction for previous care use, ethnicity and parental perceived severity, impact score as reported by teachers was significantly associated with mental healthcare use (HR 1.58; 95 % CI 1.01­2.46). CONCLUSIONS: Ethnicity is an important predictor of mental health care use in young children. Already in the youngest school-aged children, ethnic differences in the use of mental health care are present.A distinct predictor of care use in this age group is severity of emotional and behavioural problems as perceived by teachers. Therefore, teachers may be especially helpful in the process of identifying young children who need specialist mental health care.


Assuntos
Atitude Frente a Saúde/etnologia , Transtornos do Comportamento Infantil/etnologia , Etnicidade/psicologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Criança , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Etnicidade/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Masculino , Saúde Mental , Países Baixos/epidemiologia , Pais/psicologia , Percepção , Modelos de Riscos Proporcionais , Encaminhamento e Consulta/estatística & dados numéricos , Instituições Acadêmicas , Índice de Gravidade de Doença , Classe Social , Inquéritos e Questionários
13.
Eur Child Adolesc Psychiatry ; 23(5): 273-81, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23892547

RESUMO

An underrepresentation of ethnic minority children in mental health care settings is consistently reported. Parents of ethnic minority children are, however, less likely to perceive problem behaviour in their children. Our hypothesis was that, as a result of ethnic differences in problem perception, referral to care by a child health professional (CHP) would be lower for 5- to 6-year-old (high-risk) children from ethnic minority backgrounds than for their peers from the ethnic majority (Dutch origin). For 10,951 children in grade two of elementary school, parents and/or teachers completed the Strengths and Difficulties Questionnaire (SDQ) as well as questions on problem perception (PP) and perceived need for professional care (PN). Referral information was obtained from the Electronic Child Records (ECR) for 1,034 of these children. These children had a high (>90th percentile) SDQ score, and were not receiving mental health care. CHP's referred 144 children (14 %) during the routine health assessments. A lower problem perception was reported by parents of ethnic minority children (40-72 %) than by parents of the ethnic majority group (80 %; p < 0.001), but there were no ethnic differences in referral (OR range 0.9-1.9-p > 0.05). No ethnic differences were found for parental PN, nor for teacher's PP or PN. Despite a lower problem perception in ethnic minority parents when compared to ethnic majority parents, no ethnic differences were found in referral of children with problem behaviour in a preventive health care setting.


Assuntos
Transtornos do Comportamento Infantil/etnologia , Etnicidade/psicologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pais/psicologia , Percepção , Encaminhamento e Consulta/estatística & dados numéricos , Atitude Frente a Saúde , Criança , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Inquéritos e Questionários
15.
J Behav Health Serv Res ; 40(1): 5-19, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23070565

RESUMO

Variability in mental health services utilization by race/ethnicity was evaluated with a Behavioral Model approach. Subjects were 17,705 children 5 to 11 years of age in the 2005, 2007, and 2009 California Health Interview Surveys. Parents identified minor emotional difficulties in 18.7% of these children (ranging from 14.8% in Asians to 24.4% in African Americans) and definite or severe difficulties in 7.4% (5.5% in Asians to 9.7% in "other race"). Overall, 7.6% of children had at least one mental health visit in the prior year (2.3% in Asians to 11.2% in African Americans). Parent-identified need was the most salient predictor of mental health visits for all racial/ethnic groups. Beyond need, no consistent patterns could be determined across racial/ethnic groups with regard to the relationship between contextual, predisposing, and enabling measures and mental health service utilization. Different factors operated for each racial/ethnic group, suggesting the need for studies to examine mental health need, mental health service use, and determinants by racial/ethnic subgroup. These findings suggest that a "one-size-fits-all approach" with regard to policies and practices aimed at reducing mental health disparities will not be effective for all racial/ethnic groups.


Assuntos
Transtornos do Comportamento Infantil/etnologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Visita a Consultório Médico/estatística & dados numéricos , Pais , Negro ou Afro-Americano/estatística & dados numéricos , California , Criança , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Etnicidade , Feminino , Pesquisas sobre Atenção à Saúde , Necessidades e Demandas de Serviços de Saúde , Hispânico ou Latino/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Grupos Raciais , Fatores Socioeconômicos , Inquéritos e Questionários , População Branca/estatística & dados numéricos
16.
J Am Acad Child Adolesc Psychiatry ; 51(7): 703-711.e2, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22721593

RESUMO

OBJECTIVE: To investigate racial/ethnic differences in teachers' and other adults' identification and/or encouragement of parents to seek treatment for psychiatric problems in their children and to evaluate if and whether identification/encouragement is associated with service use. METHOD: Data on identification/encouragement to seek treatment for externalizing disorders (i.e., attention-deficit/hyperactivity disorder, oppositional-defiant disorder, and/or conduct disorder) and internalizing disorders (i.e., major depressive episode/dysthymia and/or separation anxiety disorder) and services used were obtained for 6,112 adolescents (13-17 years of age) in the National Comorbidity Survey Adolescent Supplement. Racial/ethnic differences were examined for Latinos, non-Latino blacks, and non-Latino whites. RESULTS: There were few racial/ethnic differences in rates of youth identification/encouragement and how identification/encouragement related to service use. Only non-Latino black youth with low severity internalizing disorders were less likely to be identified/encouraged to seek services compared with non-Latino white youth with the same characteristics (odds ratio [OR] = 0.4, 95% confidence interval [CI] = [0.2-0.7]). Identification/encouragement increased the likelihood of seeking services for externalizing and internalizing disorders for all youth. However, compared with their non-Latino white counterparts, non-Latino black youth who met criteria for internalizing disorders appeared less likely to have used any services (OR = 0.4, 95%, CI = 0.2-0.7), after adjusting for identification/encouragement, clinical, and sociodemographic characteristics. Non-Latino black youth with internalizing disorders and without identification/encouragement were less likely to use the specialty care sector than their non-Latino white counterparts. CONCLUSIONS: In this study of a nationally representative sample of adolescents, almost no ethnic/racial differences in identification/encouragement were found. However, identification/encouragement may increase service use for all youth.


Assuntos
Etnicidade/psicologia , Disparidades em Assistência à Saúde , Serviços de Saúde Mental , Grupos Minoritários/psicologia , Encaminhamento e Consulta , Adolescente , População Negra/psicologia , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/psicologia , Feminino , Acessibilidade aos Serviços de Saúde , Inquéritos Epidemiológicos , Hispânico ou Latino/psicologia , Humanos , Controle Interno-Externo , Masculino , Apoio Social , Estados Unidos , População Branca/psicologia
17.
Autism Res ; 5(3): 201-10, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22566396

RESUMO

Little research has been conducted on behavioral characteristics of children with autism spectrum disorder (ASD) from diverse cultures within the US, or from countries outside of the US or Europe, with little reliable information yet reported from developing countries. We describe the process used to engage diverse communities in ASD research in two community-based research projects-an epidemiologic investigation of 7- to 12-year olds in South Korea and the Early Autism Project, an ASD detection program for 18- to 36-month-old Zulu-speaking children in South Africa. Despite the differences in wealth between these communities, ASD is underdiagnosed in both settings, and generally not reported in clinical or educational records. Moreover, in both countries, there is low availability of services. In both cases, local knowledge helped researchers to address both ethnographic as well as practical problems. Researchers identified the ways in which these communities generate and negotiate the cultural meanings of developmental disorders. Researchers incorporated that knowledge, as they engaged communities in a research protocol, adapted and translated screening and diagnostic tools, and developed methods for screening, evaluating, and diagnosing children with ASD.


Assuntos
Transtornos Globais do Desenvolvimento Infantil/etnologia , Países em Desenvolvimento , Características de Residência , Adolescente , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/psicologia , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Transtornos Globais do Desenvolvimento Infantil/epidemiologia , Transtornos Globais do Desenvolvimento Infantil/psicologia , Pré-Escolar , Comparação Transcultural , Estudos Transversais , Diagnóstico Tardio , Educação Inclusiva/tendências , Previsões , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Lactente , República da Coreia , Pesquisa , Estigma Social , África do Sul
18.
Child Dev ; 83(1): 62-75, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22277007

RESUMO

The present study examined the prevalence and country-level correlates of 11 responses to children's behavior, including nonviolent discipline, psychological aggression, and physical violence, as well as endorsement of the use of physical punishment, in 24 countries using data from 30,470 families with 2- to 4-year-old children that participated in UNICEF's Multiple Indicator Cluster Survey. The prevalence of each response varied widely across countries, as did the amount of variance accounted for by country in relation to each response. Country-level indicators of life expectancy, educational attainment, and economic well-being were related to several responses to children's behavior. Country-level factors are widely related to parents' methods of teaching children good behavior and responding to misbehavior.


Assuntos
Educação Infantil/etnologia , Países em Desenvolvimento , Socialização , Violência/etnologia , Agressão/psicologia , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/psicologia , Educação Infantil/psicologia , Pré-Escolar , Comparação Transcultural , Desenvolvimento Econômico , Escolaridade , Feminino , Humanos , Expectativa de Vida , Masculino , Punição , Fatores Socioeconômicos , Inquéritos e Questionários , Violência/psicologia
19.
Int J Circumpolar Health ; 70(1): 37-45, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21329576

RESUMO

OBJECTIVES: To examine whether enculturation factors, like cultural activities, ethnic pride and native language competence, are related to decreased internalizing and externalizing symptoms in Indigenous Sami youth from Arctic Norway. The impact of self-efficacy on the relationship between enculturation factors and mental health problems was also examined. STUDY DESIGN: Population-based, cross-sectional questionnaire study. METHODS: The Norwegian Arctic Adolescent Health Study was conducted among 10th graders in junior high schools in north Norway during 2003-2005. The study sample consisted of 450 Indigenous Sami youth, aged 15-16 years. Internalizing symptoms were measured with the Hopkins Symptom Check List-10 (HSCL-10), while externalizing symptoms were measured by two subscales of the Strengths and Difficulties Questionnaire (SDQ). RESULTS: For boys, self-efficacy and participation in cultural activities were associated with decreased internalizing symptoms. Additionally, self-efficacy interacted with Sami language competence and cultural activities: when self-efficacy increased, these enculturation factors were related to symptom reduction. For girls, self-efficacy had an independent effect on internalizing symptoms and also strengthened the relationship between participation in cultural activities and reduced externalizing symptoms. Sami language competence was related to the reduction of both internalizing and externalizing symptoms in girls. CONCLUSIONS: In the present study, several enculturation factors as well as self-efficacy were identified as potential protective factors against mental health problems. In order to develop theoretical models that explain the mechanisms between cultural resilience and mental health, there is a need for both qualitative studies and longitudinal studies.


Assuntos
Transtornos do Comportamento Infantil/etnologia , Características Culturais , Etnicidade , Resiliência Psicológica , Adolescente , Transtornos de Ansiedade/etnologia , Regiões Árticas , Estudos Transversais , Transtorno Depressivo/etnologia , Feminino , Humanos , Masculino , Noruega/epidemiologia , Autoeficácia , Participação Social/psicologia , Inquéritos e Questionários
20.
Child Dev ; 82(1): 258-76, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21291441

RESUMO

This study examines the efficacy of ParentCorps among 4-year-old children (N = 171) enrolled in prekindergarten in schools in a large urban school district. ParentCorps includes a series of 13 group sessions for parents and children held at the school during early evening hours and facilitated by teachers and mental health professionals. ParentCorps resulted in significant benefits on effective parenting practices and teacher ratings of child behavior problems in school. Intervention effects were of similar magnitude for families at different levels of risk and for Black and Latino families. The number of sessions attended was related to improvements in parenting. Study findings support investment in and further study of school-based family interventions for children from underserved, urban communities.


Assuntos
Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/prevenção & controle , Diversidade Cultural , Educação/métodos , Terapia Familiar , Grupos Minoritários/psicologia , Psicoterapia de Grupo , Meio Social , Fatores Socioeconômicos , População Urbana , Populações Vulneráveis/etnologia , Populações Vulneráveis/psicologia , Logro , Terapia Comportamental , Educação Infantil , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Poder Familiar/etnologia , Poder Familiar/psicologia , Pacientes Desistentes do Tratamento/psicologia , Determinação da Personalidade , Pesquisa Translacional Biomédica
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