Abstract
Purpose
Data on the prevalence of mental health disorders for low-income, urban African American adolescents are scarce. This study presents data about the burden of mental disorders for this understudied population.
Methods
Mental disorders were assessed using the Diagnostic Interview Schedule for Children (C-DISC), Youth Self-Report (YSR), and Child Behavior Checklist (CBCL) among a sample of adolescents and their caregivers from very impoverished neighborhoods in a Southern city.
Results
Based on the C-DISC, 3.8, 5.1 and 7.7 % of adolescents met diagnostic criteria for major depression, post-traumatic stress disorder, and conduct disorder, respectively. There were significant differences among some of the mental health disorders based on adolescent and caregiver characteristics such as sex, school status, caregiver work status, and income level. We found a low prevalence of alcohol, marijuana, and substance abuse and dependence disorders.
Conclusions
Information about the prevalence of mental health disorders in specific communities and populations can assist in addressing unmet needs, planning for services and treatment, and reducing health disparities.
Similar content being viewed by others
References
Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, He J-P, Koretz D, McLaughlin KA, Petukhova M, Sampson NA, Zaslavsky AM, Merikangas KR (2012) Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 69(4):372–380. doi:10.1001/archgenpsychiatry.2011.160
Wu LT, Woody GE, Yang C, Pan JJ, Blazer DG (2011) Racial/ethnic variations in substance-related disorders among adolescents in the United States. Arch Gen Psychiatry 68(11):1176–1185. doi:10.1001/archgenpsychiatry.2011.120
Roberts RE, Roberts CR, Xing Y (2006) Prevalence of youth-reported DSM-IV psychiatric disorders among African, European, and Mexican American adolescents. J Am Acad Child Adolesc Psychiatry 45(11):1329–1337. doi:10.1097/01.chi.0000235076.25038.81
Kessler RC, Avenevoli S, Costello EJ, Georgia K, Green JG, Gruber MJ, He J-P, Koretz D, McLaughlin KA, Petukhova M, Sampson NA, Zaslavsky AM, Merikangas KR Appendix tables for: Prevalence, persistence, and socio-demographic correlates of DSM-IV disorders in the NCS-R Adolescent Supplement (NCS-A). National Comorbidity Survey. http://www.hcp.med.harvard.edu/ncs/publications.php. Accessed 22 Jan 2013
Latzman RD, Naifeh JA, Watson D, Vaidya JG, Heiden LJ, Damon JD, Hight TL, Young J (2011) Racial differences in symptoms of anxiety and depression among three cohorts of students in the southern United States. Psychiatry 74(4):332–348
Alegria M, Vallas M, Pumariega AJ (2010) Racial and ethnic disparities in pediatric mental health. Child Adolesc Psychiatric Clin North America 19(4):759–774. doi:10.1016/j.chc.2010.07.001
Elster A, Jarosik J, VanGeest J, Fleming M (2003) Racial and ethnic disparities in health care for adolescents: a systematic review of the literature. Arch Pediatr Adolesc Med 157(9):867–874. doi:10.1001/archpedi.157.9.867
Carson N, Cook B, Alegría M (2010) Social determinants of mental health treatment among Haitian, African American and White Youth in Community Health Centers. J Health Care Poor Underserved 21(2 Suppl):32–48. doi:10.1353/hpu.0.0297
Kodjo CM, Auinger P (2004) Predictors for emotionally distressed adolescents to receive mental health care. J Adolesc Health 35(5):368–373. doi:10.1016/j.jadohealth.2003.12.005
Garland A, Lau A, Yeh M, McCabe K, Hough R, Landsverk J (2005) Racial and Ethnic Differences in Utilization of Mental Health Services Among High-Risk Youths. A J Psychiatry 162:1336–1343
Kataoka S, Zhang L, Wells K (2002) Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. Am J Psychiatry 159(9):1548–1555
Fergusson DM, Boden JM, Horwood LJ (2007) Recurrence of major depression in adolescence and early adulthood, and later mental health, educational and economic outcomes. British J Psychiatry 191(4):335–342. doi:10.1192/bjp.bp.107.036079
Turnbull JE, George LK, Landerman R, Swartz MS, Blazer DG (1990) Social outcomes related to age of onset among psychiatric-disorders. J Consult Clin Psychol 58(6):832–839
Kessler RC, Foster CL, Saunders WB, Stang PE (1995) Social-Consequences of Psychiatric-Disorders 1, Educational-Attainment. Am J Psychiat 152(7):1026–1032
Massoglia M (2008) Incarceration, health, and racial disparities in health. Law & Society Review 42:275–306. doi:10.1111/j.1540-5893.2008.00342.x
National Research Council and Institute of Medicine (2009) Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. Board on children, youth, and families, division of behavioral and social sciences and education, Washington, DC
Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Whittle L, Lim C, Wechsler H, (CDC) CfDCaP (2012) Youth risk behavior surveillance—United States, 2011. MMWR Surveill Summ 61(4):1–162
McLeod JD, Shanahan MJ (1996) Trajectories of poverty and children’s mental health. J Health Soc Behav 37(3):207–220
Adkins DE, Wang V, Elder GHJ (2009) Structure and stress: trajectories of depressive symptoms across adolescence and young adulthood. Soc Forces 88(1):31–60
Schraedley MAPK, Gotlib IH, Hayward C (1999) Gender differences in correlates of depressive symptoms in adolescents. J Adolesc Health 25(2):98–108. doi:10.1016/s1054-139x(99)00038-5
Brook J, Richter L, Rubenstone E (2000) Consequences of adolescent drug use on psychiatric disorders in early adulthood. Ann Med 32(6):401–407
Brook JS, Balka EB, Crossman AM, Dermatis H, Galanter M, Brook DW (2010) The relationship between parental alcohol use, early and late adolescent alcohol use, and young adult psychological symptoms: a longitudinal study. Am J Addict 19(6):534–542. doi:10.1111/j.1521-0391.2010.00083.x
Schuckit MA (2006) Comorbidity between substance use disorders and psychiatric conditions. Addiction 101:76–88. doi:10.1111/j.1360-0443.2006.01592.x
Biglan A, Brennan PA, Foster SL, Holder HD (2004) Helping adolescents at risk: prevention of multiple problem behaviors. Guilford Press, New York
Bachman JG, Wallace JM Jr, O’Malley PM, Johnston LD, Kurth CL, Neighbors HW (1991) Racial/Ethnic differences in smoking, drinking, and illicit drug use among American high school seniors, 1976–1989. Am J Public Health 81(3):372–377
Johnston L, O’Malley PM, Bachman JG (1993) National survey results on drug use from Monitoring the Future Study. US Government Printing Office, Washington, DC
Wallace JM Jr, Bachman JG, O’Malley PM, Schulenberg JE, Cooper SM, Johnston LD (2003) Gender and ethnic differences in smoking, drinking and illicit drug use among American 8th, 10th and 12th grade students, 1976–2000. Addiction 98(2):225–234
Maddahian E, Newcomb MD, Bentler PM (1988) Adolescent drug use and intention to use drugs: concurrent and longitudinal analyses of four ethnic groups. Addict Behav 13(2):191–195
Bolland JM, Bryant CM, Lian BE, McCallum DM, Vazsonyi AT, Barth JM (2007) Development and risk behavior among African American, Caucasian, and mixed-race adolescents living in high poverty inner-city neighborhoods. Am J Community Psychol 40(3–4):230–249. doi:10.1007/s10464-007-9132-1
CoUaEREDiH Care (2003) Unequal treatment: confronting racial and ethnic disparities in health care (full printed version). The National Academies Press, Washington
Zimmerman FJ (2005) Social and economic determinants of disparities in professional help-seeking for child mental health problems: evidence from a national sample. Health Serv Res 40(5 Pt 1):1514–1533. doi:10.1111/j.1475-6773.2005.00411.x
Salzinger S, Feldman RS, Stockhammer T, Hood J (2002) An ecological framework for understanding risk for exposure to community violence and the effects of exposure on children and adolescents. Aggress Violent Behav 7:423–451
Fitzpatrick KM, Piko BF, Wright DR, LaGory M (2005) Depressive symptomatology, exposure to violence, and the role of social capital among African American adolescents. Am J Orthopsychiatry 75(2):262–274. doi:10.1037/0002-9432.75.2.262
Tynes BM, Umana-Taylor AJ, Rose CA, Lin J, Anderson CJ (2012) Online racial discrimination and the protective function of ethnic identity and self-esteem for African American adolescents. Dev Psychol 48(2):343–355. doi:10.1037/a0027032
Grant KE, McCormick A, Poindexter L, Simpkins T, Janda CM, Thomas KJ, Campbell A, Carleton R, Taylor J (2005) Exposure to violence and parenting as mediators between poverty and psychological symptoms in urban African American adolescents. J Adolesc 28(4):507–521. doi:10.1016/j.adolescence.2004.12.001
Services USDoHaH (2001) Mental health: culture, race, and ethnicity: a supplement to mental health: a report of the surgeon general. Rockville, MD
McDowell I (2006) Measuring health: a guide to rating scales and questionnaires, 3rd edn. Oxford University Press, New York
Mustanski B, Garofalo R, Emerson E (2010) Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths. Am J Public Health 100(12):2426–2432. doi:AJPH.2009.178319
US Census Bureau State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Nonemployer Statistics, Economic Census, Survey of Business Owners, Building Permits, Consolidated Federal Funds Report. http://quickfacts.census.gov/qfd/states/01/01097.html. Accessed November 26 2012
Bolland JM (2007) Overview of the Mobile Youth Study. University of Alabama at Birmingham, School of Public Health, USA
Park N, Lee B, Bolland J, Vazsonyi A, Sun F (2008) Early adolescent pathways of antisocial behaviors in poor, inner-city neighborhoods. SAGE, The Journal of Early Adolescence, California
Shaffer D, Fisher PW, Lucas CP (2004) The Diagnostic Interview Schedule for Children (DISC). In: Henson M (ed) Comprehensive Handbook of Psychological Assessment. Wiley, Hoboken
Shaffer D, Fisher PW, Lucas CP, Dulcan MK, Schwab-Stone ME (2000) NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry 39(1):28–38
Achenbach T, Rescorla L (2001) The Manual for the ASEBA School-Age Forms & Profiles. University of Vermont, Research Center for Children, Youth, and Families, Burlington
IBM SPSS Statistics for Windows (Released 2011). 20.0 edn. IBM Corp., Armonk, NY
Raudenbush SW, Bryk AS (2002) Hierarchical linear models: applications and data analysis methods. Advanced quantitative techniques in the social sciences; 1, 2nd edn. Sage Publications, Thousand Oaks
Weitzman BC, Guttmacher S, Weinberg S, Kapadia F (2003) Low response rate schools in surveys of adolescent risk taking behaviours: possible biases, possible solutions. J Epidemiol Community Health 57(1):63–67
Swaim RC, Beauvais F, Chavez EL, Oetting ER (1997) The effect of school dropout rates on estimates of adolescent substance use among three racial/ethnic groups. Am J Public Health 87(1):51–55
US Department of Health and Human Services About Healthy People, Foundation Health Measures, Disparities. http://healthypeople.gov/2020/about/DisparitiesAbout.aspx. Accessed 6 Feb 2012
Tobler AL, Maldonado-Molina MM, Staras SA, O’Mara RJ, Livingston MD, Komro KA (2012) Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth. Ethn Health. doi:10.1080/13557858.2012.730609
Estrada-Martinez LM, Caldwell CH, Bauermeister JA, Zimmerman MA (2012) Stressors in multiple life-domains and the risk for externalizing and internalizing behaviors among African Americans during emerging adulthood. J Youth Adolesc. doi:10.1007/s10964-012-9778-3
Wong CA, Eccles JS, Sameroff A (2003) The influence of ethnic discrimination and ethnic identification on African American adolescents’ school and socioemotional adjustment. J Pers 71(6):1197–1232
Brody GH, Chen YF, Murry VM, Ge X, Simons RL, Gibbons FX, Gerrard M, Cutrona CE (2006) Perceived discrimination and the adjustment of African American youths: a five-year longitudinal analysis with contextual moderation effects. Child Dev 77(5):1170–1189. doi:10.1111/j.1467-8624.2006.00927.x
Schraedley PK, Gotlib IH, Hayward C (1999) Gender differences in correlates of depressive symptoms in adolescents. J Adolesc Health 25(2):98–108
Rosenfield S (2012) Triple jeopardy? Mental health at the intersection of gender, race, and class. Soc Sci Med 74(11):1791–1801
Voisin DR, Neilands TB (2010) Community violence and health risk factors among adolescents on Chicago’s Southside: does gender matter? J Adolesc Health 46(6):600–602. doi:10.1016/j.jadohealth.2009.11.213
Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844
Cote S, Tremblay RE, Nagin DS, Zoccolillo M, Vitaro F (2002) Childhood behavioral profiles leading to adolescent conduct disorder: risk trajectories for boys and girls. J Am Acad Child Adolesc Psychiatry 41(9):1086–1094. doi:10.1097/00004583-200209000-00009
Zahn-Waxler C, Shirtcliff EA, Marceau K (2008) Disorders of childhood and adolescence: gender and psychopathology. Ann Rev Clin Psychol 4(1):275–303. doi:10.1146/annurev.clinpsy.3.022806.091358
Keenan K, Wroblewski K, Hipwell A, Loeber R, Stouthamer-Loeber M (2010) Age of onset, symptom threshold, and expansion of the nosology of conduct disorder for girls. J Abnorm Psychol 119(4):689–698. doi:10.1037/a0019346
Zona K, Milan S (2011) Gender differences in the longitudinal impact of exposure to violence on mental health in urban youth. J Youth Adolesc 40(12):1674–1690. doi:10.1007/s10964-011-9649-3
Foster JD, Kuperminc GP, Price AW (2004) Gender differences in posttraumatic stress and related symptoms among inner-city minority youth exposed to community violence. J Youth Adolesc 33(1):59–69. doi:10.1023/a:1027386430859
Lee S, Tsang A, Breslau J et al (2009) Mental disorders and termination of education in high-income and low- and middle-income countries: epidemiological study. Erratum in: Br J Psychiatry. 2011 Apr; 198: 327. Br J Psychiatry 194(5):411–417
Benjet C, Hernandez-Montoya D, Borges G, Mendez E, Medina-Mora ME, Aguilar-Gaxiola S (2012) Youth who neither study nor work: mental health, education and employment. Salud Publica Mex 54(4):410–417
Vaughn M, Wexler J, Beaver K, Perron B, Roberts G, Fu Q (2011) Psychiatric correlates of behavioral indicators of school disengagement in the United States. Psychiatr Q 82(3):191–206. doi:10.1007/s11126-010-9160-0
Miles DR, van den Bree MBM, Pickens RW (2002) Sex differences in shared genetic and environmental influences between conduct disorder symptoms and marijuana use in adolescents. Am J Med Genet 114(2):159–168. doi:10.1002/ajmg.10178
Shelton K, Lifford K, Fowler T, Rice F, Neale M, Harold G, Thapar A, van den Bree M (2007) The association between conduct problems and the initiation and progression of marijuana use during adolescence: a genetic analysis across time. Behav Genet 37(2):314–325. doi:10.1007/s10519-006-9124-1
Fergusson DM, Horwood LJ, Ridder EM (2007) Conduct and attentional problems in childhood and adolescence and later substance use, abuse and dependence: results of a 25-year longitudinal study. drug and alcohol dependence 88. Supplement 1:S14–S26. doi:10.1016/j.drugalcdep.2006.12.011
Pardini D, White HR, Stouthamer-Loeber M (2007) Early adolescent psychopathology as a predictor of alcohol use disorders by young adulthood. drug and alcohol dependence 88. Supplement 1:S38–S49. doi:10.1016/j.drugalcdep.2006.12.014
Weinberg NZ, Rahdert E, Colliver JD, Glantz MD (1998) Adolescent substance abuse: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 37(3):252–261. doi:10.1097/00004583-199803000-00009
De Los Reyes A, Kazdin AE (2005) Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull 13(4):483–509
Acknowledgments
This project was supported by a Grant from the National Institute of Drug Abuse (RO1DA025039). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.
Conflict of interest
There are no conflicts of interest by any authors in regard to this study or this publication.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Byck, G.R., Bolland, J., Dick, D. et al. Prevalence of mental health disorders among low-income African American adolescents. Soc Psychiatry Psychiatr Epidemiol 48, 1555–1567 (2013). https://doi.org/10.1007/s00127-013-0657-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-013-0657-3