Skip to main content
Top
Gepubliceerd in: Child Psychiatry & Human Development 2/2015

01-04-2015 | Original Article

Emotional and Behavior Problems in an Urban Pediatric Primary Care Setting

Auteurs: Shannon E. Hourigan, Michael A. Southam-Gerow, Alexis M. Quinoy

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 2/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

We sought to identify needs for behavioral health care in a large, urban pediatric primary care (PPC) clinic serving a population covered by Medicaid. Specifically, children (N = 197; 120 girls; 91 % African American) ages 8–17 years and their caregivers completed measures of internalizing and externalizing symptoms (RCADS, RCADS-P, MASC, and SDQ). Clinical elevations on all but one domain of the SDQ were significantly higher than expected. However, self-reported anxiety and depression symptoms were consistent with expectations. These findings suggest urban, low-income, primarily African American youth presenting at a PPC clinic demonstrate significant levels of behavioral and emotional symptoms. Implications of the findings include the need to ask both parents and children about child behavioral health problems and the possible influence of screening tool selection on detection.
Literatuur
1.
go back to reference Reef J, van Meurs I, Verhulst FC, van der Ende J (2010) Children’s problems predict adults’ DSM-IV disorders across 24 years. J Am Acad Child Adolesc Psychiatry 49:1117–1124PubMed Reef J, van Meurs I, Verhulst FC, van der Ende J (2010) Children’s problems predict adults’ DSM-IV disorders across 24 years. J Am Acad Child Adolesc Psychiatry 49:1117–1124PubMed
2.
go back to reference Lehrer JA, Shrier LA, Gortmaker S, Buka S (2006) Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics 118:189–200CrossRefPubMed Lehrer JA, Shrier LA, Gortmaker S, Buka S (2006) Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics 118:189–200CrossRefPubMed
3.
go back to reference Kaplow JB, Curran PJ, Angold A, Costello EJ (2001) The prospective relation between dimensions of anxiety and the initiation of adolescent alcohol use. J Clin Child Psychol 30:316–326CrossRefPubMed Kaplow JB, Curran PJ, Angold A, Costello EJ (2001) The prospective relation between dimensions of anxiety and the initiation of adolescent alcohol use. J Clin Child Psychol 30:316–326CrossRefPubMed
4.
go back to reference Foley DL, Goldston DB, Costello EJ, Angold A (2006) Proximal psychiatric risk factors for suicidality in youth: the Great Smoky Mountains study. Arch Gen Psychiatry 63:1017–1024CrossRefPubMed Foley DL, Goldston DB, Costello EJ, Angold A (2006) Proximal psychiatric risk factors for suicidality in youth: the Great Smoky Mountains study. Arch Gen Psychiatry 63:1017–1024CrossRefPubMed
5.
go back to reference Copeland WE, Miller-Johnson S, Keeler G, Angold A, Costello JE (2007) Childhood psychiatric disorders and young adult crime: a prospective, population-based study. Am J Psychiatry 164:1668–1675CrossRefPubMed Copeland WE, Miller-Johnson S, Keeler G, Angold A, Costello JE (2007) Childhood psychiatric disorders and young adult crime: a prospective, population-based study. Am J Psychiatry 164:1668–1675CrossRefPubMed
6.
go back to reference Kataoka SH, Zhang L, Wells KB (2002) Unmet need for mental health care among US children: variation by ethnicity and insurance status. Am J Psychiatry 159:1548–1555CrossRefPubMed Kataoka SH, Zhang L, Wells KB (2002) Unmet need for mental health care among US children: variation by ethnicity and insurance status. Am J Psychiatry 159:1548–1555CrossRefPubMed
7.
8.
go back to reference Slopen N, Fitzmaurice G, Williams DR, Gilman SE (2010) Poverty, food insecurity, and the behavior for childhood internalizing and externalizing disorders. J Am Acad Child Adolesc Psychiatry 49:444–452PubMed Slopen N, Fitzmaurice G, Williams DR, Gilman SE (2010) Poverty, food insecurity, and the behavior for childhood internalizing and externalizing disorders. J Am Acad Child Adolesc Psychiatry 49:444–452PubMed
9.
go back to reference Flannery DJ, Wester KL, Singer MI (2004) Impact of exposure to violence in school on child and adolescent mental health and behavior. J Commun Psychol 32:559–573CrossRef Flannery DJ, Wester KL, Singer MI (2004) Impact of exposure to violence in school on child and adolescent mental health and behavior. J Commun Psychol 32:559–573CrossRef
10.
go back to reference Horowitz K, Weine S, Jekel J (1995) PTSD symptoms in urban adolescent girls: compounded community trauma. J Am Acad Child Adolesc Psychiatry 34:1353CrossRefPubMed Horowitz K, Weine S, Jekel J (1995) PTSD symptoms in urban adolescent girls: compounded community trauma. J Am Acad Child Adolesc Psychiatry 34:1353CrossRefPubMed
11.
go back to reference Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY, Campbell AJ et al (2006) Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects. Clin Psychol Rev 26:257–283CrossRefPubMed Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY, Campbell AJ et al (2006) Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects. Clin Psychol Rev 26:257–283CrossRefPubMed
12.
go back to reference Qi CH, Kaiser AP (2003) Behavior problems of preschool children from low-income families: review of the literature. Topics Early Child Spec Educ 23:188–216CrossRef Qi CH, Kaiser AP (2003) Behavior problems of preschool children from low-income families: review of the literature. Topics Early Child Spec Educ 23:188–216CrossRef
13.
go back to reference Kelleher KJ, McInerny JK, Gardner WP, Childs GE, Wasserman RC (2000) Increasing identification of psychosocial problems. Pediatrics 105:1313–1321CrossRefPubMed Kelleher KJ, McInerny JK, Gardner WP, Childs GE, Wasserman RC (2000) Increasing identification of psychosocial problems. Pediatrics 105:1313–1321CrossRefPubMed
14.
go back to reference Chavira AD, Stein MB, Bailey K, Stein MT (2004) Child anxiety in primary care: prevalent but untreated. Depress Anxiety 20:155–164CrossRefPubMed Chavira AD, Stein MB, Bailey K, Stein MT (2004) Child anxiety in primary care: prevalent but untreated. Depress Anxiety 20:155–164CrossRefPubMed
15.
go back to reference Costello EJ, Edelbrock C, Costello AJ, Dulcan MK, Burns BJ, Brent D (1988) Psychopathology in pediatric primary care: the new hidden morbidity. Pediatrics 82:415–424PubMed Costello EJ, Edelbrock C, Costello AJ, Dulcan MK, Burns BJ, Brent D (1988) Psychopathology in pediatric primary care: the new hidden morbidity. Pediatrics 82:415–424PubMed
16.
go back to reference Polaha J, Dalton WT, Allen S (2011) The prevalence of emotional and behavior problems in pediatric primary care serving rural children. J Pediatr Psychol 36:652–660CrossRefPubMed Polaha J, Dalton WT, Allen S (2011) The prevalence of emotional and behavior problems in pediatric primary care serving rural children. J Pediatr Psychol 36:652–660CrossRefPubMed
17.
go back to reference Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844CrossRefPubMed Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844CrossRefPubMed
18.
go back to reference Lefler EK, Hartung CM, Fedele DA (2012) Psychometric properties of a primary care mental health screening tool for young children. Child Health Care 41:79–96CrossRef Lefler EK, Hartung CM, Fedele DA (2012) Psychometric properties of a primary care mental health screening tool for young children. Child Health Care 41:79–96CrossRef
19.
go back to reference Brown JD, Riley AW, Wissow LS (2007) Identification of youth psychosocial problems during pediatric primary care visits. Adm Policy Ment Health 34:269–281CrossRefPubMed Brown JD, Riley AW, Wissow LS (2007) Identification of youth psychosocial problems during pediatric primary care visits. Adm Policy Ment Health 34:269–281CrossRefPubMed
20.
go back to reference Costello EJ, Shugart MA (1992) Above and below the threshold: severity of psychiatric symptoms and functional impairment in a pediatric sample. Pediatrics 90:359–368PubMed Costello EJ, Shugart MA (1992) Above and below the threshold: severity of psychiatric symptoms and functional impairment in a pediatric sample. Pediatrics 90:359–368PubMed
21.
go back to reference Neal AM, Turner SM (1991) Anxiety disorders research with African Americans: current status. Psychol Bull 109:400–410CrossRefPubMed Neal AM, Turner SM (1991) Anxiety disorders research with African Americans: current status. Psychol Bull 109:400–410CrossRefPubMed
22.
go back to reference Neighbors HW (1988) The help-seeking behavior of Black Americans: a summary of findings from the national survey of Black Americans. J Natl Med Assoc 80:1009–1012PubMedCentralPubMed Neighbors HW (1988) The help-seeking behavior of Black Americans: a summary of findings from the national survey of Black Americans. J Natl Med Assoc 80:1009–1012PubMedCentralPubMed
23.
go back to reference Wren FJ, Berg EA, Heiden LA, Kinnamon CJ, Ohlson LA, Bridge JA et al (2007) Childhood anxiety in a diverse primary care population: parent-child reports, ethnicity, and SCARED factor structure. J Am Acad Child Adolesc Psychiatry 46:332–340CrossRefPubMed Wren FJ, Berg EA, Heiden LA, Kinnamon CJ, Ohlson LA, Bridge JA et al (2007) Childhood anxiety in a diverse primary care population: parent-child reports, ethnicity, and SCARED factor structure. J Am Acad Child Adolesc Psychiatry 46:332–340CrossRefPubMed
24.
go back to reference Weersing VR, Iyengar S, Kolko DJ, Birmaher B, Brent DA (2006) Effectiveness of cognitive-behavioral therapy for adolescent depression: a benchmarking investigation. Behav Ther 37:36–48CrossRefPubMed Weersing VR, Iyengar S, Kolko DJ, Birmaher B, Brent DA (2006) Effectiveness of cognitive-behavioral therapy for adolescent depression: a benchmarking investigation. Behav Ther 37:36–48CrossRefPubMed
25.
go back to reference Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE (2000) Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 38:835–855CrossRefPubMed Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE (2000) Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 38:835–855CrossRefPubMed
26.
go back to reference Ebesutani C, Bernstein A, Nakamura BJ, Chorpita BF, Weisz JR (2010) A psychometric analysis of the Revised Child Anxiety and Depression Scale—Parent Version in a clinical sample. J Abnorm Child Psychol 38:249–260CrossRefPubMedCentralPubMed Ebesutani C, Bernstein A, Nakamura BJ, Chorpita BF, Weisz JR (2010) A psychometric analysis of the Revised Child Anxiety and Depression Scale—Parent Version in a clinical sample. J Abnorm Child Psychol 38:249–260CrossRefPubMedCentralPubMed
27.
go back to reference Brown RC, Yaroslavsky I, Quinoy AM, Friedman AD, Brookman RR, Southam-Gerow MA (2013) Factor structure of measures of anxiety and depression symptoms in African American youth. Child Psychiatry Hum Dev 44:525–536CrossRefPubMedCentralPubMed Brown RC, Yaroslavsky I, Quinoy AM, Friedman AD, Brookman RR, Southam-Gerow MA (2013) Factor structure of measures of anxiety and depression symptoms in African American youth. Child Psychiatry Hum Dev 44:525–536CrossRefPubMedCentralPubMed
28.
go back to reference March JS, Parker JDA, Sullivan K, Stallings P, Conners CK (1997) The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry 36:554–565CrossRefPubMed March JS, Parker JDA, Sullivan K, Stallings P, Conners CK (1997) The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry 36:554–565CrossRefPubMed
29.
go back to reference Brown RC, Yaroslavsky I, Quinoy AM, Friedman AD, Brookman RR, Southam-Gerow MA (2013) Psychometric evaluation of measures of anxiety and depression symptoms in an urban African American sample. Child Psychiatry Hum Dev 44:525–536 Brown RC, Yaroslavsky I, Quinoy AM, Friedman AD, Brookman RR, Southam-Gerow MA (2013) Psychometric evaluation of measures of anxiety and depression symptoms in an urban African American sample. Child Psychiatry Hum Dev 44:525–536
30.
go back to reference Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRefPubMed Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRefPubMed
31.
go back to reference Bourdon KH, Goodman R, Rae DS, Simpson G, Koretz DS (2005) The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties. J Am Acad Child Adolesc Psychiatry 44:557–564CrossRefPubMed Bourdon KH, Goodman R, Rae DS, Simpson G, Koretz DS (2005) The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties. J Am Acad Child Adolesc Psychiatry 44:557–564CrossRefPubMed
32.
go back to reference Shirk SR, Kaplinski H, Gudmundsen G (2009) School-based cognitive-behavioral therapy for depression: a benchmarking study. J Emot Behav Disord 17:106–117CrossRef Shirk SR, Kaplinski H, Gudmundsen G (2009) School-based cognitive-behavioral therapy for depression: a benchmarking study. J Emot Behav Disord 17:106–117CrossRef
33.
go back to reference US Department of Health and Human Services (2009) Annual update of the HHS poverty guidelines. Fed Regist 74:4199–4201 US Department of Health and Human Services (2009) Annual update of the HHS poverty guidelines. Fed Regist 74:4199–4201
34.
go back to reference Holm S (1979) A simple sequentially rejective multiple test procedure. Scand Stat Theory Appl 6:65–70 Holm S (1979) A simple sequentially rejective multiple test procedure. Scand Stat Theory Appl 6:65–70
35.
go back to reference Jaccard J, Guilamo-Ramos V (2002) Analysis of variance frameworks in clinical child and adolescent psychology: issues and recommendations. J Clin Child Adolesc Psychol 31:130–146CrossRefPubMed Jaccard J, Guilamo-Ramos V (2002) Analysis of variance frameworks in clinical child and adolescent psychology: issues and recommendations. J Clin Child Adolesc Psychol 31:130–146CrossRefPubMed
36.
go back to reference Centers for Disease Control and Prevention (2010) Youth risk behavior surveillance—United States, 2009. MMWR Surveill Summ 59:1–142 Centers for Disease Control and Prevention (2010) Youth risk behavior surveillance—United States, 2009. MMWR Surveill Summ 59:1–142
37.
go back to reference Fitzpatrick KM, Boldizar JP (1993) The prevalence and consequences of exposure to violence among African American youth. J Am Acad Child Adolesc Psychiatry 32:424–430CrossRefPubMed Fitzpatrick KM, Boldizar JP (1993) The prevalence and consequences of exposure to violence among African American youth. J Am Acad Child Adolesc Psychiatry 32:424–430CrossRefPubMed
38.
go back to reference Manassis K, Ickowicz A, Picard E, Antle B, McNeill T, Chahaver A et al (2009) An innovative child CBT training model for community mental health practitioners in Ontario. Acad Psychiatry 33:394–399CrossRefPubMed Manassis K, Ickowicz A, Picard E, Antle B, McNeill T, Chahaver A et al (2009) An innovative child CBT training model for community mental health practitioners in Ontario. Acad Psychiatry 33:394–399CrossRefPubMed
39.
go back to reference 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 131:483–509CrossRefPubMed 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 131:483–509CrossRefPubMed
40.
go back to reference Goodman A, Goodman R (2009) Strengths and difficulties questionnaire as a dimensional measure of child mental health. J Am Acad Child Adolesc Psychiatry 48:400–403CrossRefPubMed Goodman A, Goodman R (2009) Strengths and difficulties questionnaire as a dimensional measure of child mental health. J Am Acad Child Adolesc Psychiatry 48:400–403CrossRefPubMed
41.
go back to reference Goodman A, Goodman R (2011) Population mean scores predict child mental disorder rates: validating SDQ prevalence estimators in Britain. J Child Psychol Psychiatry 52:100–108CrossRefPubMed Goodman A, Goodman R (2011) Population mean scores predict child mental disorder rates: validating SDQ prevalence estimators in Britain. J Child Psychol Psychiatry 52:100–108CrossRefPubMed
42.
go back to reference Dickey WC, Blumberg SJ (2004) Revisiting the factor structure of the Strengths and Difficulties Questionnaire: United States, 2001. J Am Acad Child Adolesc Psychiatry 43:1159–1167CrossRefPubMed Dickey WC, Blumberg SJ (2004) Revisiting the factor structure of the Strengths and Difficulties Questionnaire: United States, 2001. J Am Acad Child Adolesc Psychiatry 43:1159–1167CrossRefPubMed
43.
go back to reference Ruchkin V, Jones S, Vermeiren R, Schwab-Stone M (2008) The Strengths and Difficulties Questionnaire: the self-report version in American urban and suburban youth. Psychol Assess 20:175–182CrossRefPubMed Ruchkin V, Jones S, Vermeiren R, Schwab-Stone M (2008) The Strengths and Difficulties Questionnaire: the self-report version in American urban and suburban youth. Psychol Assess 20:175–182CrossRefPubMed
44.
go back to reference McLean CP, Anderson ER (2009) Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev 29:496–505CrossRefPubMed McLean CP, Anderson ER (2009) Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev 29:496–505CrossRefPubMed
45.
go back to reference Poulton R, Milne BJ, Craske MG, Menzies RG (2001) A longitudinal study of the etiology of separation anxiety. Behav Res Ther 39:1395–1410CrossRefPubMed Poulton R, Milne BJ, Craske MG, Menzies RG (2001) A longitudinal study of the etiology of separation anxiety. Behav Res Ther 39:1395–1410CrossRefPubMed
46.
go back to reference 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 33:59–69CrossRef 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 33:59–69CrossRef
47.
go back to reference Kingery JN, Ginsburg GS, Burstein M (2009) Factor structure and psychometric properties of the Multidimensional Anxiety Scale for Children in an African American adolescent sample. Child Psychiatry Hum Dev 40:287–300CrossRefPubMed Kingery JN, Ginsburg GS, Burstein M (2009) Factor structure and psychometric properties of the Multidimensional Anxiety Scale for Children in an African American adolescent sample. Child Psychiatry Hum Dev 40:287–300CrossRefPubMed
48.
go back to reference Lambert SF, Cooley MR, Campbell KDM, Benoit MZ, Stansbury R (2004) Assessing anxiety sensitivity in inner-city African American children: psychometric properties of the Childhood Anxiety Sensitivity Index. J Clin Child Adolesc Psychol 33:248–259CrossRefPubMed Lambert SF, Cooley MR, Campbell KDM, Benoit MZ, Stansbury R (2004) Assessing anxiety sensitivity in inner-city African American children: psychometric properties of the Childhood Anxiety Sensitivity Index. J Clin Child Adolesc Psychol 33:248–259CrossRefPubMed
49.
go back to reference Wissow LS, Brown J, Fothergill KE, Gadomski A, Hacker K, Salmon P et al (2013) Universal mental health screening in pediatric primary care: a systematic review. J Am Acad Child Adolesc Psychiatry 52:1134–1147CrossRefPubMedCentralPubMed Wissow LS, Brown J, Fothergill KE, Gadomski A, Hacker K, Salmon P et al (2013) Universal mental health screening in pediatric primary care: a systematic review. J Am Acad Child Adolesc Psychiatry 52:1134–1147CrossRefPubMedCentralPubMed
50.
go back to reference Bailey KA, Chavira DA, Stein MT, Stein MB (2006) Brief measures to screen for social phobia in primary care pediatrics. J Pediatr Psychol 31:512–521CrossRefPubMed Bailey KA, Chavira DA, Stein MT, Stein MB (2006) Brief measures to screen for social phobia in primary care pediatrics. J Pediatr Psychol 31:512–521CrossRefPubMed
51.
go back to reference Foy JM, Kelleher KJ, Laraque D, the American Academy of Pediatrics Task Force on Mental Health, (2010) Enhancing pediatric mental health care: strategies for preparing a primary care practice. Pediatrics 125:S87–S108CrossRefPubMed Foy JM, Kelleher KJ, Laraque D, the American Academy of Pediatrics Task Force on Mental Health, (2010) Enhancing pediatric mental health care: strategies for preparing a primary care practice. Pediatrics 125:S87–S108CrossRefPubMed
52.
go back to reference Weersing VR, Gonzalez A, Campo JV, Lucas AN (2008) Brief behavioral therapy for pediatric anxiety and depression: piloting an integrated treatment approach. Cogn Behav Pract 15:126–139CrossRef Weersing VR, Gonzalez A, Campo JV, Lucas AN (2008) Brief behavioral therapy for pediatric anxiety and depression: piloting an integrated treatment approach. Cogn Behav Pract 15:126–139CrossRef
Metagegevens
Titel
Emotional and Behavior Problems in an Urban Pediatric Primary Care Setting
Auteurs
Shannon E. Hourigan
Michael A. Southam-Gerow
Alexis M. Quinoy
Publicatiedatum
01-04-2015
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 2/2015
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-014-0469-z

Andere artikelen Uitgave 2/2015

Child Psychiatry & Human Development 2/2015 Naar de uitgave