Skip to main content

Advertisement

SpringerLink
Log in

The Role of Parent Characteristics in Community-Based Medication Treatment for Children with Disruptive Behavior Problems

  • Brief Report
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Studies have documented increased psychoactive medication use rates among children, but little is known about what child and/or family characteristics predict medication treatment in community-based care. This study examines the role of parent characteristics in children’s medication treatment, while accounting for other potential predictors. Participants included 213 children ages 4–13 with disruptive behavior problems. Medication treatment was assessed by parent report; potential predictors of medication treatment, including child characteristics and parent characteristics (e.g., education level, perceived strain and psychopathology) were assessed at service intake. Over 60 % of children used a psychoactive medication during the 16 month study period (most commonly stimulants). Parent education level and reported strain were significant predictors of children’s medication treatment even when accounting for other significant predictors such as child diagnosis, age, race/ethnicity, etc. Results highlight the role that parent characteristics have in accessing community-based medication treatment for children with disruptive behavior problems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Andersen, R. M., McCutcheon, A., Aday, L. A., Chiu, G. Y., & Bell, R. (1983). Exploring dimensions of access to medical care. Health Services Research, 18, 49–74.

    PubMed  CAS  Google Scholar 

  • Angold, A., Erkanli, E., Farmer, E. M., Fairbank, J. A., Burns, B. J., Keeler, G., et al. (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59, 893–901.

    Article  PubMed  Google Scholar 

  • Bickman, L., Guthrie, P. R., Foster, E. M., Lambert, E. W., Summerfelt, W. T., Breda, C. S., et al. (1995). Evaluating managed mental health services: The Fort Bragg experiment. New York: Plenum Press.

    Book  Google Scholar 

  • Biederman, J., Spencer, T. J., Newcorn, J. H., Gao, H., Milton, D. R., Feldman, P. D., et al. (2007). Effect of comorbid symptoms of oppositional defiant disorder on responses to atomoxetine in children with ADHD: A meta-analysis of controlled clinical trial data. Psychopharmacology (Berl), 190(1), 31–41.

    Article  CAS  Google Scholar 

  • Boggs, S. R., Eyberg, S., & Reynolds, L. A. (1990). Concurrent validity of the Eyberg child behavior inventory. Journal of Clinical Child Psychology, 19, 75–78.

    Article  Google Scholar 

  • Brannan, A. M., Heflinger, C. A., & Bickman, L. (1997). The caregiver strain questionnaire: Measuring the impact on the family of living with a child with serious emotional disturbance. Journal of Emotional and Behavioral Disorders, 5(4), 212–222.

    Article  Google Scholar 

  • Burke, J., Loeber, R., & Birmaher, B. (2002). Oppositional defiant disorder and conduct disorder: A review of the past 10 years, Part II. Journal of the American Academy of Child and Adolescent Psychiatry, 41(11), 1275–1293.

    Article  PubMed  Google Scholar 

  • Bussing, R., Mason, D. M., Leon, C. E., & Sinha, K. (2003). Agreement between CASA parent reports and provider records of children’s ADHD services. The Journal of Behavioral Health Services & Research, 30(4), 462–469.

    Article  Google Scholar 

  • Comer, J. S., Olfson, M., & Mojtabai, R. (2010). National trends in child and adolescent psychotropic polypharmacy in office-based practice, 1996–2007. Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 1001–1010.

    Article  PubMed  Google Scholar 

  • Crystal, S., Olfson, M., Huang, C., Pincus, H., & Gerhard, T. (2009). Broadened use of atypical antipsychotics: Safety, effectiveness, and policy challenges. Health Affairs, 28(5), 770–781.

    Article  Google Scholar 

  • Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13(3), 595–605.

    Article  PubMed  CAS  Google Scholar 

  • dos Reis, S., Zito, J., Safer, D., Gardner, J., Puccia, K., & Owens, P. J. (2005). Multiple psychotropic medication use for youths: A two-state comparison. Journal of Child and Adolescent Psychopharmacology, 15(1), 68–77.

    Article  Google Scholar 

  • Essock, S. M., Covell, N. H., Leckman-Westin, E., Lieberman, J. A., Sederer, L. I., Kealey, E., et al. (2009). Identifying clinically questionable psychotropic prescribing practices for medicaid recipients in New York State. Psychiatric Services, 60(12), 1595–1602.

    Article  PubMed  Google Scholar 

  • Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37(1), 215–237.

    Article  Google Scholar 

  • Foster, E. M., Kelsch, C. C., Kamradt, B., Sosna, T., & Yang, Z. (2001). Expenditures and sustainability in systems of care. Journal of Emotional and Behavioral Disorders, 9, 53–70.

    Article  Google Scholar 

  • Garland, A. F., Brookman-Frazee, L., Hurlburt, M. S., Accurso, E. C., Zoffness, R. J., Haine-Schlagel, R., et al. (2010). Mental health care for children with disruptive behavior problems: A view inside the therapists’ offices. Psychiatric Services, 61(8), 788–795.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Hough, R. L., McCabe, K. M., Yeh, M., Wood, P. A., & Aarons, G. A. (2001). Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry, 40(4), 409–418.

    Article  PubMed  CAS  Google Scholar 

  • Goodwin, R., Gould, M., Blanco, C., & Olfson, M. (2001). Prescription of psychotropic medications to youths in office-based practice. Psychiatric Services, 52(8), 1081–1087.

    Article  PubMed  CAS  Google Scholar 

  • Ipser, J., & Stein, D. (2007). Systemic review of pharmacotherapy of disruptive behavior disorders in children and adolescents. Psychopharmacology (Berl), 19, 127–140.

    Article  Google Scholar 

  • Jensen, P. S., Arnold, L. E., Swanson, J. M., Vitiello, B., Abikoff, H. B., Greenhill, L. L., et al. (2007). 3 Year follow-up of the NIMH MTA study. Journal of the American Academy of Child and Adolescent Psychiatry, 46(8), 989–1002.

    Article  PubMed  Google Scholar 

  • Jensen, P., Bhatara, V., Vitiello, B., Hoagwood, K., Feil, M., & Burke, L. (1999). Psychoactive medication prescribing practices for US children: Gaps between research and clinical practice. Journal of the American Academy of Child and Adolescent Psychiatry, 38(5), 557–565.

    Article  PubMed  CAS  Google Scholar 

  • Kaplan, S., Heiligenstein, J., West, S., Busner, J., Harder, D., Dittman, R., et al. (2004). Efficacy and safety of atomoxetine in childhood attention-deficit/hyperactivity disorder with comorbid oppositional defiant disorder. Journal of Attention Disorders, 8(2), 45–52.

    Article  PubMed  CAS  Google Scholar 

  • Leslie, L. K., Aarons, G. A., Haine, R. A., & Hough, R. L. (2007). Caregiver depression and medication use by youths with ADHD who receive services in the public sector. Psychiatric Services, 58(1), 131–134.

    Article  PubMed  Google Scholar 

  • Leslie, L. K., Weckerly, J., Landsverk, J., Hough, R. L., Hurlburt, M. S., & Wood, P. A. (2003). Racial/ethnic differences in the use of psychotropic medication in high-risk children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 42(12), 1433–1442.

    Article  PubMed  Google Scholar 

  • Luby, J., Stalets, M., & Belden, A. (2007). Psychotropic prescriptions in a sample including both healthy and mood and disruptive disordered preschoolers: Relationships to diagnosis, impairment, prescriber type, and assessment methods. Journal of Child and Adolescent Psychopharmacology, 17(2), 205–215.

    Article  PubMed  Google Scholar 

  • Marrato, E. H., Nicol, G. E., Maahs, D., Druss, B. G., Hartung, D. M., Valuck, R. J., et al. (2010). Metabolic screening in children receiving antipsychotic drug treatment. Pediatrics & Adolescent Medicine, 164(4), 344–351.

    Article  Google Scholar 

  • McCabe, K. M., Yeh, M., Lau, A., Garland, A., & Hough, R. (2003). Racial/ethnic differences in caregiver strain and perceived social support among parents of youth with emotional and behavioral problems. Mental Health Services Research, 5(3), 137–147.

    Article  PubMed  Google Scholar 

  • McLennan, J., Wathen, N., MacMillan, H., & Lavis, J. (2006). Research-practice gaps in child mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 658–665.

    Article  PubMed  Google Scholar 

  • MTA group. (1999). A 14 month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal treatment study of children with ADHD. Archives of General Psychiatry, 56(12), 1073–1086.

    Article  Google Scholar 

  • Olfson, M., Marcus, S., Weissman, M., & Jensen, P. (2002). National trends in the use of psychotropic medications by children. Journal of the American Academy of Child and Adolescent Psychiatry, 14(5), 514–521.

    Article  Google Scholar 

  • Pappadopulos, E., et al. (2009). Medication adherence in MTA: Saliva methylphenidate samples versus parent report and mediating effect of concomitent behavioral therapy. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5), 501–510.

    Article  PubMed  Google Scholar 

  • Raghavan, R., Zima, B. T., Andersen, R. M., Leibowitz, A. A., Schuster, M. A., & Landsverk, J. (2005). Psychotropic medication use in a national probability sample of children in the child welfare system. Journal of Child and Adolescent Psychopharmacology, 15(1), 97–106.

    Article  PubMed  Google Scholar 

  • Riddle, M., Kastelic, E. A., & Frosch, E. (2005). Pediatric psychopharmacology. Journal of Child Psychology and Psychiatry and Allied Disciplines, 42(1), 73–90.

    Google Scholar 

  • Shin, S., & Brown, T. (2005). Racial and ethnic disparities in caregiver strain and the use of child mental health services: A structural equation model. Psychiatric Services, 60(8), 1039–1045.

    Article  Google Scholar 

  • van de Wiel, N. M., Matthys, W., Cohen-Kettenis, P. T., Maassen, G. H., Lochman, J. E., & van Engeland, H. (2007). The effectiveness of an experimental treatment when compared to care as usual depends on the type of care as usual. Behavior Modification, 31(3), 298–312.

    Article  PubMed  Google Scholar 

  • Varley, C., & McClellan, J. (2009). Implications of marked weight gain associated with atypical antipsychotic medications in children and adolescents. Journal of American Medical Association, 302(16), 1811–1812.

    Article  CAS  Google Scholar 

  • Yeh, M., McCabe, K., Hough, R. L., Lau, A., Fakhry, F., & Garland, A. (2005). Why bother with beliefs? Examining relationships between race/ethnicity, parental beliefs about causes of child problems and mental health service use. Journal of Consulting and Clinical Psychololgy, 73(5), 800–807.

    Article  Google Scholar 

  • Zima, B., Hurlburt, M., Knapp, P., Ladd, H., Tang, L., Duan, N., et al. (2005). Quality of publicly-funded outpatient specialty mental health care for common childhood psychiatric disorders in California. Journal of the American Academy of Child and Adolescent Psychiatry, 44(2), 130–144.

    Article  PubMed  Google Scholar 

  • Zito, J., Safer, D., dos dosReis S, S., Gardner, J. F., Gardner, J. F., Magder, L., et al. (2003). Psychotropic practice patterns for youth: a 10 year perspective. Archives of Pediatrics and Adolescent Medicine, 157, 17–25.

    Article  PubMed  Google Scholar 

  • Zito, J., Safer, D., Sai, D., Gardner, J. F., Thomas, D., Coombes, P., et al. (2008). Psychotropic medication patterns among youth in foster care. Pediatrics, 121, 157–163.

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by NIH Funding: R01MH66070 (AFG), K23MH077584 (LBF), and 1P30MH074678 (J. Landsverk, PI).

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of California, San Diego, CA, USA

    Ann F. Garland & Lauren Brookman-Frazee

  2. The Child and Adolescent Services Research Center (CASRC), Rady Children’s Hospital, 3020 Children’s Way, MC 5033, San Diego, CA, 92123, USA

    Ann F. Garland & Lauren Brookman-Frazee

  3. Massachusetts General Hospital, Boston, MA, USA

    Emily Gray

Authors
  1. Ann F. Garland
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lauren Brookman-Frazee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emily Gray
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ann F. Garland.

Additional information

Statistics consultant: Scott Roesch, Ph.D.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Garland, A.F., Brookman-Frazee, L. & Gray, E. The Role of Parent Characteristics in Community-Based Medication Treatment for Children with Disruptive Behavior Problems. Community Ment Health J 49, 507–514 (2013). https://doi.org/10.1007/s10597-012-9514-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-012-9514-1

Keywords

Search

Navigation