ARTICLES
DSM-IV Disorders in Children With Borderline to Moderate Intellectual Disability. II: Child and Family Predictors

https://doi.org/10.1097/01.CHI.0000046891.27264.C1Get rights and content

ABSTRACT

Objective

To identify child and family factors that predict DSM-IV disorders in children with intellectual disability.

Method

In 1997, a total of 968 6- to 18-year-olds were randomly selected from Dutch schools for intellectual disability (response 69.3%). Parents completed the Child Behavior Checklist, Developmental Behavior Checklist, Vineland Screener, and instruments addressing their child's physical health, family functioning, and parental mental health. One year later, parents of 474 children, randomly selected from the 1997 participants (response 86.8%), completed the anxiety, mood, and disruptive disorder modules of the Diagnostic Interview Schedule for Children-IV.

Results

Both child and family factors were significantly related to DSM-IV outcome 1 year later. Social incompetence, inadequate daily living skills, child health problems, negative life events, emotional and behavioral problems, and parental mental health problems were the strongest predictors of DSM-IV disorders 1 year later. After correcting for the level of behavioral problems in the previous year, the first four factors proved to be significant risk factors for DSM-IV outcome.

Conclusions

These factors can improve the identification of children at risk and point to topics that need attention in diagnostic and intervention procedures.

Section snippets

METHOD

The sample characteristics, procedure, and some of the instruments are described in Part I of the present study (Dekker and Koot, 2003). A brief summary follows as well as a description of additional instruments.

Predicting any DSM-IV Disorder

Most child factors predicted the presence of any DSM-IV disorder, except for the child's educational level, gender, and age. Parental psychopathology, referral to mental health care, and single parent family were the only family factors predicting DSM-IV disorder 1 year later. Age and gender moderated some associations (Table 2).

Children with problem behaviors, especially externalizing behaviors and self-absorbed behaviors, had the highest relative risk for DSM-IV disorder 1 year later. Almost

DISCUSSION

The results from this study showed that most included child factors and that some family factors predicted impairing psychiatric disorders in children with ID 1 year later. Inadequate daily living skills, chronic physical condition, social incompetence, negative life events, high physical complaints, parental psychopathology, and parental referral to mental health care were the strongest predictors of DSM-IV disorders. After correcting for T1 emotional/ behavioral problems, the first four

REFERENCES (47)

  • C Stanger et al.

    Three-year course of behavioral/emotional problems in a national sample of 4- to 16-year-olds, II: predictors of syndromes

    J Am Acad Child Adolesc Psychiatry

    (1992)
  • CN Velez et al.

    A longitudinal analysis of selected risk factors for childhood psychopathology

    J Am Acad Child Adolesc Psychiatry

    (1989)
  • S Williams et al.

    Risk factors for behavioral and emotional disorder in preadolescent children

    J Am Acad Child Adolesc Psychiatry

    (1990)
  • TM Achenbach

    Manual for the Child Behavior Checklist/4–18 and 1991 Profiles

    (1991)
  • TM Achenbach

    Manual for the Young Adult Self-Report and Young Adult Behavior Checklist

    (1997)
  • GF Berden et al.

    Major life events and changes in the behavioural functioning of children

    J Child Psychol Psychiatry

    (1990)
  • J Byles et al.

    Ontario Child Health Study: reliability and validity of the general functioning subscale of the McMaster Family Assessment Device

    Fam Process

    (1988)
  • Cental Bureau of Statistics

    Standaard Beroepen classificatie 1992

    (1993)
  • MC Dekker et al.

    Emotional and behavioral problems in children and adolescents with and without intellectual disability

    J Child Psychol Psychiatry

    (2002)
  • MC Dekker et al.

    Psychometric properties of the revised Developmental Behaviour Checklist scales in Dutch children with intellectual disability

    J Intellect Disabil Res

    (2002)
  • TJ Dishion et al.

    The development and ecology of antisocial behavior

  • EM Dykens

    Psychopathology in children with intellectual disability

    J Child Psychol Psychiatry

    (2000)
  • SL Einfeld et al.

    Population prevalence of psychopathology in children and adolescents with intellectual disability, I: rationale and methods

    J Intellect Disabil Res

    (1996)
  • Cited by (0)

    Supported by Sophia Scientific Foundation grant 206 , the Health Research and Development Council grant 28-2724 , and the Foundation of Friends of New Spraeland.

    View full text