Introduction to Abnormal Child and Adolescent Psychology. Robert Weis

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СКАЧАТЬ psychological problems. For example, parents with higher incomes may be better able to afford higher-quality health care, nutrition, or schooling for their children. These early experiences, in turn, can protect their children from the emergence of mental health problems.

      Of course, genetic and environmental factors often interact to place children at risk for disorders. For example, in one large study, researchers examined the prevalence of ADHD in children from low- and high-income families (Rowland et al., 2019). Children from low-income families were 6 times more likely than children from high-income families to have ADHD if neither parent had the disorder. However, if a parent also had ADHD, low-income children were 10 times more likely than high-income children to have the disorder. These findings suggest that both genetic risk and environmental quality affect prevalence.

      A related predictor of children’s mental health is family composition. Recent research indicates that youths living with only one biological parent are twice as likely to develop an anxiety or mood disorder as youths living with both biological parents. Furthermore, adolescents living in single-parent homes may be 6 times more likely to develop a behavior or substance use disorder as youths living in a two-parent household (Kessler et al., 2012a). The association between single-parent families and increased mental health problems is partially explained by SES; single parents often earn lower family incomes than two-parent families. However, single parents also report greater stress and may have more difficulty monitoring their children’s behavior than two-parent families. These factors, in turn, can contribute to their children’s behavior problems (Frick, 2013).

      Race and Ethnicity

      The relationship between ethnicity and childhood disorders is complex. Certain disorders are more commonly diagnosed in non-Latino White families. For example, the prevalence of autism spectrum disorder is approximately twice as high among young non-Latino White children (1.1%) compared to Latino (0.5%) or African American (0.4%) youths. Similarly, ADHD is more frequently diagnosed in non-Latino White youths (9.1%) than in African American (8.0%) or Latino (4.1%) children. Anxiety disorders are also slightly more common among White youths compared to their non-White peers (Perou et al., 2016).

      On the other hand, African American youths are more likely to develop conduct problems than White youths. Specifically, approximately 8.1% of African American youths will develop oppositional defiant behavior or conduct disorder at some point in childhood, compared to 4.2% of White and 3.9% of Latino youths (Perou et al., 2016).

      What explains these differences? One possibility is that differences in SES partially explain these differences in mental disorders across ethnicities. Sadly, members of many minority groups in the United States disproportionately come from lower-SES families (Taylor & Wang, 2013). Consequently, minority families often face many of the same risks confronted by low-SES families: reduced access to high-quality health care and nutrition, less optimal child care, impoverished educational experiences, and higher family stress. Immigrant families also face special risks, such as stress associated with language differences and acculturation (Coll & Magnuson, 2014). These risk factors might explain the higher prevalence of conduct problems among some minority youths. Indeed, when researchers control for SES, there are fewer differences in the percentage of children diagnosed with mental disorders across ethnic groups (Hayden & Mash, 2014).

      Another possibility is that children’s racial or ethnic background might partially determine the likelihood that their disorders are identified and treated. For example, African American and Latino children tend to be diagnosed with autism much later than non-Latino White children (Ratto, Reznick, & Turner-Brown, 2015). Research indicates that minority parents are often less able to recognize the early signs of autism; consequently, their children’s disorder may remain undiagnosed and untreated (Magaña, Lopez, Aguinaga, & Morton, 2013). Similarly, recent research has found that many Latino parents regard the hyperactive–impulsive symptoms of ADHD to be developmentally normative. Consequently, they may be less likely to view their children’s symptoms as problematic and less likely to seek treatment (Gerdes, Lawton, Haack, & Hurtado, 2014).

      A third possibility is that these differences in prevalence reflect cultural values across racial and ethnic groups. For example, African American adolescents are much less likely to develop alcohol and other drug use problems than non-Latino White adolescents (Kessler et al., 2012a). Some experts have argued that African American culture, which tends to discourage heavy alcohol use, protects many of these youths from substance use problems (Zapolski, Pedersen, McCarthy, & Smith, 2014). Furthermore, the more African American adolescents endorsed these cultural beliefs, the more likely they were to avoid alcohol and other drugs (Stock et al., 2013).

       Review

       The prevalence of mental health problems is higher among adolescents than among prepubescent children.

       In childhood, boys are more likely to experience a mental health problem than girls. In adolescence, girls are more likely to experience a mental health problem than boys.

       SES reflects parents’ education, employment status, and income. Children from low-SES families are at increased risk for mental health problems.

       Certain disorders, like ADHD and anxiety disorders, are most often diagnosed in non-Latino White children. Other disorders, like conduct problems, are most often diagnosed in children from other racial or ethnic backgrounds. These differences might reflect family SES, cultural factors that affect help-seeking, and/or actual differences in prevalence as a function of race and ethnicity.

      Do Most Children With Mental Health Problems Receive Treatment?

      Access to Treatment

      Although 20% of children and adolescents will develop a mental health problem at some point prior to adulthood, only about one-half of these youths receive treatment. Recent epidemiological studies indicate that only 51% of children and 45% of adolescents with mental disorders receive therapy or medication (Centers for Disease Control and Prevention, 2016b; Costello, He, Sampson, Kessler, & Merikangas, 2014). The likelihood that a youth will receive treatment depends on his or her disorder. For example, youths with ADHD are most likely to receive treatment, usually in the form of stimulant medication (e.g., Adderall, Ritalin). In contrast, youths with anxiety disorders are least likely to receive treatment, despite the fact that anxiety disorders are among the most treatable of all childhood mental health problems (Weisz et al., 2017).

      Children and adolescents with mental health problems are most likely to receive treatment at a school (24%), specialized mental health clinic (23%), or medical facility (10%). Some children receive services through other social agencies (8%), clinics that offer complementary or alternative medicine (5%), or the juvenile justice system (5%). As we might expect, youths with ADHD and learning disabilities are most likely to receive treatment at school, whereas youths with certain high-risk conditions such as eating disorders and substance use problems are more likely to visit specialized mental health clinics or hospitals. Children and adolescents with anxiety and mood disorders are most likely to be treated by their pediatricians.

      Not all children have equal access to high-quality mental health care. High-SES families are most likely to obtain mental health services for their children usually from psychologists and physicians. In contrast, youths from lower-SES backgrounds disproportionately receive treatment through public schools, human-service agencies, and the juvenile justice system. Furthermore, African American youths are less likely than non-Latino White youths to receive treatment (Costello et al., 2014).

      Altogether, these data indicate that only about one-half of youths with mental health problems receive the treatment they need. When children are able to access treatment, it is often not delivered by mental health СКАЧАТЬ