The goal of these analyses was to use existing data to provide an empirically-based estimate of t... more The goal of these analyses was to use existing data to provide an empirically-based estimate of the prevalence in the population of Serious Emotional Disturbance (SED) in children and adolescents, to assist States in their task, required under PL 102-321, of including such estimates in their applications for Block Grant funds. Seven data sets were identified that could provide estimates of SED. The principal investigators agreed on common definitions of the key components of SED: a psychiatric diagnosis and significant functional impairment. Two definitions of impairment were used: domain-specific (impairment in one or more of three areas of functioning) and global (in the worst 10% over all). They also defined a set of correlates and risk factors for SED: age, gender, race/ethnicity, and poverty. Investigators then reanalyzed their own data, using these standard definitions, and calculated the proportion of SED youth who received mental health care. The median estimate of SED with global impairment was 5.4%, with a range from 4.3% to 7.4%. Estimates of SED with domain-specific impairment ranged from 5.5% to 16.9% (median 7.7%). Rates were slightly higher in boys. There were no clear ethnic differences. Poverty doubled the risk of SED. Only one SED
Journal of the American Academy of Psychoanalysis, 1982
We have presented a justification for the application of some of the principles of individual psy... more We have presented a justification for the application of some of the principles of individual psychic development to the understanding of societal development. The interplay between the various systems of organization provides a circular and reciprocal interaction between the individual and the broader organizational levels of which he is a part. We have noted how individuals contribute to the characteristics of these organizational levels, as they contribute to his own. An illustration of this interplay has been provided by describing the impact of a societal condition such as colonialism on the colonized individual, as well as its force in shaping the character of the collectivity. Its effect on individual parameters of self-definition and self-esteem has been noted, and its possible relevance to psychotherapeutic processes pointed out.
Journal of the American Academy of Child Psychiatry, 1978
... MD a. a Dr. Kestenbaum is Director and Dr. Bird is Assistant Director of the Division of Chil... more ... MD a. a Dr. Kestenbaum is Director and Dr. Bird is Assistant Director of the Division of Child and Adolescent Psychiatry, St. Luke's Hospital Center, New York City. Available online 6 January 2010. Abstract. This paper describes ...
The main objective of the manuscript is to present a review of the literature of the psychiatric ... more The main objective of the manuscript is to present a review of the literature of the psychiatric epidemiological studies carried out in Puerto Rico in the last decade. Data from three major epidemiological surveys carried out in the last decade is presented which provide evidence against prior long standing observations that Puerto Ricans reported higher levels of psychiatric symptomatology as compared to other populations and ethnic groups in the United States. The studies selected for review were the universe of population epidemiological studies carried out in Puerto Rico in the last decade. All studies used island wide probability sampling procedures to select the study population. Rates of psychiatric disorders in Puerto Rico were found to be significantly different from those obtained in United States communities. Exceptions were somatization disorder and symptoms which were found to be significantly more common in Puerto Rico and drug abuse/dependence which was found to be co...
Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologi... more Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family members. The FHE was administered to one informant in
Background. Little is known about the extent and correlates of unmet need for mental health servi... more Background. Little is known about the extent and correlates of unmet need for mental health services in community samples of children and adolescents. Methods. Data were obtained from the 1285 parent\youth pairs interviewed at four sites in the USA and Puerto Rico in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Unmet need was defined to exist if psychopathology and associated functional impairment were present but no mental health services had been received in the previous 6 months. Results. Of the total sample, 17n1 % had unmet need. Adjusting for demographic variables, logistic regression analyses revealed that unmet need was significantly associated with : indicators of economic disadvantage, such as being on public assistance and not being covered by health insurance ; opinions of the parents and children or adolescents that the latter had poor mental health ; parental psychopathology ; poor school grades ; and parent-reported access barriers such as concern that the child would want to solve the problem unassisted, would refuse to attend mental health services, or would be hospitalized or taken away against the parent's will. No youth-reported access barriers were significantly associated with unmet need. Conclusions. The economic correlates of unmet need may attain increased importance in the light of current reform in health care financing in the USA. Access may be facilitated by increasing parental knowledge of mental health services and enabling children and adolescents to initiate contact with services independently of their families.
The Diagnostic Interview Schedule (DIS) was designed for use in large-sample surveys of mental he... more The Diagnostic Interview Schedule (DIS) was designed for use in large-sample surveys of mental health to produce categorical diagnoses according to criteria such as those found in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, based on structured information about lifetime symptoms provided to nonclinician interviewers. Using symptom data from a probability sample of community residents
OBJECTIVES. Few studies have assessed the relationship between depressive symptoms and early onse... more OBJECTIVES. Few studies have assessed the relationship between depressive symptoms and early onset of alcohol use in children and early adolescents. We aimed to determine whether depressive symptoms in children are associated with subsequent initiation of alcohol use and, if so, whether this association is merely a result of demographic, parental, and/or individual risk factors shared by depression and alcohol use or independent of these shared risk factors. METHODS. Analyses were based on a subsample of 10- to 13-year-old children (N = 1119) from the Boricua Youth Study, a longitudinal study of psychopathology among Puerto Rican children and early adolescents. Children in the study were assessed over 3 waves between 2000 and 2004. In-person structured interviews were conducted with both parents and children. RESULTS. Depressive symptoms and alcohol use shared some significant risk and protective factors, such as parental psychopathology, parenting, child exposure to violence, and a...
Journal of the American Academy of Child & Adolescent Psychiatry, 2008
, has a child and adolescent psychiatrist as lead author, and epitomizes scholarly excellence in ... more , has a child and adolescent psychiatrist as lead author, and epitomizes scholarly excellence in key areas of our discipline. As has been the tradition in the past years, the challenge of identifying the recipientsVand the harder one of not selecting so many deserving othersVwas shared by your President, your Editor, and last year's awardees.
Journal of the American Academy of Child & Adolescent Psychiatry, 1990
The desirability of incorporating a measure of impairment to the categorization of childhood psyc... more The desirability of incorporating a measure of impairment to the categorization of childhood psychopathology in the community is examined. The use of the Children's Global Assessment Scale (CGAS) for this purpose is recommended. The choice of 61 (definite case) and 71 (probable case) as cutpoints on the Children's Global Assessment Scale is supported empirically by the data on service utilization, parental perceived need, and behavior problem scores obtained in the Puerto Rico Child Psychiatry Epidemiological Study.
Journal of the American Academy of Child & Adolescent Psychiatry, 1987
... Reliability of Child Diagnosis in a Hispanic Sample GLORISA J. CANINO, PH.D., HECTOR R. BIRD,... more ... Reliability of Child Diagnosis in a Hispanic Sample GLORISA J. CANINO, PH.D., HECTOR R. BIRD, MD, MARITZA RUBIO-STIPEC, MA, MICHEL A. WOODBURY, MD, JULIO C. RIBERA, PH.D., SARAH E. HUERTAS, MD, AND MYRNA J. SESMAN, PH.D ... ShatTer. ... Brasic, J.. ct al. ...
Journal of the American Academy of Child & Adolescent Psychiatry, 2006
Objective: This is the first of two related articles on a study carried out between 2000 and 2003... more Objective: This is the first of two related articles on a study carried out between 2000 and 2003 designed to assess the prevalence, associated comorbidities, and correlates of disruptive behavior disorders in two populations of Puerto Rican children: one in the Standard Metropolitan Areas of San Juan and Caguas in Puerto Rico, and the other in the south Bronx in New York City. Method: This article provides the study_s background, design, and methodology. Probability samples of children ages 5 to 13 years were drawn at the two sites (n = 2,491). Subjects and their primary caretakers were interviewed using the Diagnostic Interview Schedule for Children-IV and a wide array of risk factor measures. The samples were weighted to correct for differences in the probability of selection resulting from sample design and to adjust for differences from the 2000 U.S. Census in the age/gender distribution. Results: The samples are representative of the populations of Puerto Rican children in the south Bronx and in the Standard Metropolitan Areas in Puerto Rico. Of the 2,940 children identified as eligible for the study, 2,491 participated for an overall compliance rate of 85%. Conclusions: The study results, to be described in an accompanying report, are generalizable to the two target populations. J. Am. Acad. Child Adolesc.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To examine the unique cases contributed by parent and child informants to diagnostic classificati... more To examine the unique cases contributed by parent and child informants to diagnostic classification, with the goal of identifying those diagnoses for which either or both informants are needed. The authors examined survey data from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a 4-community epidemiology survey of 9- to 17-year-old children and their parents. Parent-child dyads (1,285 pairs) were independently interviewed by lay persons with the Diagnostic Interview Schedule for Children; a subset of these pairs (n = 247) were also interviewed by clinicians. Agreement between parents and children was examined with respect to levels of impairment, need for/use of services, and clinicians' diagnoses. Parents and children rarely agreed on the presence of diagnostic conditions, regardless of diagnostic type. Nonetheless, most child-only- and parent-only-identified diagnoses were similarly related to impairment and clinical validation, with 2 exceptions: child-only-identified attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Overall findings suggest that most "discrepant" diagnoses (those reported by one but not the other informant) reflect meaningful clinical conditions. In some instances, however, diagnoses reported by one but not the other informant should be treated with caution, as they may not reflect the full diagnostic condition (e.g., possibly child-only-identified ADHD or ODD). Further research is needed to determine the salience of child-only- or parent-only-reported cases.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To investigate the extent to which adolescents in the community with current substance use disord... more To investigate the extent to which adolescents in the community with current substance use disorders (SUD) experience co-occurring psychiatric disorders. Diagnostic data were obtained from probability samples of 401 children and adolescents, aged 14 to 17 years, and their mothers/caretakers, who participated in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The rates of mood and disruptive behavior disorders are much higher among adolescents with current SUD than among adolescents without SUD. Comparison with adult samples suggests that the rates of current comorbidity of SUD with psychiatric disorders are the same among adolescents as adults, and lower for lifetime disruptive disorders/antisocial personality disorder among adolescents than adults. The high rate of coexisting psychiatric disorders among adolescents with SUD in the community needs to be taken into account in prevention and treatment programs.
Objective-To examine the relationship between parental reports of child asthma and levels and slo... more Objective-To examine the relationship between parental reports of child asthma and levels and slopes of anxiety and depression symptoms among two contrasting groups of Puerto Rican youth, and to determine whether asthma is a special risk above and beyond parents' reports of other youths' medical conditions. Methods-Two probability samples of youth in San Juan and Caguas, Puerto Rico (n=673) and in the south Bronx, New York (n=598), and their caretakers were interviewed in three yearly assessments. Parental reports of their children's asthma during each assessment were used to indicate whether youth had intermittent (PR=34%, NY=23%) or persistent (PR=7%, NY=16%) asthma. Youths' depression and anxiety symptoms were assessed using self reports to the DISC-IV. Information on youths' medical comorbidity was gathered through parental reports. Results-Multilevel analyses adjusting for comorbid medical conditions indicated that parental reports of youths' intermittent and persistent asthma were related to higher levels, but similar slopes, of anxiety and depression among youth in New York. In Puerto Rico, youth with persistent asthma experienced less improvement in anxiety over time than youth without asthma, but no other associations were found. Conclusion-Having asthma, based on parental reports, represents a risk factor for Puerto Rican youths' internalizing symptoms, even after adjusting for comorbid medical conditions. This risk is more pronounced among youth living in New York, which highlights the importance of
The Journal of Mental Health Policy and Economics, 1998
Background: Several recent studies of child outpatient mental health service use in the US have s... more Background: Several recent studies of child outpatient mental health service use in the US have shown that having private insurance has no effect on the propensity to use services. Some studies also find that public coverage has no beneficial effect relative to no insurance. Aims: This study explores several potential explanations, including inadequate measurement of mental health status, bandwagon effects, unobservable heterogeneity and public sector substitution for private services, for the lack of an effect of private insurance on service use. Methods: We use secondary analysis of data from the three mainland US sites of NIMH's 1992 field trial of the Cooperative Agreement for Methodological Research for Multi-Site Surveys of Mental Disorders in Child and Adolescent Populations (MECA) Study. We examine whether or not a subject used any mental health service, school-based mental health services or outpatient mental health services, and the number of outpatient visits among users. We also examine use of general medical services as a check on our results. We conduct regression analysis; instrumental variables analysis, using instruments based on employment and parental history of mental health problems to identify insurance choice, and bivariate probit analysis to examine multiservice use. Results: We find evidence that children with private health insurance have fewer observable (measured) mental health problems. They also appear to have a lower unobservable (latent) propensity to use mental health services than do children without coverage and those with Medicaid coverage. Unobserved differences in mental health status that relate to insurance choice are found to contribute to the absence of a positive effect for private insurance relative to no coverage in service use regressions. We find no evidence to suggest that differences in attitudes or differences in service availability in children's census tracts of residence explain the non-effect of insurance. Finally, we find that the lack of a difference is not a consequence of substitution of school-based for office-based services. School-based and office-based specialty
Journal of Clinical Child & Adolescent Psychology, 2007
There is a growing need for multicultural collaboration in child mental health services, training... more There is a growing need for multicultural collaboration in child mental health services, training, and research. To facilitate such collaboration, this study tested the 8-syndrome structure of the Child Behavior Checklist (CBCL) in 30 societies. Parents' CBCL ratings of 58,051 6-to 18-year-olds were subjected to confirmatory factor analyses, which were conducted separately for each society. Societies represented Asia; Africa; Australia; the Caribbean; Eastern, Western, Southern, and Northern Europe; the Middle East; and North America. Fit indices strongly supported the correlated 8-syndrome structure in each of 30 societies. The results support use of the syndromes in diverse societies.
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
The goal of these analyses was to use existing data to provide an empirically-based estimate of t... more The goal of these analyses was to use existing data to provide an empirically-based estimate of the prevalence in the population of Serious Emotional Disturbance (SED) in children and adolescents, to assist States in their task, required under PL 102-321, of including such estimates in their applications for Block Grant funds. Seven data sets were identified that could provide estimates of SED. The principal investigators agreed on common definitions of the key components of SED: a psychiatric diagnosis and significant functional impairment. Two definitions of impairment were used: domain-specific (impairment in one or more of three areas of functioning) and global (in the worst 10% over all). They also defined a set of correlates and risk factors for SED: age, gender, race/ethnicity, and poverty. Investigators then reanalyzed their own data, using these standard definitions, and calculated the proportion of SED youth who received mental health care. The median estimate of SED with global impairment was 5.4%, with a range from 4.3% to 7.4%. Estimates of SED with domain-specific impairment ranged from 5.5% to 16.9% (median 7.7%). Rates were slightly higher in boys. There were no clear ethnic differences. Poverty doubled the risk of SED. Only one SED
Journal of the American Academy of Psychoanalysis, 1982
We have presented a justification for the application of some of the principles of individual psy... more We have presented a justification for the application of some of the principles of individual psychic development to the understanding of societal development. The interplay between the various systems of organization provides a circular and reciprocal interaction between the individual and the broader organizational levels of which he is a part. We have noted how individuals contribute to the characteristics of these organizational levels, as they contribute to his own. An illustration of this interplay has been provided by describing the impact of a societal condition such as colonialism on the colonized individual, as well as its force in shaping the character of the collectivity. Its effect on individual parameters of self-definition and self-esteem has been noted, and its possible relevance to psychotherapeutic processes pointed out.
Journal of the American Academy of Child Psychiatry, 1978
... MD a. a Dr. Kestenbaum is Director and Dr. Bird is Assistant Director of the Division of Chil... more ... MD a. a Dr. Kestenbaum is Director and Dr. Bird is Assistant Director of the Division of Child and Adolescent Psychiatry, St. Luke's Hospital Center, New York City. Available online 6 January 2010. Abstract. This paper describes ...
The main objective of the manuscript is to present a review of the literature of the psychiatric ... more The main objective of the manuscript is to present a review of the literature of the psychiatric epidemiological studies carried out in Puerto Rico in the last decade. Data from three major epidemiological surveys carried out in the last decade is presented which provide evidence against prior long standing observations that Puerto Ricans reported higher levels of psychiatric symptomatology as compared to other populations and ethnic groups in the United States. The studies selected for review were the universe of population epidemiological studies carried out in Puerto Rico in the last decade. All studies used island wide probability sampling procedures to select the study population. Rates of psychiatric disorders in Puerto Rico were found to be significantly different from those obtained in United States communities. Exceptions were somatization disorder and symptoms which were found to be significantly more common in Puerto Rico and drug abuse/dependence which was found to be co...
Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologi... more Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family members. The FHE was administered to one informant in
Background. Little is known about the extent and correlates of unmet need for mental health servi... more Background. Little is known about the extent and correlates of unmet need for mental health services in community samples of children and adolescents. Methods. Data were obtained from the 1285 parent\youth pairs interviewed at four sites in the USA and Puerto Rico in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Unmet need was defined to exist if psychopathology and associated functional impairment were present but no mental health services had been received in the previous 6 months. Results. Of the total sample, 17n1 % had unmet need. Adjusting for demographic variables, logistic regression analyses revealed that unmet need was significantly associated with : indicators of economic disadvantage, such as being on public assistance and not being covered by health insurance ; opinions of the parents and children or adolescents that the latter had poor mental health ; parental psychopathology ; poor school grades ; and parent-reported access barriers such as concern that the child would want to solve the problem unassisted, would refuse to attend mental health services, or would be hospitalized or taken away against the parent's will. No youth-reported access barriers were significantly associated with unmet need. Conclusions. The economic correlates of unmet need may attain increased importance in the light of current reform in health care financing in the USA. Access may be facilitated by increasing parental knowledge of mental health services and enabling children and adolescents to initiate contact with services independently of their families.
The Diagnostic Interview Schedule (DIS) was designed for use in large-sample surveys of mental he... more The Diagnostic Interview Schedule (DIS) was designed for use in large-sample surveys of mental health to produce categorical diagnoses according to criteria such as those found in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, based on structured information about lifetime symptoms provided to nonclinician interviewers. Using symptom data from a probability sample of community residents
OBJECTIVES. Few studies have assessed the relationship between depressive symptoms and early onse... more OBJECTIVES. Few studies have assessed the relationship between depressive symptoms and early onset of alcohol use in children and early adolescents. We aimed to determine whether depressive symptoms in children are associated with subsequent initiation of alcohol use and, if so, whether this association is merely a result of demographic, parental, and/or individual risk factors shared by depression and alcohol use or independent of these shared risk factors. METHODS. Analyses were based on a subsample of 10- to 13-year-old children (N = 1119) from the Boricua Youth Study, a longitudinal study of psychopathology among Puerto Rican children and early adolescents. Children in the study were assessed over 3 waves between 2000 and 2004. In-person structured interviews were conducted with both parents and children. RESULTS. Depressive symptoms and alcohol use shared some significant risk and protective factors, such as parental psychopathology, parenting, child exposure to violence, and a...
Journal of the American Academy of Child & Adolescent Psychiatry, 2008
, has a child and adolescent psychiatrist as lead author, and epitomizes scholarly excellence in ... more , has a child and adolescent psychiatrist as lead author, and epitomizes scholarly excellence in key areas of our discipline. As has been the tradition in the past years, the challenge of identifying the recipientsVand the harder one of not selecting so many deserving othersVwas shared by your President, your Editor, and last year's awardees.
Journal of the American Academy of Child & Adolescent Psychiatry, 1990
The desirability of incorporating a measure of impairment to the categorization of childhood psyc... more The desirability of incorporating a measure of impairment to the categorization of childhood psychopathology in the community is examined. The use of the Children's Global Assessment Scale (CGAS) for this purpose is recommended. The choice of 61 (definite case) and 71 (probable case) as cutpoints on the Children's Global Assessment Scale is supported empirically by the data on service utilization, parental perceived need, and behavior problem scores obtained in the Puerto Rico Child Psychiatry Epidemiological Study.
Journal of the American Academy of Child & Adolescent Psychiatry, 1987
... Reliability of Child Diagnosis in a Hispanic Sample GLORISA J. CANINO, PH.D., HECTOR R. BIRD,... more ... Reliability of Child Diagnosis in a Hispanic Sample GLORISA J. CANINO, PH.D., HECTOR R. BIRD, MD, MARITZA RUBIO-STIPEC, MA, MICHEL A. WOODBURY, MD, JULIO C. RIBERA, PH.D., SARAH E. HUERTAS, MD, AND MYRNA J. SESMAN, PH.D ... ShatTer. ... Brasic, J.. ct al. ...
Journal of the American Academy of Child & Adolescent Psychiatry, 2006
Objective: This is the first of two related articles on a study carried out between 2000 and 2003... more Objective: This is the first of two related articles on a study carried out between 2000 and 2003 designed to assess the prevalence, associated comorbidities, and correlates of disruptive behavior disorders in two populations of Puerto Rican children: one in the Standard Metropolitan Areas of San Juan and Caguas in Puerto Rico, and the other in the south Bronx in New York City. Method: This article provides the study_s background, design, and methodology. Probability samples of children ages 5 to 13 years were drawn at the two sites (n = 2,491). Subjects and their primary caretakers were interviewed using the Diagnostic Interview Schedule for Children-IV and a wide array of risk factor measures. The samples were weighted to correct for differences in the probability of selection resulting from sample design and to adjust for differences from the 2000 U.S. Census in the age/gender distribution. Results: The samples are representative of the populations of Puerto Rican children in the south Bronx and in the Standard Metropolitan Areas in Puerto Rico. Of the 2,940 children identified as eligible for the study, 2,491 participated for an overall compliance rate of 85%. Conclusions: The study results, to be described in an accompanying report, are generalizable to the two target populations. J. Am. Acad. Child Adolesc.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To examine the unique cases contributed by parent and child informants to diagnostic classificati... more To examine the unique cases contributed by parent and child informants to diagnostic classification, with the goal of identifying those diagnoses for which either or both informants are needed. The authors examined survey data from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a 4-community epidemiology survey of 9- to 17-year-old children and their parents. Parent-child dyads (1,285 pairs) were independently interviewed by lay persons with the Diagnostic Interview Schedule for Children; a subset of these pairs (n = 247) were also interviewed by clinicians. Agreement between parents and children was examined with respect to levels of impairment, need for/use of services, and clinicians' diagnoses. Parents and children rarely agreed on the presence of diagnostic conditions, regardless of diagnostic type. Nonetheless, most child-only- and parent-only-identified diagnoses were similarly related to impairment and clinical validation, with 2 exceptions: child-only-identified attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Overall findings suggest that most "discrepant" diagnoses (those reported by one but not the other informant) reflect meaningful clinical conditions. In some instances, however, diagnoses reported by one but not the other informant should be treated with caution, as they may not reflect the full diagnostic condition (e.g., possibly child-only-identified ADHD or ODD). Further research is needed to determine the salience of child-only- or parent-only-reported cases.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To investigate the extent to which adolescents in the community with current substance use disord... more To investigate the extent to which adolescents in the community with current substance use disorders (SUD) experience co-occurring psychiatric disorders. Diagnostic data were obtained from probability samples of 401 children and adolescents, aged 14 to 17 years, and their mothers/caretakers, who participated in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The rates of mood and disruptive behavior disorders are much higher among adolescents with current SUD than among adolescents without SUD. Comparison with adult samples suggests that the rates of current comorbidity of SUD with psychiatric disorders are the same among adolescents as adults, and lower for lifetime disruptive disorders/antisocial personality disorder among adolescents than adults. The high rate of coexisting psychiatric disorders among adolescents with SUD in the community needs to be taken into account in prevention and treatment programs.
Objective-To examine the relationship between parental reports of child asthma and levels and slo... more Objective-To examine the relationship between parental reports of child asthma and levels and slopes of anxiety and depression symptoms among two contrasting groups of Puerto Rican youth, and to determine whether asthma is a special risk above and beyond parents' reports of other youths' medical conditions. Methods-Two probability samples of youth in San Juan and Caguas, Puerto Rico (n=673) and in the south Bronx, New York (n=598), and their caretakers were interviewed in three yearly assessments. Parental reports of their children's asthma during each assessment were used to indicate whether youth had intermittent (PR=34%, NY=23%) or persistent (PR=7%, NY=16%) asthma. Youths' depression and anxiety symptoms were assessed using self reports to the DISC-IV. Information on youths' medical comorbidity was gathered through parental reports. Results-Multilevel analyses adjusting for comorbid medical conditions indicated that parental reports of youths' intermittent and persistent asthma were related to higher levels, but similar slopes, of anxiety and depression among youth in New York. In Puerto Rico, youth with persistent asthma experienced less improvement in anxiety over time than youth without asthma, but no other associations were found. Conclusion-Having asthma, based on parental reports, represents a risk factor for Puerto Rican youths' internalizing symptoms, even after adjusting for comorbid medical conditions. This risk is more pronounced among youth living in New York, which highlights the importance of
The Journal of Mental Health Policy and Economics, 1998
Background: Several recent studies of child outpatient mental health service use in the US have s... more Background: Several recent studies of child outpatient mental health service use in the US have shown that having private insurance has no effect on the propensity to use services. Some studies also find that public coverage has no beneficial effect relative to no insurance. Aims: This study explores several potential explanations, including inadequate measurement of mental health status, bandwagon effects, unobservable heterogeneity and public sector substitution for private services, for the lack of an effect of private insurance on service use. Methods: We use secondary analysis of data from the three mainland US sites of NIMH's 1992 field trial of the Cooperative Agreement for Methodological Research for Multi-Site Surveys of Mental Disorders in Child and Adolescent Populations (MECA) Study. We examine whether or not a subject used any mental health service, school-based mental health services or outpatient mental health services, and the number of outpatient visits among users. We also examine use of general medical services as a check on our results. We conduct regression analysis; instrumental variables analysis, using instruments based on employment and parental history of mental health problems to identify insurance choice, and bivariate probit analysis to examine multiservice use. Results: We find evidence that children with private health insurance have fewer observable (measured) mental health problems. They also appear to have a lower unobservable (latent) propensity to use mental health services than do children without coverage and those with Medicaid coverage. Unobserved differences in mental health status that relate to insurance choice are found to contribute to the absence of a positive effect for private insurance relative to no coverage in service use regressions. We find no evidence to suggest that differences in attitudes or differences in service availability in children's census tracts of residence explain the non-effect of insurance. Finally, we find that the lack of a difference is not a consequence of substitution of school-based for office-based services. School-based and office-based specialty
Journal of Clinical Child & Adolescent Psychology, 2007
There is a growing need for multicultural collaboration in child mental health services, training... more There is a growing need for multicultural collaboration in child mental health services, training, and research. To facilitate such collaboration, this study tested the 8-syndrome structure of the Child Behavior Checklist (CBCL) in 30 societies. Parents' CBCL ratings of 58,051 6-to 18-year-olds were subjected to confirmatory factor analyses, which were conducted separately for each society. Societies represented Asia; Africa; Australia; the Caribbean; Eastern, Western, Southern, and Northern Europe; the Middle East; and North America. Fit indices strongly supported the correlated 8-syndrome structure in each of 30 societies. The results support use of the syndromes in diverse societies.
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
Uploads
Papers by Hector Bird