Preventing Mental, Emotional, and Behavioral Disorders Among Young People Progress and Possibilities (2009) / Chapter Skim
Currently Skimming:
2 The Nature and Extent of the Problem
2 The Nature and Extent of the Problem
Pages 35-58
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From page 35... ...
of mental illness in the United States showed that more than one in four (26.2 percent) adults had a mental disorder in the 12 months up to the time of the survey (Kessler, Anthony, et al., 1997)
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From page 36... ...
they impose heavy costs to society because of the resultant need for extra care, the social disruption that they can cause, and the risk that affected young people will underperform as adults. The significant economic costs of treating disorders warrant an increased focus on preventing them (Smit, Cuijpers, et al., 2006)
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From page 37... ...
Studies in the United States show that fewer than one in eight children with an MEB disorder is currently receiving treatment in the mental health or substance abuse systems, and only about one in four has ever received treatment (Burns, Costello, et al., 1995; Farmer, Burns, et al., 2003; Kataoka, Zhang, and Wells, 2002)
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From page 38... ...
For example, in a set of studies using identical methods, the prevalence of disruptive behavior disorders was lowest in Puerto Rican youth living in Puerto Rico, higher in mainland Hispanic and white youth, and highest in mainland African Americans, even after controlling for a range of risk factors (Bird, Canino, et al., 2001)
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From page 39... ...
/2000-2004 8-15/Conduct disorders/(parent CDISC) /2000-2004 8-15/Depression/(parent CDISC)
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From page 40... ...
Treatment for youth alcohol, marijuana, cocaine (including crack) , Administration ages 12-17 is defined as receiving treatment or counseling hallucinogens, heroin, inhalants, tobacco, for problems with behaviors or emotions from specific pain relievers, tranquilizers, stimulants, and mental health or other health professionals in school, sedatives; substance abuse treatment history home, or from other outpatient or inpatient settings in the and DSM-IV diagnoses.
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From page 41... ...
National Survey of Questions asked for ADHD, depression, anxiety, oppositional One-time survey (2007-2008) of ~86,000 Children's Health defiant disorder, behavioral or conduct problems, autism, children ages 0-17.
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From page 42... ...
This section reviews current epidemiological information about the more common MEB disorders up to age 25: conduct disorder and oppositional defiant disorder, often combined as disruptive behavior disorders; attention deficit hyperactivity disorder (ADHD) ; anxiety disorders, including posttraumatic stress disorder; depression; and drug abuse and dependence.
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From page 43... ...
0.6 0.2 0.3 1.1 Attention deficit hyperactivity disorder (34) 4.5 0.7 3.3 6.2 Any disruptive behavior disorder (23)
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From page 44... ...
Conduct Disorder (28) Oppositional Defiant Disorder (21)
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From page 45... ...
. Disruptive behavior disorders (conduct disorder, oppositional defiant disorder)
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From page 46... ...
, rates of reporting one or more episodes of a disorder by age 21 were 16.4 percent for disruptive behavior disorders, 14.5 percent for anxiety disorders, and 10.4 percent for depressive disorders. Comorbidity Many children have more than one MEB disorder.
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From page 47... ...
. Fig2-2.eps NOTE: ADHD = attention deficit hyperactivity disorder; Anx = anxiety; DBD = conduct disorder/oppositional defiant disorder; Dep = depression; SUD = substance use disorder.
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From page 48... ...
As the figure demonstrates, comorbidity is widespread, and there are clear patterns; there is greater comorbidity among disruptive behavior disorders, ADHD, and substance abuse disorders, on one hand, and among the emotional disorders (anxiety and depression) , than between emotional and disruptive behavioral disorders, on the other.
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From page 49... ...
Disruptive behavioral disorders and ADHD had the earliest onset, followed by emotional disorders (anxiety and depressive disorders)
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From page 50... ...
now make it possible to identify children with symptoms of several disorders at an early stage. In addition, developmentally informed interventions that aim at known antecedent risk factors during childhood and early adolescence can provide important opportunities for prevention.
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From page 51... ...
Epidemiology invented the term "risk factors" in the 1950s when the Framingham Heart Study showed that cardiovascular disease did not have a single cause but many different factors contributing to increased risk, no single factor being either necessary or sufficient. MEB disorders seem to have more in common with chronic diseases like cardiovascular disease than with infectious diseases, in having multiple risk factors.
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From page 52... ...
For example, while sexual abuse, poor parental supervision, and deviant peers were risk factors for both conduct disorder and oppositional defiant disorder, parental depression and loss of close relations and friends were specific to conduct disorder in these analyses. In the emotional disorders, parental depression was a specific risk for depression but was not associated with any anxiety disorders, whereas parental drug use and unemployment were associated with anxiety disorders but not with depression (see also Chapter 4)
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There is, of course, no simple answer to this question. National surveys and databases can be helpful in monitoring some of the epidemiological factors thought to be associated with emotional or behavioral disorders.
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. Substance abuse develops faster in boys than girls, and behavioral disorders remain higher in boys (Rutter, Caspi, and Moffitt, 2003)
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From page 55... ...
Data specific to the United States come from a patchwork of small, local studies. Conclusion: Although the United States collects rich data related to drug use and abuse, systematic data related to the prevalence and inci dence of mental, emotional, and behavioral disorders in young people are sparse.
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From page 56... ...
It has recently expanded its population survey, NSDUH, beyond substance abuse, making it another potential option. However, while a specific agency may need to be identified to provide data on the prevalence and incidence of disorders, inclusion of data related to risk and protective factors is likely to require the involvement and input of multiple HHS agencies, making this a departmental responsibility.
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From page 57... ...
must provide national data on mental health and substance abuse treatment services and on persons with mental and substance use disorders. This mandate includes the determination of the national incidence and prevalence of the various forms of mental disorder and substance abuse, as well as characteristics of treatment programs.
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