Associations Between Child and Parent Mental Health Among Families of Color Living in Poverty Impacted Communities

Background and Purpose:

Disruptive Behavior Disorders (DBD) such as Oppositional Defiant Disorder and Conduct Disorder, are chronic, impairing diagnoses associated with lower educational attainment, substance misuse, comorbid mental health disorders, delinquency, incarceration and premature death. Children who live in communities impacted by poverty are at an increased risk of DBDs, which is due in part to exposure to environmental stressors such as community violence, under-funded schools, and scarce resources. Elevated parental stress and depression are also associated with the onset and perpetuation of DBDs, as poor parental emotional health negatively impacts key aspects of parenting implicated in youth behavior problems, such as the quality of parenting and the parent-child bond. While approximately one half of youth referrals to public systems are a result of conduct problems, families living in communities characterized by poverty are the least likely to access mental health services, and have high rates of premature termination from treatment. The purpose of this study is to describe the demographic and psychiatric characteristics of a sample of families impacted by poverty in order to address factors, such as high rates of parental stress and depression, that undermine familial health.

Methods:  

Baseline data from 437 caregivers seeking treatment at a public mental health clinic within one of the five NYC boroughs were analyzed. Most children were male (60%), and identified racially as Hispanic/Latino (50%) or Black/African-American (33%). Caregivers most often identified as the child’s mother (61%), unmarried (42%), and reported an income of less than $9,999 a year

Results:

On average, children reported high levels of DBDs (M= 14.33, SD = 4.97), as measured by the Disruptive Behavior Disorder Oppositional Defiant Subscale, and high levels of oppositional defiant behaviors (M= 9.36, SD= 3.40), as measured by the Oppositional Defiant Disorder Subscale within the Iowa Connors Rating Scale.  As for caregiver factors, the majority of participants reported clinically significant levels of depression as measured by the Center for Epidemiological Studies Depression Scale (42%; CESD ≥ 16) and stress as measured by the Parenting Stress Index (40.3%; PSI ≥ 90) at baseline.  Children of caregivers with clinically significant levels of stress reported significantly higher levels of disruptive behavior disorders (M=16.40, SD= 4.00; t(332)=-3.86, p= .000) and oppositional defiant disorders (M=10.12, SD= 3.24; t(315)=-3.87, p= .000) as compared to children of caregivers with non-clinically significant levels of stress (DBD M=14.78, SD= 3.57; ODD M=8.76, SD=3.34).  Children of caregivers with clinically significant levels of depression reported significantly higher levels of DBDs (M=16.03, SD= 4.05) in comparison to children of caregivers with non-clinically significant levels of depression (M=15.10, SD= 3.78; t(339)=-2.19, p= .029). 

Conclusions and Implications:

These findings display the severity of both child and adult mental health symptoms among a sample of families living in poverty-impacted communities within New York City and the need to address both child and parent emotional health in order to improve outcomes at both the individual and family levels.