266411 Co-occurrence of emotional and behavioral problems in Washington State youth: Prevalence and links to socioeconomic stress

Tuesday, October 30, 2012 : 4:30 PM - 4:50 PM

Sarah Charlesworth-Attie, MPH , Department of Epidemiology, University of Washington, Seattle, WA
Molly Adrian, PhD , Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA
Sara Jaye Sanford, MPH , Immunization Action Coalition of WA, WithinReach, Seattle, WA
Elizabeth McCauley, PhD , Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA
Ann Vander Stoep, PhD , School of Public Health, University of Washington, Seattle, WA
Background: Adolescent depression and suicidality are common and virulent, but often undetected. The co-occurrence of such emotional difficulties with behavioral problems predicts especially poor global functioning through the transition to adulthood. Methods: We estimated the prevalence of co-occurring emotional problems (EP) and behavioral problems (BP) in Washington State adolescents, using 10th grade respondents to the 2010 Healthy Youth Survey. We used logistic regression to examine associations between emotional (depression, suicide ideation and attempt) and behavioral (heavy drinking, physical fighting, gang membership, weapon-carrying) problem indicators and socioeconomic stress as measured by past-year food insecurity. Results: Among 26117 respondents, 18% had BP alone, 17% had EP alone and 17% had both. Forty-seven percent of youth indicating BP also reported EP, compared to 26% of those denying BP. Endorsement of depression was associated with heavy drinking (odds ratio [OR]=2.4, p<0.001), physical fighting (OR=2.3, p<0.001), gang membership (OR=1.9, p<0.001) and weapon-carrying (OR=2.3, p<0.001). Associations between past-year suicide attempt and problem behaviors were even stronger. Youth endorsing either EP or BP were twice as likely to report food insecurity; those with problems in both domains had a 4.6-fold increased odds of food insecurity. Conclusions: Almost half of 10th graders with BP also suffer emotionally, indicating that interventions for youth with behavioral issues should address EP, and that screening for depression and suicidality should target those with BP. Adolescent mental health surveillance is an important tool for monitoring the prevalence and trends in these impairing conditions, identifying high risk groups, and optimizing prevention efforts.

Learning Areas:
Program planning
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain the rationale for surveillance and etiologic research on the co-occurrence of emotional and behavioral problems in adolescents. Compare the population burden of co-occurring and non-co-occurring emotional and behavioral problems in high-school students. Identify which behavioral problems are most strongly associated with depression and suicidality among adolescents. Describe the disproportionate burden of adolescent psychopathological comorbidity in families experiencing socioeconomic stress.

Keywords: Data/Surveillance, Co-morbid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied/worked in mental health since 1996. My masters training focused on the the epidemiology of adolescent mental health conditions. I continue to develop interest and expertise in working with large, population-based data sets through my doctoral training in epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.