Child mental health in Jordanian orphanages: effect of placement change on behavior and caregiving

BMC Pediatrics

Rasha Al-Sharaihah¹  Kathryne B Brewer²  Rawan W Ibrahim¹  Craig S Schwalbe²  Robin E Gearing²  Michael J MacKenzie² 

[1] Columbia University Middle East Research Center – Amman, 1255 Amsterdam Ave., NY, NY, USA;Columbia University, 1255 Amsterdam Ave., NY, NY, USA

关键词: Placement disruption;    Placement change;    Goodness-of-fit;    Externalizing;    Internalizing;    Behavioral problems;    Mental health;    Institutional care;    Orphanage;   

Others  :  1177651
DOI  :  10.1186/s12887-014-0316-1

 received in 2013-12-10, accepted in 2014-12-12,  发布年份 2014

【 摘 要 】

Background

To assess the mental health and behavioral problems of children in institutional placements in Jordan to inform understanding of current needs, and to explore the effects of placement change on functioning and staff perceptions of goodness-of-fit.

Methods

An assessment was completed of 134 children between 1.5–12 years-of-age residing in Jordanian orphanages. The Child Behavior Checklist was used to assess prevalence rates of problems across externalizing and internalizing behavior and DSM-IV oriented subscales. Also included was caregiver perceived goodness-of-fit with each child, caregiving behavior, and two placement change-clock variables; an adjustment clock measuring time since last move, and an anticipation clock measuring time to next move.

Results

28% were in the clinical range for the internalizing domain on the CBCL, and 22% for the externalizing domain. The children also exhibited high levels of clinical range social problems, affective disorder, pervasive developmental disorder, and conduct problems. Internalizing problems were found to decrease with time in placement as children adjust to a prior move, whereas externalizing problems increased as the time to their next age-triggered move drew closer, highlighting the anticipatory effects of change. Both behavioral problems and the change clocks were predictive of staff perceptions of goodness-of-fit with the children under their care.

Conclusions

These findings add to the evidence demonstrating the negative effects of orphanage rearing, and highlight the importance of the association between behavioral problems and child-caregiver relationship pathways including the timing of placement disruptions and staff perceptions of goodness-of-fit.

【 授权许可】

   
2014 MacKenzie et al.; licensee BioMed Central.

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