Prevalence and gender patterns of mental health problems in German youth with experience of violence: the KiGGS study

BMC Public Health

Franz Petermann²  Robert Schlack¹ 

[1] Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Strasse 62-66, 12101 Berlin, Germany;University of Bremen, Center of Clinical Psychology and Rehabilitation, Grazer Strasse 2-6, 28334 Bremen, Germany

关键词: Representative study;    Gender;    Substance use;    Somatic problems;    Disordered eating behaviors;    ADHD;    Conduct problems;    Emotional problems;    Mental health;    Youth violence;   

Others  :  1162054
DOI  :  10.1186/1471-2458-13-628

 received in 2012-12-10, accepted in 2013-06-13,  发布年份 2013

【 摘 要 】

Background

Research examining mental health in violence-affected youth in representative samples is rare. Using data from the nationally representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) this study reports on gender-specific prevalence rates and associations of a broad range of internalizing and externalizing mental health problems: emotional problems, conduct problems, ADHD, disordered eating, somatic pain and substance use in youth variously affected by violence. While internalizing is generally more common in girls and externalizing in boys, observations of prior non-normative studies suggest reverse associations once an individual is affected by violence. The occurrence of such “gender cross-over effects” is therefore examined in a representative sample.

Methods

The sample consisted of 6,813 adolescents aged 11 to 17 from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Applying multivariate logistic regression analyses, associations between each type of violence history and mental health indicator were determined for perpetrators, victims, and perpetrating victims of youth violence. Moderating effects of gender were examined by using product term interaction.

Results

Victim status was associated primarily with internalizing problems, while perpetrators were more prone to externalizing problems. Perpetrating victims stood out with respect to the number and strength of risk associations with all investigated mental health indicators. However, the risk profiles of all violence-affected youth included both internalizing and externalizing mental health problems. Gender cross-over effects were found for girls and boys: despite lower overall prevalence, girls affected by violence were at far higher risk for conduct problems and illicit drug use; by contrast, somatic pain, although generally lower in males, was positively associated with perpetrator status and perpetrating victim status in boys. All violence-affected youth exhibited significantly higher rates of cumulative mental health problems.

Conclusions

The results highlight the importance of violence for the mental health of youth. They reveal a particular vulnerability as a function of gender. Implications for policy making, clinical practice and research are discussed.

【 授权许可】

   
2013 Schlack and Petermann; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Ford T, Goodman R, Meltzer H: The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolescent Psychiatry 2003, 42:1203-1211.
• [2]Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J: Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-a). J Am Acad Child Adolescent Psychiatry 2010, 49:980-989.
• [3]Teplin LA, Abram KM, McClelland GM, Dulcan MK, Mericle AA: Psychiatric disorders in youth in juvenile detention. Arch Gen Psychiatry 2002, 59:1133-1143.
• [4]Centers for Disease Control and Prevention: Understanding youth violence. 2012. [Fact sheet 2012] [http://www.cdc.gov/violenceprevention/pdf/yv_factsheet2012-a.pdf webcite.]
• [5]Ackard DM, Neumark-Sztainer D: Date violence and date rape among adolescents: associations with disordered eating behaviors and psychological health. Child Abuse Negl 2002, 26:455-473.
• [6]Jantzer V, Haffner J, Parzer P, Resch F: Victims of bullying at school: depression, suicidality, and self-harm in german adolescents. Kindh Entwickl 2012, 21:40-46.
• [7]Unnever JD: Bullies, aggressive victims, and victims: are they distinct groups? Aggress Behav 2005, 31:153-171.
• [8]Veenstra R, Lindenberg S, Oldehinkel AJ, De Winter AF, Verhulst FC, Ormel J: Bullying and victimization in elementary schools: a comparison of bullies, victims, bully/victims, and uninvolved preadolescents. Dev Psychol 2005, 41:672-681.
• [9]Logan-Greene PL, Nurius PS, Herting JR, Walsh E, Thompson EA: Violent victimization and perpetration: joint and distinctive implications for adolescent development. Vict Offender 2010, 5:329-353.
• [10]Schlack R, Hölling H, Petermann F: Psychosocial risk and protective factors in children and adolescents with experiences of violence. Psychol Rundsch 2009, 60:137-151.
• [11]Eisenberg N, Cumberland A, Spinrad TL, Fabes RA, Shepard SA, Reiser M, Murphy BC, Losoya SH, Guthrie IK: The relations of regulation and emotionality to children’s externalizing and internalizing problem behavior. Child Dev 2001, 72:1112-1134.
• [12]Rescorla L, Achenbach T, Ivanova MY, Dumenci L, Almqvist F, Bilenberg N, Bird H, Chen W, Dobrean A, Döpfner M, et al.: Behavioral and emotional problems reported by parents of children ages 6 to 16 in 31 societies. J Emot Behav Disord 2007, 15:130-142.
• [13]Petermann F, Jaščenoka J, Koglin U, Karpinski N, Petermann U, Kullik A: Lifetime prevalence of affective disorders in adolescence. Kindh Entwickl 2012, 21:2009-2218.
• [14]Gaylord-Harden NK, Cunningham JA, Zelencik B: Effects of exposure to community violence on internalizing symptoms: does desensitization to violence occur in African American youth? J Abnorm Child Psychol 2011, 39:711-719.
• [15]Gibson CL: An investigation of neighborhood disadvantage, low self-control, and violent victimization among youth. Youth Violence Juv Justice 2012, 10:41-63.
• [16]Siegel RS, La Greca AM, Harrison HM: Peer victimization and social anxiety in adolescents: prospective and reciprocal relationships. J Youth Adolesc 2009, 38:1096-1109.
• [17]Racine S, Root T, Klump K, Bulik C: Environmental and genetic risk factors for eating disorders: a developmental perspective. In Eating disorders in children and adolescents: a clinical handbook. Edited by Le Grange D, Lock J. New York: The Guilford Press; 2011:63-89.
• [18]Romito P, Grassi M: Does violence affect one gender more than the other? The mental health impact of violence among male and female university students. Soc Sci Med 2007, 65:1222-1234.
• [19]Striegel-Moore RH, Dohm F-A, Pike KM, Wilfley DE, Fairburn CG: Abuse, bullying, and discrimination as risk factors for binge eating disorder. Am J Psychiatry 2002, 159:1902-1907.
• [20]Petermann F, Petermann U: Adolescence. Kindh Entwickl 2012, 2012:194-197.
• [21]Piko BF, Keresztes N, Pluhar ZF: Aggressive behaviour and psychosocial health among children. Pers Individ Dif 2006, 40:885-895.
• [22]Ireland JL, Culpin V: The relationship between sleeping problems and aggression, anger and impulsivity in a population of juvenile and young offenders. J Adolesc Health 2006, 38:649-655.
• [23]Fekkes M, Pijpers FIM, Fredriks AM, Vogels T, Verloove-Vanhorik SP: Do bullied children get ill or do ill children get bullied? Pediatrics 2006, 117:1568-1574.
• [24]Moffit T, Caspi A, Rutter M, Silva PA: Sex differences in antisocial behavior: conduct disorder, delinquency, and violence in the Dunedin longitudinal study. Cambridge: Cambridge University Press; 2001.
• [25]Fang X, Massetti GM, Ouyang L, Grosse SD, Mercy JA: Attention-deficit/hyperactivity disorder, conduct disorder, and young adult intimate partner violence. Arch Gen Psychiatry 2010, 67:1179-1186.
• [26]Witthöft J, Koglin U, Petermann F: Comorbidity of aggressive behavior and ADHD. Kindh Entwickl 2010, 19:218-227.
• [27]American Psychiatric Associaton: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR 4th edn. Washington, DC: Author; 2000.
• [28]Holmberg K, Hjern A: Bullying and attention-deficit-hyperactivity disorder in 10-year-olds in a Swedish community. Dev Med Child Neurol 2008, 50:134-138.
• [29]Tharp-Taylor S, Haviland A, D’Amico EJ: Victimization from mental and physical bullying and substance use in early adolescence. Addict Behav 2009, 34:561-567.
• [30]Kuntsche E, Knibbe R, Engels R, Gmel G: Bullying and fighting among adolescents - Do drinking motives and alcohol use matter? Addict Behav 2007, 32:3131-3135.
• [31]Hankin BL, Abramson LY: Development of gender differences in depression: an elaborated cognitive vulnerability–transactional stress theory. Psychol Bull 2001, 127:773-796.
• [32]Cyranowski JM, Frank E, Young E, Shear MK: Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Arch Gen Psychiatry 2000, 57:21-27.
• [33]Jose PE, Brown I: When does the gender difference in rumination begin? Gender and age differences in the use of rumination by adolescents. J Youth Adolesc 2008, 37:180-192.
• [34]Hankin BL: Development of sex differences in depressive and co-occurring anxious symptoms during adolescence: descriptive trajectories and potential explanations in a multiwave prospective study. J Clin Child Adolesc Psychol 2009, 38:460-472.
• [35]Kahl H, Schaffrath RA, Schlaud M: Sexual maturation of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Aadolescents (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:677-685.
• [36]Deecher D, Andree TH, Sloan D, Schechter LE: From menarche to menopause: exploring the underlying biology of depression in women experiencing hormonal changes. Psychoneuroendocrinology 2008, 33:3-17.
• [37]Kercher AJ, Rapee RM, Schniering CA: Neuroticism, life events and negative thoughts in the development of depression in adolescent girls. J Abnorm Child Psychol 2009, 37:903-915.
• [38]Stoltenborgh M, Van IJzendoorn MH, Euser EM, Bakermans-Kranenburg MJ: A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat 2011, 16:79-101.
• [39]Eme R: Male life-course persistent antisocial behavior: a review of neurodevelopmental factors. Aggress Violent Behav 2009, 14:348-358.
• [40]Odgers CL, Moretti MM: Aggressive and antisocial girls: research update and challenges. Int J Forensic Ment Health 1:103-119.
• [41]Cross SE, Madson L: Models of the self: self-construals and gender. Psychol Bull 1997, 122:5-37.
• [42]Corrado R, Odgers C, Cohen I: The use of incarceration for female youth: protection for whom? Can J Criminol 2000, 42:189-206.
• [43]Vincent GM, Grisso T, Terry A, Banks S: Sex and race differences in mental health symptoms in juvenile justice: the MAYSI-2 national meta-analysis. J Am Acad Child Adolescent Psychiatry 2008, 47:282-290.
• [44]Voisin DR, Neilands TB: Community violence and health risk factors among adolescents on Chicago’s southside: does gender matter? J Adolesc Health 2010, 46:600-602.
• [45]Schiff M, McKay M: Urban youth disruptive behavioral difficulties: exploring the associations with parenting and gender. Fam Process 2003, 42:517-529.
• [46]Swanson SA, Crow SJ, Le Grange D, Swendson J, Merikangas KR: Prevalence and correlates of eating disorders in adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 2011, 68:E1-E10.
• [47]Loeber R, Keenan K: Interaction between conduct disorder and its comorbid conditions: effects of age and gender. Clin Psychol Rev 1994, 14:497-523.
• [48]Kurth B, Lange C, Kamtsiuris P, Hölling H: Health monitoring at the Robert Koch Institute. Status and perspectives. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2009, 52:557-570.
• [49]Hölling H, Schlack R, Kamtsiuris P, Butschalowsky H, Schlaud M, Kurth B: The KiGGS study. Nationwide representative longitudinal and cross-sectional study on the health of children and adolescents within the framework of health monitoring at the Robert Koch Institute. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012, 55:836-842.
• [50]Kamtsiuris P, Lange M, Rosario AS: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): sample design, response and nonresponse analysis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:547-556.
• [51]Kurth B-M, Kamtsiuris K, Hölling H, Schlaud M, Dölle R, Ellert U, Kahl H, Knopf H, Lange M, Mensink GBM, et al.: The challenge of comprehensively mapping children’s health in a nation-wide health survey. Design of the German KiGGS-study. BMC Public Health 2008, 8:196. BioMed Central Full Text
• [52]Kish L: Survey sampling. New York: John Wiley Sons Inc; 1965.
• [53]Ashpurwis und, Behrens GmbH: BIK regions: metropolitan areas, city regions, middle and low order centers - description of method of the last update 2000. Hamburg; 2001.
• [54]Cox LH: A constructive procedure for unbiased cotrolled rounding. J Am Stat Assoc 1987, 82:520-524.
• [55]Schlack R, Hölling H: Children’s and adolescent’s experiences of violence based on subjective self-reporting. First results from the German Health Interview and Examination Survey (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:819-826.
• [56]Goodman R: The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 1997, 38:581-586.
• [57]Woerner W, Becker A, Rothenberger A: Normative data and scale properties of the German parent SDQ. Eur Child Adolesc Psychiatry 2004, 13:ii3-ii10.
• [58]Morgan JF, Reid F, Lacey JH: The Scoff questionnaire: assessment of a new screening tool for eating disorders. BMJ 1999, 319:1467-1468.
• [59]Cohrs S, Schlack R, Skarupke C, Lange K, Kunz D, Szagun B: Prävalenz von Schlafstörungen bei Adoleszenten und Zusammenhänge mit dem Vorliegen protektiver Faktoren – Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). 2011. [Paper presented at the 2011 Kongress of the Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN)]
• [60]Schlack R, Hölling H, Kurth B, Huss M: The prevalence of attention-deficit-hyperactivity disorder (ADHD) among children and adolescents in Germany. Initial results from the German Health Interview and Examination Survey for Children and Adolescents KiGGS. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:827-836.
• [61]Arbeitsgemeinschaft ADHS der Kinder- und Jugendärzte e.V: ADHS bei Kindern und Jugendlichen (Aufmerksamkeits-Defizit-Hyperaktivitäts-Störung). Leitlinie der Arbeitsgemeinschaft ADHS der Kinder- und Jugendärzte e.V. Aktualisierte Fassung Januar 2007. 2007. http://www.agadhs.de/uploads/Leitlinie2009.pdf webcite
• [62]Lampert T, Thamm M: Consumption of tobacco, alcohol and drugs among adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:600-608.
• [63]Borges G, Cherpitel C, Orozco R, Bond J, Ye Y, Macdonald S, Rehm J, Poznyak V: Multicentre study of acute alcohol use and non-fatal injuries: data from the WHO collaborative study on alcohol and injuries. Bull World Health Organ [online]. 2006, 84:453-460.
• [64]Allison P: Missing data. Thousand Oaks, CA: Sage; 2001.
• [65]Jaccard J: Interaction effects in logistic regression. Thousand Oaks, CA: Sage; 2001.
• [66]Hölling H, Kurth BM, Rothenberger A, Becker A, Schlack R: Assessing psychopathological problems of children and adolescents from 3 to 17 years in a nationwide representative sample: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Eur Child Adolesc Psychiatry 2008, 17(Suppl 1):34-41.
• [67]Hölling H, Schlack R: Eating disorders in children and adolescents. First results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:794-799.
• [68]Kaltiala-Heino R, Rimpelä M, Rantanen P, Rimpelä A: Bullying at school—an indicator of adolescents at risk for mental disorders. J Adolesc 2000, 23:661-674.
• [69]Cauffman E, Lexcen FJ, Goldweber A, Shulman EP, Grisso T: Gender differences in mental health symptoms among delinquent and community youth. Youth Violence Juv Justice 2007, 5:287-307.
• [70]Pellegrini AD, Bartini M, Brooks F: School bullies, victims, and aggressive victims: factors relating to group affiliation and victimization in early adolescence. Br J Educ Psychol 1999, 91:216-224.
• [71]Nansel TR, Craig W, Overpeck MD, Saluja G, Ruan J: Cross-national consistency in the relationship between bullying behaviors and psychosocial adjustment. Arch Pediatr Adolesc Med 2004, 158:730-736.
• [72]Flannery D, Singer M, Wester K: Violence exposure, psychological trauma, and suicide risk in a community sample of dangerous adolescents. J Am Acad Child Adolescent Psychiatry 2006, 40:435-442.
• [73]Odgers CL, Moretti MM, Burnette ML, Chauhan P, Waite D, Reppucci ND: A latent variable modeling approach to identifying subtypes of serious and violent female juvenile offenders. Agress Behav 2007, 33:339-352.
• [74]Cuevas CA, Finkelhor D, Turner HA, Ormrod RK: Juvenile delinquency and victimization: a theoretical typology. J Interpers Violence 2007, 22(12):1581-1602.
• [75]Dodge KA: Translational science in action: hostile attributional style and the development of aggressive behavior problems. Dev Psychopathol 2006, 18:791-814.
• [76]Marsee MA, Weems CF, Taylor LK: Exploring the association between aggression and anxiety in youth: a look at aggressive subtypes, gender and social cognition. J Child Fam Stud 2008, 17:154-168.
• [77]Schwartz D, Proctor LJ, Chien DH: The aggressive victim of bullying. In Peer harassment in school: the plight of the vulnerable and victimized. Edited by Juvonen J, Graham S. New York: The Guilford Press; 2001:147-174.
• [78]Petermann F, Kullik A: Early emotion dysregulation: an indicator for mental disorders in childhood. Kindh Entwickl 2011, 20:186-196.
• [79]Kerig PK, Ward RM, Vanderzee KL, Moeddel MA: Posttraumatic stress as a mediator of the relationship between trauma and mental health problems among juvenile delinquents. J Youth Adolesc 2009, 38:1214-1225.
• [80]Teplin LA, Abram KM, McLelland GM, Mericle AA, Dulcan MK, Washburn JJ: Psychiatric disorders of youth in detention. Washington, D.C: U.S. Government Printing Office; 2006.
• [81]Caron C, Rutter M: Comorbidity in child psychopathology: concepts, issues and research strategies. J Child Psychol Psychiatry 1991, 32:1063-1080.
• [82]Reitz E, Deković M, Meijer A: The structure and stability of externalizing and internalizing problem behavior during early adolescence. J Youth Adolesc 2005, 34:577-588.
• [83]Perry DG, Pauletti RE: Gender and adolescent development. J Res Adolesc 2011, 21:61-74.
• [84]Yunger JL, Carver PR, Perry DG: Does gender identity influence children’s psychological well-being? Dev Psychol 2004, 40:572-582.
• [85]Carver PR, Yunger JL, Perry DG: Gender identity and adjustment in middle childhood. Sex Roles 2003, 49:95-109.
• [86]Goldweber A, Brody D, Cauffman E: Interdisciplinary perspectives on persistent female offending: a review of theory and research. In The development of persistent criminality. Edited by Savage J. Oxford: Oxford University Press; 2009:205-230.
• [87]Thornberry TP, Krohn MD: The self-report method for measuring delinquency and crime. In Criminal justice 2000. Volume 4. Measurement and analysis of crime and justice. Edited by Duffee D. Rockville: National Institute of Justice/NCJRS; 2000:33-83.
• [88]Schulevaluation F: Gewalt als soziales Problem in Schulen. Die Dresdner Studie: Untersuchungsergebnisse und Präventionsstrategien. Leske und Budrich: Opladen; 1998.
• [89]Schlack R, Ravens-Sieberer U, Petermann F: Psychological problems, protective factors and health-related quality of life in youth affected by violence: the burden of the multiply victimised. J Adolesc 2013, 36:587-601.
• [90]Patel V, Flisher AJ, Hetrick S, McGorry P: Mental health of young people: a global public-health challenge. Lancet 2007, 369:1302-1313.
• [91]Krug EG, Mercy JA, Dahlberg LL, Zwi AB: The world report on violence and health. Lancet 2002, 360:1083-1088.
• [92]Sigel EJ, Harpin SB: Primary care practitioners’ detection of youth violence involvement. Clin Pediatr 2013, 52:411-417.