title: Change in children's emotional and behavioural problems over a one-year period: Associations with parental problem recognition and service use.
abstract: Although children with emotional or behavioural problems are at increased risk of future problems, knowledge of factors associated with persistence and change in child problems, once these problems exist, is limited. Using repeated measures analyses of variance, the present study investigated the association of parental problem recognition, professional and informal service use, and sociodemographic factors with change in child problems over a one-year period, in a sample of 360 children and adolescents with emotional and behavioural problems. Higher overall problem levels were found in children (aged 4-11 years at baseline) versus adolescents (aged 12-17 years), in boys, and in children with less educated parents, which indicates the need to address preventive actions at these groups. Although rates of service use were low, children who had been in contact with general practitioners or mental health services had higher overall problem levels, suggesting that children who need it most end up receiving professional care. Although child emotional and behavioural problems decreased significantly over time, this change was not associated with utilisation of professional or informal services. Our findings imply the need for methodologically sound research into the effectiveness of professional and informal services for child emotional and behavioural problems.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands. M.Zwaanswijk@nivel.nl
authors.forename: Marieke
authors.initials: M
authors.lastname: Zwaanswijk
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Verhaak
authors.forename: Jan
authors.initials: J
authors.lastname: van der Ende
authors.forename: Jozien M
authors.initials: JM
authors.lastname: Bensing
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D000342:Affective Symptoms / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000523:psychology; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009426:Netherlands; D015588:Observer Variation; D010290:Parents / Q000193:education / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D021641:Recognition, Psychology; D012008:Recurrence