title: Different treatment thresholds in non-Western children with behavioral problems.
abstract: OBJECTIVE
  First, to investigate whether non-Western children in the Netherlands are less likely to be treated for behavioral problems than Western children; second, to examine whether discrepancies in treatment status are related to differences in level of problem behavior and impairment.
  
  
  METHODS
  The study included 2,185 children of the four largest ethnic groups in the Netherlands, namely, 684 Dutch, 702 Moroccan, 434 Turkish, and 365 Surinamese children from grades three to five of elementary school. Teachers completed the Strengths and Difficulties Questionnaire and five DSM-IV items on externalizing problems. In addition, they provided information on the treatment status of the child.
  
  
  RESULTS
  Moroccan boys displayed more problem behavior, Turkish boys less problem behavior, and Surinamese boys similar rates of problem behavior compared with Dutch boys. No difference in problem behavior was found between Western and non-Western girls. Adjusted for age, level of problem behavior, and impairment, Moroccan and Turkish children and Surinamese girls were less likely to receive treatment for problem behavior.
  
  
  CONCLUSIONS
  The higher treatment thresholds of non-Western children compared with Western children in the Netherlands could not be explained by differences in level of problem behavior or impairment. Detection of behavioral problems in non-Western children should receive more attention.
authors.affiliation: Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands. b.zwirs@wkz.azu.nl
authors.forename: Barbara W C
authors.initials: BW
authors.lastname: Zwirs
authors.forename: Huibert
authors.initials: H
authors.lastname: Burger
authors.forename: Tom W J
authors.initials: TW
authors.lastname: Schulpen
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
mesh_terms: D001526:Behavioral Symptoms / Q000208:ethnology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009018:Morocco / Q000208:ethnology; D009426:Netherlands / Q000453:epidemiology / Q000208:ethnology; D016017:Odds Ratio; D012306:Risk; D013532:Suriname / Q000208:ethnology; D014421:Turkey / Q000208:ethnology