title: Is developmental and behavioral pediatrics training related to perceived responsibility for treating mental health problems?
abstract: OBJECTIVE
  The aim of this study was to investigate training in developmental and behavioral pediatrics (DBP) for graduating residents, their competencies in diagnosing and treating child mental health (MH) problems, and whether the amount of DBP training and/or perceived competencies are associated with perceived responsibility for treating 3 MH problems.
  
  
  METHODS
  Data were collected from 636 residents who completed the American Academy of Pediatrics's 2007 Graduating Residents Survey. The survey included questions on training and self-rated competencies in multiple MH skill areas and perceived responsibility for identifying and treating/managing children's MH problems. Weighted multivariable logistic regression analyses examined associations between training, competencies, and perceived responsibility for treating/managing attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression.
  
  
  RESULTS
  Ninety percent of respondents completed a DBP rotation, with 86% reporting >3 to 4 weeks of training. Duration of DBP rotation was related to training and perceived competencies in MH skill areas, and nearly all residents who reported high competencies were trained in those skill areas. However, <50% reported their competencies as "very good" or "excellent." Residents with training and high competency in dosing with medications were most likely to agree that pediatricians should be responsible for treating/managing ADHD, anxiety, and depression.
  
  
  CONCLUSIONS
  DBP training is highly associated with self-rated MH competencies, and highly assessed competencies are related to perceived responsibility for treating/managing common MH problems; yet 14% of graduating residents have <3 to 4 weeks of DBP training. These results argue for providing more high-quality educational experience with proven effectiveness to produce confident pediatricians who will be more responsive to identifying and treating MH problems of their patients.
authors.affiliation: Department of Pediatrics and Stanford Health Policy, 117 Encina Commons, Stanford University, Stanford, California 94305, USA. sarah.horwitz@stanford.edu
authors.forename: Sarah McCue
authors.initials: SM
authors.lastname: Horwitz
authors.forename: Gretchen
authors.initials: G
authors.lastname: Caspary
authors.forename: Amy
authors.initials: A
authors.lastname: Storfer-Isser
authors.forename: Manpreet
authors.initials: M
authors.lastname: Singh
authors.forename: Wanda
authors.initials: W
authors.lastname: Fremont
authors.forename: Mana
authors.initials: M
authors.lastname: Golzari
authors.forename: Ruth E K
authors.initials: RE
authors.lastname: Stein
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001524:Behavioral Medicine / Q000193:education*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy*; D010372:Pediatrics / Q000193:education*; D010819:Physician's Role; D002666:Psychology, Child / Q000193:education*