title: Child mental health in Jordanian orphanages: effect of placement change on behavior and caregiving.
abstract: 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.
authors.affiliation: Columbia University, 1255 Amsterdam Ave., NY, NY, USA. mm3038@columbia.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: MacKenzie
authors.affiliation: Columbia University, 1255 Amsterdam Ave., NY, NY, USA. rg2372@columbia.edu.
authors.forename: Robin E
authors.initials: RE
authors.lastname: Gearing
authors.affiliation: Columbia University, 1255 Amsterdam Ave., NY, NY, USA. css2109@columbia.edu.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Schwalbe
authors.affiliation: Columbia University Middle East Research Center - Amman, 1255 Amsterdam Ave., NY, NY, USA. ri2184@columbia.edu.
authors.forename: Rawan W
authors.initials: RW
authors.lastname: Ibrahim
authors.affiliation: Columbia University, 1255 Amsterdam Ave., NY, NY, USA. kbb2110@columbia.edu.
authors.forename: Kathryne B
authors.initials: KB
authors.lastname: Brewer
authors.affiliation: Columbia University Middle East Research Center - Amman, 1255 Amsterdam Ave., NY, NY, USA. rs3163@columbia.edu.
authors.forename: Rasha
authors.initials: R
authors.lastname: Al-Sharaihah
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology*; D054540:Child, Orphaned / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D019372:Orphanages; D015995:Prevalence