HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Costello, E J Articles by Erkanli, A Search for Related Content PubMed PubMed Citation Articles by Costello, E J Articles by Erkanli, A

Psychiatric disorders among American Indian and white youth in Appalachia: the Great Smoky Mountains Study.

E J Costello, E M Farmer, A Angold, B J Burns and A Erkanli

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.

OBJECTIVES: This study examined prevalence of psychiatric disorders, social and family risk factors for disorders, and met and unmet needs for mental health care among Appalachian youth. METHODS: All 9-, 11-, and 13-year-old American Indian children in an 11-county area of the southern Appalachians were recruited, together with a representative sample of the surrounding population of White children. RESULTS: Three-month prevalences of psychiatric disorders were similar (American Indian, 16.7%; White, 19.2%). Substance use was more common in American Indian children (9.0% vs 3.8% in White children), as was comorbidity of substance use and psychiatric disorder (2.5% vs 0.9%). American Indian poverty, family adversity (e.g., parental unemployment, welfare dependency), and family deviance (parental violence, substance abuse, and crime) rates were higher, but the rate of family mental illness, excluding substance abuse, was lower. Child psychiatric disorder and mental health service use were associated with family mental illness in both ethnic groups but were associated with poverty and family deviance only in White children. Despite lower financial barriers, American Indian children used fewer mental health services. CONCLUSIONS: This study suggests that poverty and crime play different roles in different communities in the etiology of child psychiatric disorder.

This article has been cited by other articles:

				W. E. Copeland, G. Keeler, A. Angold, and E. J. Costello Traumatic Events and Posttraumatic Stress in Childhood Arch Gen Psychiatry, May 1, 2007; 64(5): 577 - 584. [Abstract] [Full Text] [PDF]

				G. L. Canivez and K. J. Bohan Adjustment Scales for Children and Adolescents and Native American Indians: Factorial Validity Generalization for Yavapai Apache Youths Journal of Psychoeducational Assessment, December 1, 2006; 24(4): 329 - 341. [Abstract] [PDF]

				G. D. Morris, P. B. Wood, and R. G. Dunaway Self-Control, Native Traditionalism, and Native American Substance Use: Testing the Cultural Invariance of a General Theory of Crime Crime Delinquency, October 1, 2006; 52(4): 572 - 598. [Abstract] [PDF]

				D. L. Foley, D. B. Goldston, E. J. Costello, and A. Angold Proximal psychiatric risk factors for suicidality in youth: the great smoky mountains study. Arch Gen Psychiatry, September 1, 2006; 63(9): 1017 - 1024. [Abstract] [Full Text] [PDF]

				A. R. Stiffman, S. Freedenthal, P. Dore, E. Ostmann, V. Osborne, and H. Silmere The Role of Providers in Mental Health Services Offered to American-Indian Youths Psychiatr Serv, August 1, 2006; 57(8): 1185 - 1191. [Abstract] [Full Text] [PDF]

				S. P. Cuffe, C. G. Moore, and R. E. McKeown Prevalence and Correlates of ADHD Symptoms in the National Health Interview Survey J Atten Disord, November 1, 2005; 9(2): 392 - 401. [Abstract] [PDF]

				J. Beals, S. M. Manson, N. R. Whitesell, P. Spicer, D. K. Novins, C. M. Mitchell, and for the AI-SUPERPFP Team Prevalence of DSM-IV Disorders and Attendant Help-Seeking in 2 American Indian Reservation Populations Arch Gen Psychiatry, January 1, 2005; 62(1): 99 - 108. [Abstract] [Full Text] [PDF]

				S. A. Stansfeld, M. M. Haines, J. A. Head, K. Bhui, R. Viner, S. J. C. Taylor, S. Hillier, E. Klineberg, and R. Booy Ethnicity, social deprivation and psychological distress in adolescents: School-based epidemiological study in east London The British Journal of Psychiatry, September 1, 2004; 185(3): 233 - 238. [Abstract] [Full Text] [PDF]

				D. A. Goebert, C. K. Bell, E. S. Hishinuma, L. B. Nahulu, R. C. Johnson, J. Foster, B. S. Carlton, J. F. Mcdermott Jr, J. Y. Chang, and N. N. Andrade Influence of Family Adversity on School-Related Behavioural Problems among Multi-Ethnic High School Students School Psychology International, May 1, 2004; 25(2): 193 - 206. [Abstract] [PDF]

				B. Duran, M. Sanders, B. Skipper, H. Waitzkin, L. H. Malcoe, S. Paine, and J. Yager Prevalence and Correlates of Mental Disorders Among Native American Women in Primary Care Am J Public Health, January 1, 2004; 94(1): 71 - 77. [Abstract] [Full Text]

				G. Canino, P. E. Shrout, M. Rubio-Stipec, H. R. Bird, M. Bravo, R. Ramirez, L. Chavez, M. Alegria, J. J. Bauermeister, A. Hohmann, et al. The DSM-IV Rates of Child and Adolescent Disorders in Puerto Rico: Prevalence, Correlates, Service Use, and the Effects of Impairment Arch Gen Psychiatry, January 1, 2004; 61(1): 85 - 93. [Abstract] [Full Text] [PDF]

				D. P. Jutte, A. Burgos, F. Mendoza, C. B. Ford, and L. C. Huffman Use of the Pediatric Symptom Checklist in a Low-Income, Mexican American Population Arch Pediatr Adolesc Med, December 1, 2003; 157(12): 1169 - 1176. [Abstract] [Full Text] [PDF]

				E. J. Costello, S. Mustillo, A. Erkanli, G. Keeler, and A. Angold Prevalence and Development of Psychiatric Disorders in Childhood and Adolescence Arch Gen Psychiatry, August 1, 2003; 60(8): 837 - 844. [Abstract] [Full Text] [PDF]

				A. Angold, A. Erkanli, E. M. Z. Farmer, J. A. Fairbank, B. J. Burns, G. Keeler, and E. J. Costello Psychiatric Disorder, Impairment, and Service Use in Rural African American and White Youth Arch Gen Psychiatry, October 1, 2002; 59(10): 893 - 901. [Abstract] [Full Text] [PDF]

				E. J. Costello, G. P. Keeler, and A. Angold Poverty, Race/Ethnicity, and Psychiatric Disorder: A Study of Rural Children Am J Public Health, September 1, 2001; 91(9): 1494 - 1498. [Abstract] [Full Text] [PDF]

				S. M. Horwitz, K. Hoagwood, A. R. Stiffman, T. Summerfeld, J. R. Weisz, E. J. Costello, K. Rost, D. L. Bean, L. Cottler, P. J. Leaf, et al. Reliability of the Services Assessment for Children and Adolescents Psychiatr Serv, August 1, 2001; 52(8): 1088 - 1094. [Abstract] [Full Text] [PDF]

				D. K. Novins, J. Beals, W. H. Sack, and S. M. Manson Unmet Needs for Substance Abuse and Mental Health Services Among Northern Plains American Indian Adolescents Psychiatr Serv, August 1, 2000; 51(8): 1045 - 1047. [Abstract] [Full Text] [PDF]

				D. K. Novins, C. M. Fleming, J. Beals, and S. M. Manson Commentary: Quality of Alcohol, Drug, and Mental Health Services for American Indian Children and Adolescents American Journal of Medical Quality, July 1, 2000; 15(4): 148 - 156. [Abstract] [PDF]