Emotional and Behavioral Problems and Their Underlying Risk Factors Among Children in New South Wales, Australia

Abstract

Objective: Emotional and behavioral problems during childhood and adolescence add stress to any family and are a common challenge that parents, caregivers, and teachers face. Studies in this regard are limited in Australia. This study estimated the prevalence of emotional and behavioral problems among Australian children and examined a number of associated risk factors, including unhealthy family functioning. Method: The current study utilized data from a multistage stratified continuous survey conducted by the New South Wales (NSW) Ministry of Health, during 2005-8. A computer-assisted telephone interviewing method (CATI) was employed. Among other data items, the surveys collected information on demographics, family functioning measured by the General Functioning Scale [1], and emotional and behavioral problems measured by the Strengths and Difficulties Questionnaire (SDQ) [2, 3]. Children aged 4-15 years (n = 7,210) from the surveys were included in this study. The SAS procedures SURVEYFREQ and SURVEYLOGISTIC were used for the analyses. Results: Emotional problems (12.1 percent), hyperactivity-inattention (11.1 percent), and conduct problems (9.6 percent) were the most prevalent, followed by peer problems (8.6 percent). Overall, 7.6 percent of the children were estimated to be at risk of developing clinically significant emotional and behavioral problems. After adjusting for several major demographic factors, unhealthy family functioning stood out as significantly associated with increased risks for emotional problems (odds ratio [OR] = 2.53; 95 percent confidence interval [CI] = 1.36-4.69), conduct problems (OR = 3.83; 95 percent CI = 1.88-7.84), peer problems (OR = 6.26; 95 percent CI = 4.43-11.42), and the overall risk of developing clinically significant emotional and behavioral problems (OR = 5.06; 95 percent CI = 2.42-10.58). Other demographic risk factors were also identified. Conclusions: Early interventions, services and support need to focus on children from unhealthy family functioning and certain demographic backgrounds.