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Mental health of adolescents: variations by borderline intellectual functioning and disability

Abstract

Adolescence is a period of elevated stress for many young people, and it is possible that the challenges of adolescence are different for vulnerable groups. We aimed to document the depressive and anxiety symptoms, emotional–behavioural difficulties and suicidal/self-harming behaviours among adolescents with borderline intellectual functioning (BIF) or a disability, compared to those with neither disability nor BIF. Data were drawn from the nationally representative Longitudinal Study of Australian Children. Participants were 2950 adolescents with complete data for waves 3–6 (years 2008–2014), aged 14–15 years in 2014. Anxiety and depression symptoms and self-harming/suicidal thought/behaviours were self-reported. Emotional–behavioural difficulties items came from the Strengths and Difficulties Questionnaire, and were parent-, and adolescent-reported. Results of logistic regression analyses indicate that the emotional–behavioural difficulties of adolescents with either a disability or BIF, were worse than for those with neither disability nor BIF. While adolescents with a disability reported more anxiety symptoms, no clear associations were observed for self-harming/suicidal thoughts/behaviours or depressive symptoms for those with either BIF or a disability. Adolescents with BIF or a disability are at higher risk of poor mental health than those with neither disability nor BIF, and it is vital that factors contributing to these differences are identified in order to reduce these mental health inequalities.

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References

  1. 1.

    Patton GC, Sawyer SM, Santelli JS et al (2016) Our future: a lancet commission on adolescent health and wellbeing. Lancet 387:2423–2478

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Patel V, Flisher AJ, Hetrick S et al (2007) Mental health of young people: a global public-health challenge. Lancet 369:1302–1313

    Article  PubMed  Google Scholar 

  3. 3.

    Gore FM, Bloem PJN, Patton GC et al (2011) Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet 377:2093–2102

    Article  PubMed  Google Scholar 

  4. 4.

    United Nations Children’s Fund (2011) The State of the World’s Children 2011: adolescence—an age of opportunity. United Nations Children's Fund, New York

    Book  Google Scholar 

  5. 5.

    Pine DS, Cohen P, Brook J (2001) Adolescent fears as predictors of depression. Biol Psychiatry 50:721–724

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    World Health Organization (2014) Health for the world’s adolescents: a second chance in the second decade. World Health Organization, WHO, Geneva

    Google Scholar 

  7. 7.

    Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136

    Article  CAS  Google Scholar 

  8. 8.

    Shakespeare T (2014) Disability rights and wrongs revisited, 2nd edn. Routledge, Abingdon

    Google Scholar 

  9. 9.

    Suris JC, Michaud PA, Viner R (2004) The adolescent with a chronic condition. Part I: developmental issues. Arch Dis Child 89:938–942

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Michaud P-A, Suris JC, Viner R (2007) The adolescent with a chronic condition: epidemiology, developmental issues and health care provision. In WHO discussion papers on adolescence. World Health Organization, Geneva

    Google Scholar 

  11. 11.

    Australian Bureau of Statistics (2015) 4430.0-disability, ageing and carers, Australian Bureau of Statistics, Canberra

    Google Scholar 

  12. 12.

    Peltopuro M, Ahonen T, Kaartinen J et al (2014) Borderline intellectual functioning: a systematic literature review. Intellect Dev Disabil 52:419–443

    Article  PubMed  Google Scholar 

  13. 13.

    Emerson E, Hatton C (2007) Mental health of children and adolescents with intellectual disabilities in Britain. Br J Psychiatry 191:493–499

    Article  PubMed  Google Scholar 

  14. 14.

    Emerson E, Einfeld S, Stancliffe RJ (2009) The mental health of young children with intellectual disabilities or borderline intellectual functioning. Soc Psychiatry Psychiatr Epidemiol 45:579–587

    Article  PubMed  Google Scholar 

  15. 15.

    Hawton K, Saunders KEA, O’Connor RC (2012) Self-harm and suicide in adolescents. Lancet 379:2373–2382

    Article  Google Scholar 

  16. 16.

    World Health Organisation (2017) Global accelerated action for the health of adolescents (AA-HA!) Guidance to support country implementation. World Health Organization, Geneva

    Google Scholar 

  17. 17.

    Nock MK (2010) Self-injury. Annu Rev Clin Psychol 6:339–363

    Article  PubMed  Google Scholar 

  18. 18.

    Takahashi Y (2001) Depression and suicide. Jpn Med Assoc J 44:359–363

    Google Scholar 

  19. 19.

    Zisook S, Rush AJ, Lesser I et al (2007) Preadult onset vs. adult onset of major depressive disorder: a replication study. Acta Psychiatr Scand 115:196–205

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Barnes AJ, Eisenberg ME, Resnick MD (2010) Suicide and self-injury among children and youth with chronic health conditions. Pediatrics 125:889–895

    Article  PubMed  Google Scholar 

  21. 21.

    Van Roy B, Groholt B, Heyerdahl S et al (2010) Understanding discrepancies in parent-child reporting of emotional and behavioural problems: effects of relational and socio-demographic factors. BMC Psychiatry 10:1–12

    Article  Google Scholar 

  22. 22.

    Becker A, Hagenberg N, Roessner V et al (2004) Evaluation of the self-reported SDQ in a clinical setting: do self-reports tell us more than ratings by adult informants? Eur Child Adolesc Psychiatry Suppl 13:17–24

    Article  Google Scholar 

  23. 23.

    Soloff C, Lawrence D, Johnstone R (2005) Sample design: LSAC technical paper, no. 1, Melbourne

  24. 24.

    Sanson A, Misson S (2005) Summarising children’s wellbeing: the LSAC Outcome Index. Australian Institute of Family Studies, Melbourne

    Google Scholar 

  25. 25.

    Rothman S (2004) Peabody picture vocabulary test: LSAC Australian short-form. Australian Council for Educational Research, Melbourne

    Google Scholar 

  26. 26.

    Misson S, Sanson A, Berthelsen D et al. (2011) Tracking children’s development over time: the longitudinal study of Australian children outcome indices, waves 2 and 3. Australian Institute of Family Studies, Melbourne

    Google Scholar 

  27. 27.

    Williams PE, Wieiss LG, Rolfhus E (2003) WISC-IV technical report #1: theoretical model and test blueprint. The Psychological Corporation, San Antonio, Texas

    Google Scholar 

  28. 28.

    National Center for Education Statistics (2004) User’s manual for the ECLS-K third grade public-use data files and electronic code book. US Department of Education, Institute of Education Sciences, Washington DC

    Google Scholar 

  29. 29.

    Klasen H, Woerner W, Wolke D et al (2000) Comparing the German versions of the Strengths and Difficulties Questionnaire (SDQ-Deu) and the Child Behavior Checklist. Eur Child Adolesc Psychiatry 9:271–276

    Article  CAS  PubMed  Google Scholar 

  30. 30.

    Emerson E (2005) Use of the Strengths and Difficulties Questionnaire to assess the mental health needs of children and adolescents with intellectual disabilities. J Intellect Dev Disabil 30:14–23

    Article  Google Scholar 

  31. 31.

    Goodman R, Scott S (1999) Comparing the Strengths and Difficulties Questionnaire and the child behavior checklist: is small beautiful? J Abnorm Child Psychol 27:17–24

    Article  CAS  PubMed  Google Scholar 

  32. 32.

    Mellor D (2005) Normative data for the Strengths and Difficulties Questionnaire in Australia. Aust Psychol 40:215–222

    Article  Google Scholar 

  33. 33.

    Angold A, Costello EJ, Messer SC et al (1995) Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Methods Psychiatr Res 5:237–249

    Google Scholar 

  34. 34.

    Ford R, King T, Priest N et al (2017) Bullying and mental health and suicidal behaviour among 14- to 15-year-olds in a representative sample of Australian children. Aust N Z J Psychiatry 51:897–908

    Article  PubMed  Google Scholar 

  35. 35.

    Spence SH (1998) A measure of anxiety symptoms among children. Behav Res Ther 36:545–566

    Article  CAS  PubMed  Google Scholar 

  36. 36.

    Thapar A, Mcguffin P (1998) Validity of the shortened Mood and Feelings Questionnaire in a community sample of children and adolescents: a preliminary research note. Psychiatry Res 81:259268

    Article  Google Scholar 

  37. 37.

    Thabrew H, Stasiak K, Bavin L-M et al (2018) Validation of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) in New Zealand help-seeking adolescents. Int J Methods Psychiatr Res 27:e1610

    Article  PubMed  Google Scholar 

  38. 38.

    Australian Bureau of Statistics (2016) Socio-Economic Indexes for Areas (SEIFA): Technical Paper # 2033.0.55.001. Australian Bureau of Statistics, Canberra

    Google Scholar 

  39. 39.

    Priest N, King T, Bécares L et al (2016) Bullying victimization and racial discrimination among Australian children. Am J Public Health 106:1882–1884

    Article  PubMed  PubMed Central  Google Scholar 

  40. 40.

    Young R, Johnson D (2013) Methods for handling missing secondary respondent data. J Marriage Fam 75:221–234

    Article  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Allison PD (2001) Missing data. Sage Publications, Thousand Oaks

    Google Scholar 

  42. 42.

    Norton A, Monahan K (2015) Growing up in Australia: the longitudinal study of Australian children (LSAC) technical paper no. 15 wave 6 weighting and non-response. Australian Bureau of Statistics, Canberra

    Google Scholar 

  43. 43.

    StataCorp LP (2013) Stata base reference manual release 13. Stata Press, College Station, Texas

    Google Scholar 

  44. 44.

    Kaptein S, Jansen DEMC, Vogels AGC et al (2008) Mental health problems in children with intellectual disability: use of the Strengths and Difficulties Questionnaire. J Intellect Disabil Res 52:125–131

    CAS  PubMed  Google Scholar 

  45. 45.

    Hysing M, Elgen I, Gillberg C et al (2007) Chronic physical illness and mental health in children. Results from a large-scale population study. J Child Psychol Psychiatry Allied Discipl 48:785–792

    Article  Google Scholar 

  46. 46.

    Achenbach TM, McConaughy SH, Howell CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101:213–232

    Article  CAS  PubMed  Google Scholar 

  47. 47.

    Van Der Meer M, Dixon A, Rose D (2008) Parent and child agreement on reports of problem behaviour obtained from a screening questionnaire, the SDQ. Eur Child Adolesc Psychiatry 17:491–497

    Article  PubMed  Google Scholar 

  48. 48.

    Karver MS (2006) Determinants of multiple informant agreement on child and adolescent behavior. J Abnorm Child Psychol 34:251–262

    Article  PubMed  Google Scholar 

  49. 49.

    Stone LL, Otten R, Engels RCME et al (2010) Psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire for 4- to 12-year-olds: a review. Clin Child Fam Psychol Rev 13:254–274

    Article  PubMed  PubMed Central  Google Scholar 

  50. 50.

    Garber J (2006) Depression in children and adolescents. Linking risk research and prevention. Am J Prev Med 31:104–125

    Article  Google Scholar 

  51. 51.

    King T, Aitken Z, Milner A et al. (2018) To what extent is the association between disability and mental health in adolescents mediated by bullying? A causal mediation analysis. Int J Epidemiol 47:1402–1413

    Article  PubMed  Google Scholar 

  52. 52.

    Emerson E, Felce D, Stancliffe RJ (2013) Issues concerning self-report data and population-based data sets involving people with intellectual disabilities. Intellect Dev Disabil 51:333–348

    Article  PubMed  Google Scholar 

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Acknowledgements

This paper uses unit record data from Growing Up in Australia, the Longitudinal Study of Australian Children. The study is conducted in partnership between the Department of Social Services (DSS), the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). The findings and views reported in this paper are those of the authors and should not be attributed to DSS, AIFS or the ABS. We thank the children and adolescents, parents and carers, and teachers who participated in the study.

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Correspondence to Tania L. King.

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None to declare.

Financial support

This study was funded by a Disability Research Initiative Grant from the University of Melbourne, and an NHMRC Centre of Research Excellence in Disability and Health Grant (APP1116385).

Ethical standards

The LSAC study has ethics approval from the Australian Institute of Family Studies Ethics Committee. The Ethics Committee is registered with the Australian Health Ethics Committee, a subcommittee of the National Health and Medical Research Council (NHMRC). Written informed consent was obtained from the caregiver on behalf of each of the study children.

Availability of data and materials

Data used in this study are not available for sharing due to ethical and data management requirements. The researchers welcome potential collaborations.

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King, T.L., Milner, A., Aitken, Z. et al. Mental health of adolescents: variations by borderline intellectual functioning and disability. Eur Child Adolesc Psychiatry 28, 1231–1240 (2019). https://doi.org/10.1007/s00787-019-01278-9

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Keywords

  • Adolescence
  • Emotional–behavioural difficulties
  • Mental health
  • Suicide
  • Self-harm
  • Borderline intellectual functioning
  • Disability