Abstract
Children with externalizing behavior disorders such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) have greatly increased risk of unintentional injury, but it is unclear what mechanisms are responsible for that increased risk. This study followed 22 children participating in a summer camp for children with ADHD. Injury incidents were recorded daily and a set of primary symptoms of behavioral disorders were recorded at 15-min intervals over the course of the 6-week summer camp experience (roughly 300 h of observing each child). We predicted symptoms of ODD and CD would be more strongly related to injury incidence than symptoms of ADHD. Results from univariate Poisson regression models confirmed our prediction. Symptoms of ODD and CD—violations and intentional aggression in particular—were related to injury incidence but symptoms of ADHD were not. This finding is consistent with a growing body of evidence that oppositional, noncompliant, and aggressive behavior patterns might be primarily responsible for increased risk for injury among children with externalizing behavior disorders.
Similar content being viewed by others
References
Adickes, M. S., & Stuart, M. J. (2004). Youth football injuries. Sports Medicine, 34, 201–207.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
Brehaut, J. C., Miller, A., Raina, P., & McGrail, K. M. (2002). Childhood behavior disorders and injuries among children and youth: A population-based study. Pediatrics, 111, 262–269.
Byrne, J. M., Bawden, H. N., Beattie, T., & DeWolfe, N. A. (2003). Risk for injury in preschoolers: Relationship to attention deficit hyperactivity disorder. Child Neuropsychology, 9, 142–151.
Cameron, A. C., & Trivedi, P. K. (1998). Regression analysis of count data. Cambridge, UK: Cambridge University Press.
Davidson, L. L. (1987). Hyperactivity, antisocial behavior, and childhood injury: A critical analysis of the literature. Developmental and Behavioral Pediatrics, 8, 335–340.
Davidson, L. L., Hughes, S. J., & O’Connor, P. A. (1988). Preschool behavior problems and subsequent risk of injury. Pediatrics, 82, 644–651.
DiScala, C., Lescohier, I., Barthel, M., & Li, G. (1998). Injuries to children with attention deficit hyperactivity disorder. Pediatrics, 102, 1415–1421.
Emery, C. A., Meeuwisse, W. H., & Hartmann, S. E. (2005). Evaluation of risk factors for injury in adolescent soccer: Implementation and validation of an injury surveillance system. American Journal of Sports Medicine, 33, 1182–1891.
Epstein, S. (1983). Aggregation and beyond: Some basic issues on the prediction of behavior. Journal of Personality, 51, 360–392.
Farmer, J. E., & Peterson, L. (1995). Injury risk factors in children with attention deficit hyperactivity disorder. Health Psychology, 14, 325–332.
Junge, A., Rösch, D., Peterson, L., Graf-Baumann, T., & Dvorak, J. (2002). Prevention of soccer injuries: A prospective intervention study in youth amateur players. The American Journal of Sports Medicine, 30, 652–659.
Lam, L. T., Yang, L., Zheng, Y., Ruan, C., & Lei, Z. (2006). Attention deficit and hyperactivity disorder tendency and unintentional injury among adolescents in China. Accident Analysis and Prevention, 38, 1176–1182.
Morrongiello, B. A., Ondejko, L., & Littlejohn, A. (2004). Understanding toddlers’ in-home injuries: I. Context, correlates and determinants. Journal of Pediatric Psychology, 29, 415–431.
National Center for Injury Prevention, Control [NCIPC]. (2002). CDC Injury Research Agenda. Atlanta, GA: Centers for Disease Control and Prevention.
National Center for Injury Prevention and Control [NCIPC]. (2006). WISQARS TM (Web-based Injury Statistics Query and Reporting System). Retrieved May 29, 2006, from http://www.cdc.gov/ncipc/wisqars/.
Pelham, W.E., Greiner, A.R., & Gnagy, E.M. (1998). Children’s summer treatment program manual. Buffalo, NY: CTADD.
Rowe, R., Maughan, B., & Goodman, R. (2004). Childhood psychiatric disorder and unintentional injury: Findings from a national cohort study. Journal of Pediatric Psychology, 29, 119–130.
Rushton, J. P., Brainerd, C. J., & Pressley, M. (1983). Behavioral development and construct validity: The principle of aggregation. Psychological Bulletin, 94, 18–38.
Schwebel, D. C., & Barton, B. K. (2006). Temperament and children’s unintentional injuries. In M. Vollrath (Ed.), Handbook of personality and health (pp. 51–71). New York: Wiley.
Schwebel, D. C., Binder, S. C., & Plumert, J. M. (2002). Using an injury diary to describe the ecology of children’s daily injuries. Journal of Safety Research, 33, 301–319.
Schwebel, D. C., Hodgens, J. B., & Sterling, S. (2006). How mothers parent their children with behavior disorders: Implications for unintentional injury risk. Journal of Safety Research, 37, 167–173.
Schwebel, D. C., Speltz, M. L., Jones, K., & Bardina, P. (2002). Unintentional injury in preschool boys with and without early onset of disruptive behavior. Journal of Pediatric Psychology, 27, 727–737.
Sleet, D. A., & Bryn, S. (Eds.). (2003). Injury prevention for children and youth. American Journal of Health Education, 34(5 suppl), S1–S64.
Swensen, A., Birnbaum, H. G., Ben Hamadi, R., Greenberg, P., Cremieux, P., & Secnik, K. (2004). Incidence and costs of accidents among attention-deficit/hyperactivity disorder patients. Journal of Adolescent Health, 35, 346.e1–346.e9.
Author information
Authors and Affiliations
Corresponding author
Additional information
Thanks to Sylvie Mrug, Peter Winslett, and the other staff members of the STP camp for their cooperation.
Rights and permissions
About this article
Cite this article
Schwebel, D.C., Tavares, C.L., Lucas, E.K. et al. Unintentional Injury Risk in Children with Externalizing Behavior Disorders at Summer Camp. J Clin Psychol Med Settings 14, 145–151 (2007). https://doi.org/10.1007/s10880-007-9058-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-007-9058-7