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Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States

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Abstract

The Project to Learn About Youth-Mental Health (PLAY–MH; 2014–2018) is a school-based, two-stage study designed to estimate the prevalence of selected mental disorders among K-12 students in four U.S.-based sites (Colorado, Florida, Ohio, and South Carolina). In Stage 1, teachers completed validated screeners to determine student risk status for externalizing or internalizing problems or tics; the percentage of students identified as being at high risk ranged from 17.8% to 34.4%. In Stage 2, parents completed a structured diagnostic interview to determine whether their child met criteria for fourteen externalizing or internalizing disorders; weighted prevalence estimates of meeting criteria for any disorder were similar in three sites (14.8%–17.8%) and higher in Ohio (33.3%). PLAY–MH produced point-in-time estimates of mental disorders in K-12 students, which may be used to supplement estimates from other modes of mental disorder surveillance and inform mental health screening and healthcare and educational services.

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Notes

  1. The prevalence of tic disorders (due to use of a newly developed assessment tool to identify school-aged children and adolescents who meet diagnostic criteria for tic disorders), co-occurrence of disorders, and associated treatment will be reported in separate upcoming manuscripts.

  2. Although at the time of the study, the DSM-IV-TR was published, the DISC assessment tool was based on DSM-IV criteria rather than DSM-IV-TR. The disorders included in this study did not change between versions.

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Acknowledgements

The manuscript’s co-authors would like to acknowledge the contributions of the study’s co-investigators and senior-level collaborators to help guide the study design and research plans (Bethany Bell, Emma Blackmore, James Hardin, Eloise Kaizar, Joshua Mann, Eric Moody, Steven Rosenberg, Robert Valois, and Susanna Visser), the site project teams for their efforts to coordinate data collection and conduct data management (W. Joshua Bradley, Kaitlynn Burgess, Meaghan Flynn, Rebecca Glassman, Kristina Hightshoe, Sarah Hoover, Rachel Partin, Alyssa Poskarbiewicz, Nuri Reyes, Gina Sacchetti, Madeleine E. Schwartz, and E. Rebekah Siceloff), and student interns for providing background research assistance (Allison Badgley, Bradley Firchow, Corey Jones, Darielle Oliver, and Amanda Vasi). We would also like to acknowledge the contributions of the study interviewers, staff members from the participating school districts, and the families who participated in the study. A preliminary version of this study was presented at the 65th annual meeting of the American Academy of Child and Adolescent Psychiatry in Seattle, WA, USA on October 24, 2018.

Funding

This study was supported by the Disability Research and Dissemination Center (DRDC) cooperative agreement U01DD001007, which was funded by the Centers for Disease Control and Prevention (CDC).

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Authors and Affiliations

  1. Division of Human Development and Disability, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-4, Atlanta, GA, 30341-3717, USA

    Melissa L. Danielson, Rebecca H. Bitsko, Joseph R. Holbrook, Sana N. Charania & Angelika H. Claussen

  2. Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA

    Sana N. Charania

  3. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Robert E. McKeown

  4. Department of Psychiatry, University of Florida College of Medicine–Jacksonville, Jacksonville, FL, USA

    Steven P. Cuffe

  5. Department of Psychology, Ohio University, Athens, OH, USA

    Julie Sarno Owens & Steven W. Evans

  6. Department of Pediatrics and Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA

    Lorraine Kubicek

  7. Department of Psychology, University of South Carolina, Columbia, SC, USA

    Kate Flory

Authors
  1. Melissa L. Danielson
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  2. Rebecca H. Bitsko
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  4. Sana N. Charania
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  5. Angelika H. Claussen
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  6. Robert E. McKeown
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  9. Steven W. Evans
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  11. Kate Flory
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Corresponding author

Correspondence to Melissa L. Danielson.

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Conflict of Interest

Dr. Cuffe has received funding from Alkermes, Boehringer Ingelheim, and Ostuka America Pharmaceutical, Inc. Dr. Owens has received funding from the Institute of Education Sciences. Dr. Evans has received funding from Institute of Education Sciences, National Institute of Mental Health, and Patient Center Outcomes Research Initiative. Dr. Kubicek has received funding from Substance Abuse and Mental Health Services Administration and Colorado Clinical and Translational Sciences Institute. All other authors declare they have no conflict of interest.

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Danielson, M.L., Bitsko, R.H., Holbrook, J.R. et al. Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States. Child Psychiatry Hum Dev 52, 500–514 (2021). https://doi.org/10.1007/s10578-020-01027-z

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