Poster #165 - Family Stress Moderates Emotional and Behavioral Symptoms for Children in a Partial Hospital Setting

• In Event: 1-061 - Poster Session 02
  In Poster Session: PS 02 Section - Prevention and Interventions

Integrative Statement

Abstract
Objective: Mental health problems affect nearly one in five children and is a growing public health concern. Partial hospitalization programs are an increasingly utilized, multidisciplinary treatment for children with social, emotional, and behavioral needs. Although previous work suggests these programs improve children’s mental health functioning (Grizenko & Sayegh, 1990; Martin et al., 2013; Milin et al., 2000), outcomes research has been limited. Furthermore, few studies have examined moderators of outcomes to determine for who greater gains and/or change will likely occur. This study examines moderators of emotional and behavioral outcomes in children with serious mental illness, with particular focus on demographic (age, race, insurance type, and gender) and family (stressors and supports) factors. Method: The study includes 287 children ages 7-13 (M = 10.17, SD = 1.60) and their caregivers. Inclusion criteria included a minimum length of stay of five days, completion of intake assessment within a week of entering the program, and completion of assessment at the time of discharge from program. Only data from the first admission was included in analyses for children who had multiple admissions. Children completed standardized questionnaires at admission and discharge including the Behavior Assessment System for Children-2 (BASC-2) the Child Depression Inventory 2 (CDI-2), and the Screen for Child Anxiety Related Disorders (SCARED) while caregivers completed the Strengths and Difficulties Questionnaire (SDQ). Results: Results indicate improvements in children’s anxiety, depressive symptoms, psychological adjustment, and emotional symptoms over the course of treatment. Furthermore, children with private insurance reported significant decreases in depressive (F(1,171)= 27.15, p < .001) and emotional symptoms (F(1, 154)= 39.15, p <.001) compared to children with state funded insurance. Females reported sharper decreases in depressive symptoms (F(1,103)= 25.04, p<.001) compared to males (F(1, 179)= 5.56, p=.019). When examining family factors, children in families with no stressors in the past month demonstrated sharper declines in depressive symptoms (F(1,136)= 34.27, p < .001) compared to children in families with one or more stressors in the past month (F(1,140)= 6.67, p=.011). This interaction effect remained significant in sensitivity analyses controlling for insurance type and gender. Finally, children in families with no stressors occurring in the past month reported sharper decreases in emotional symptoms (F(1,116)= 36.92, p <.001) compared to children in families with one or more stressors in the past month (F(1, 120)= 12.44, p= .001). Family support did not moderate these outcomes. Conclusion: Findings suggest partial hospitalization programs may be effective in treating children’s emotional and behavioral problems over the course of treatment. Furthermore, this study suggests family stressors is an important factor to consider and emphasize in treatment, and identifying families who endorse recent stressors and targeting these stressors early in treatment may be an important initial step.

Authors

• Mona Yaptangco, Brown University
  Presenting Author

• Teresa M Preddy, Bradley Hospital/Brown University
  Non-Presenting Author

• Katharine E Musella, Bradley Hospital
  Non-Presenting Author

• Stephanie H. Parade, Bradley Research Center/Brown University
  Non-Presenting Author

• Stephanie Umaschi, Bradley Research Center/Brown University
  Non-Presenting Author

• Anne Walters, Bradley Hospital/Brown University
  Non-Presenting Author