Advertisement

Burden of Unmet Mental Health Needs in Assault-Injured Youths Presenting to the Emergency Department

  • Julia S. Anixt
    Correspondence
    Address correspondence to Julia S. Anixt, MD, Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH 45229.
    Affiliations
    Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio (Dr Anixt); Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Copeland-Linder and Dr Cheng); National Institute of Child Health and Human Development, Bethesda, Md (Dr Haynie)
    Search for articles by this author
  • Nikeea Copeland-Linder
    Affiliations
    Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio (Dr Anixt); Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Copeland-Linder and Dr Cheng); National Institute of Child Health and Human Development, Bethesda, Md (Dr Haynie)
    Search for articles by this author
  • Denise Haynie
    Affiliations
    Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio (Dr Anixt); Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Copeland-Linder and Dr Cheng); National Institute of Child Health and Human Development, Bethesda, Md (Dr Haynie)
    Search for articles by this author
  • Tina L. Cheng
    Affiliations
    Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio (Dr Anixt); Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Copeland-Linder and Dr Cheng); National Institute of Child Health and Human Development, Bethesda, Md (Dr Haynie)
    Search for articles by this author
Published:November 24, 2011DOI:https://doi.org/10.1016/j.acap.2011.10.001

      Abstract

      Objectives

      To determine if there is a gap between behavioral symptoms and previously recognized mental health conditions in youth victims of peer assault injuries and to describe gender differences in psychological symptoms.

      Methods

      A cross-sectional comparison of rates of previously diagnosed mental health conditions and clinical range behavioral symptoms as measured by the Child Behavior Checklist (CBCL) in 168 youths (range, 10–15 years old) presenting to the emergency department (ED) after an interpersonal assault injury. The Fisher exact test was used for comparisons.

      Results

      Mental health symptoms were common among assault-injured youths. More than half of the youths demonstrating clinical range symptoms on the attention problems or anxious/depressed scales of the CBCL had no prior diagnosis of these conditions. Girls were more likely than boys to exhibit clinical range aggressive behavior symptoms (odds ratio [OR], 3.61; 95% confidence interval [CI], 1.64–7.97). Aggressive behavior was associated with clinical range scores on the other problem scales of the CBCL.

      Conclusions

      After an ED visit for an assault-related injury, less than half of 10 to 15 year olds with significant symptoms of common mental conditions reported having a previously diagnosed disorder, reflecting a burden of unmet psychological needs. An ED visit for an assault injury provides an opportunity to screen for emotional/behavioral symptoms and to refer to appropriate follow-up mental health care.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Centers for Disease Control and Prevention. Injury Center: Violence Prevention. Youth Violence Facts at a Glance 2010. Available at: http://www.cdc.gov/ViolencePrevention/pdf/YV-DataSheet-a.pdf. Accessed October 10, 2010.

        • Zun L.S.
        • Rosen J.M.
        Psychosocial needs of young persons who are victims of interpersonal violence.
        Pediatr Emerg Care. 2003; 19: 15-19
        • Singer M.I.
        • Anglin T.M.
        • Song L.Y.
        • Lunghofer L.
        Adolescents’ exposure to violence and associated symptoms of psychological trauma.
        JAMA. 1995; 273: 477-482
        • McCart M.R.
        • Davies W.H.
        • Phelps L.F.
        • et al.
        Psychosocial needs of African American youth presenting to a pediatric emergency department with assault-related injuries.
        Pediatr Emerg Care. 2006; 22: 154-159
        • Song L.Y.
        • Singer M.I.
        • Anglin T.M.
        Violence exposure and emotional trauma as contributors to adolescents’ violent behaviors.
        Arch Pediatr Adolesc Med. 1998; 152: 531-536
        • Cheng T.L.
        • Schwarz D.
        • Brenner R.A.
        • et al.
        Adolescent assault injury: risk and protective factors and locations of contact for intervention.
        Pediatrics. 2003; 112: 931-938
      2. Department of Health and Human Services. Youth violence: a report of the Surgeon General; 2001. Available at: http://www.surgeongeneral.gov/library/youthviolence/toc.html. Accessed October 10, 2010.

        • Mollen C.J.
        • Fein J.A.
        • Vu T.N.
        • et al.
        Characterization of nonfatal events and injuries resulting from youth violence in patients presenting to an emergency department.
        Pediatr Emerg Care. 2003; 19: 379-384
        • Underwood M.
        Social Aggression among Girls.
        The Guilford Press, New York2003
        • Cheng T.L.
        • Haynie D.
        • Brenner R.
        • et al.
        Effectiveness of a mentor-implemented, violence prevention intervention for assault-injured youths presenting to the emergency department: results of a randomized trial.
        Pediatrics. 2008; 122: 938-946
        • Achenbach T.M.
        Manual for the Child Behavior Checklist/4-18 and 1991 Profile.
        University of Vermont Department of Psychiatry, Burlington, VT1991
        • Achenbach T.
        • Rescorla L.
        Manual for ASEBA School-Age Forms and Profiles.
        University of Vermont, Research Center for Children, Youth and Families, Burlington, VT2001
      3. Stata Statistical Software: Release 9.0 [computer program].
        StataCorp, College Station, Tex2005
      4. Adolescent assault victim needs: a review of issues and a model protocol. American Academy of Pediatrics Task Force on Adolescent Assault Victim Needs.
        Pediatrics. 1996; 98: 991-1001
        • Sims D.W.
        • Bivins B.A.
        • Obeid F.N.
        • et al.
        Urban trauma: a chronic recurrent disease.
        J Trauma. 1989; 29: 940-947
        • Pailler M.E.
        • Kassam-Adams N.
        • Datner E.M.
        • Fein J.A.
        Depression, acute stress and behavioral risk factors in violently injured adolescents.
        Gen Hosp Psychiatry. 2007; 29: 357-363
        • Purugganan O.H.
        • Stein R.E.
        • Silver E.J.
        • Benenson B.S.
        Exposure to violence and psychosocial adjustment among urban school-aged children.
        J Dev Behav Pediatr. 2003; 24: 424-430
        • McFarlane J.M.
        • Groff J.Y.
        • O’Brien J.A.
        • Watson K.
        Behaviors of children who are exposed and not exposed to intimate partner violence: an analysis of 330 black, white, and Hispanic children.
        Pediatrics. 2003; 112: e202-e207
        • Moskowitz H.
        • Griffith J.L.
        • DiScala C.
        • Sege R.D.
        Serious injuries and deaths of adolescent girls resulting from interpersonal violence: characteristics and trends from the United States, 1989–1998.
        Arch Pediatr Adolesc Med. 2001; 155: 903-908