Emotional and Behavioral Problems in Children Living With Addicted Family Members: Prevention Challenges in an Underprivileged Suburban Community

Vilela, Thaís dos Reis; Silva, Rebeca de Souza e; Grandi, Camila Garcia de; Rocha, Marina Monzani da; Figlie, Neliana Buzi

doi:10.1590/1982-43272664201610

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Articles • Paidéia (Ribeirão Preto) 26 (64) • May-Aug 2016 • https://doi.org/10.1590/1982-43272664201610 copy

Emotional and Behavioral Problems in Children Living With Addicted Family Members: Prevention Challenges in an Underprivileged Suburban Community^* * Article derived from the third author master's thesis under the supervision of the fifth author, defended in 2012, in the Graduate Program in Psychiatry and Medical Psychology at the Universidade Federal de São Paulo.

Problemas Emocionais e Comportamentais de Crianças que Convivem com Familiares Dependentes Químicos: Desafios de Prevenção em uma Comunidade Suburbana Desfavorecida

Problemas Emocionales y de Comportamiento en Niños que Viven con Familiares Adictos: Desafios de Prevención en una Comunidad Suburbana Desfavorecida

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Children living with substance abusers are more likely to experience negative outcomes. Our goal was to compare caregivers' reports on the Child Behavior Checklist (CBCL) and a socioeconomic and risk form of psychological aspects of children exposed to substance abuse assisted versus not assisted by a preventive intervention program in an underprivileged community. This observational intervention study was conducted with 66 caregivers of children who attended the program and 35 caregivers of children from the same community who did not attend. Ages ranged between six and 11 years old. Chi-square and logistic regression tests indicate that children exposed to substance abusers have more mental health problems than the general population and those who did not participate in the preventive intervention program presented worse outcomes, with higher rates of behavioral/emotional problems and exposure to risk situations. Results suggest that preventive actions might be helpful to promote the mental health of children at risk, validating the need for public policies and services.

Keywords
substance-related disorders; child behavior checklist; mental health; risk factors; drug abuse prevention

	Intervention Group (n = 66)		Control Group (n = 35)		Total (n = 101)		p
	N	%	n	%	n	%	p
Gender							.929
Female	27	40.9	14	40.0	41	40.6
Male	39	59.1	21	60.0	60	59.4
Age^* * p < .05.							.035
6 to 8 years old	15	22.7	15	42.9	30	29.7
9 to 11 years old	51	77.3	20	57.1	71	70.3
Color							.072
White	29	43.9	09	25.7	38	37.6
Non-white	37	56.1	26	74.3	63	62.4
Religion^* * p < .05.							.000
Yes	56	91.8	22	62.9	78	81.3
No	05	8.2	13	37.1	18	18.8
Children Educational level^* * p < .05.							.007
Up to E.F.1 Completed (equivalent to 3rd grade)	47	71.2	33	94.3	80	79.2
Up to E.F.2 Uncompleted (equivalent to 5th grade)	19	28.8	02	5.7	21	20.8
School Repetitions							.961
None	64	97.0	34	97.1	98	97.0
One	02	3.0	01	2.9	3	3.0
Brazil Economic Classification Criteria							.692
Class B	01	1.5	01	2.9	02	2.0
Class C	46	70.8	22	62.9	68	68.0
Class D	18	27.7	12	34.3	30	30.0
Parents' marital status: Married?							.579
Yes (married or living together)	34	51.5	16	45.7	50	49.5
No (single, divorced, separated)	32	48.5	19	54.3	51	50.5
Number of substance abusers who coexists							.522
One substance abuser	47	71.2	27	77.1	74	73.3
More than one substance abuser	19	28.8	8	22.9	27	26.7
Substance Abuser Member							.068
First-degree relatives	57	86.4	25	71.4	82	81.2
Second-degree relatives	09	13.6	10	28.6	19	18.8
Type of drug consumed							.159
Alcohol	38	57.6	15	42.9	53	52.5
Illicit drug	28	42.4	20	57.1	48	47.5
Stressful situations
Psychiatric hospitalization	07	11.5	09	25.7	16	16.7	.072
Family severe disease	19	30.6	13	37.1	32	33.0	.513
Suicide^* * p < .05.	01	1.6	08	22.9	09	9.3	.001
Attempted suicide^* * p < .05.	04	6.5	11	31.4	15	15.5	.001
Police problems	10	16.1	09	25.7	19	19.6	.253
Death of a family member^* * p < .05.	12	19.422	15	42.9	27	27.8	.013
Physical aggression between family	14	.6	14	40.0	28	28.9	.069

	Intervention Group (n = 66)		Control Group (n = 35)		Total (N = 101)		p
	n	%	n	%	n	%	p
Internalizing Scale^a^ p < .01.							.000
Non-clinical	57	84.4	17	48.6	74	73.3
Clinical^§ § Scores in the clinical range in comparison to Group 3 cutpoints (Achenbach & Rescorla, 2007). aIncludes Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints subscales. bIncludes Rule Breaking Behavior and Aggressive Behavior subscales. cIncludes all problems items of the CBCL. dIncludes Activities, Social and School subscales.	09	13.6	18	51.4	27	26.7
Externalizing Scale^b^ p < .01.							.004
Non-clinical	46	69.7	14	40.0	60	59.4
Clinical^§ § Scores in the clinical range in comparison to Group 3 cutpoints (Achenbach & Rescorla, 2007). aIncludes Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints subscales. bIncludes Rule Breaking Behavior and Aggressive Behavior subscales. cIncludes all problems items of the CBCL. dIncludes Activities, Social and School subscales.	20	30.3	21	60.0	41	40.6
Total Problems Scale^c^ p < .01.							.001
Non-clinical	47	71.2	13	37.1	60	59.4
Clinical^§ § Scores in the clinical range in comparison to Group 3 cutpoints (Achenbach & Rescorla, 2007). aIncludes Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints subscales. bIncludes Rule Breaking Behavior and Aggressive Behavior subscales. cIncludes all problems items of the CBCL. dIncludes Activities, Social and School subscales.	19	28.8	22	62.9	41	40.6
Total Competencies Scale^d							.050
Non-clinical	44	66.7	28	79.4	72	71.3
Clinical^§ § Scores in the clinical range in comparison to Group 3 cutpoints (Achenbach & Rescorla, 2007). aIncludes Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints subscales. bIncludes Rule Breaking Behavior and Aggressive Behavior subscales. cIncludes all problems items of the CBCL. dIncludes Activities, Social and School subscales.	22	33.3	07	20.6	29	28.7

Variables	WaldX²	p	OR	95% CI
Sex^a a Control variables	.391	.532	.666	[.186, 2.382]
Age^ab	8.570	.003	7.483	[1.945, 28.794]
Religion^b b Significant variables	8.985	.003	.095	[.021, .443]
Brazil Economic Classification Criteria^a a Control variables	.157	.692	.780	[1.345, 25.516]
Type of drug (alcohol or illicit)^a a Control variables	1.089	.297	.538	[.168, 1.725]
Substance Abuser Member^ab	5.546	.019	5.859	[.228, 2.669]
Stress Situation: Death of a family member^b b Significant variables	7.253	.007	.161	[.043, .608]
Internalizing Scale^b b Significant variables	8.971	.003	.376	[.198, .713]

Universidade de São Paulo, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Programa de Pós-Graduação em Psicologia Av.Bandeirantes 3900 - Monte Alegre, 14040-901 Ribeirão Preto - São Paulo - Brasil, Tel.: (55 16) 3315-3829 - Ribeirão Preto - SP - Brazil
E-mail: paideia@usp.br

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[1] Correspondence address: Thaís dos Reis Vilela. Av. Corifeu de Azevedo Marques, 3202, apt 174-D, Jardim das Indústrias. CEP 12241-040. São José dos Campos-SP, Brazil. thaisvilela1@gmail.com