Science to Practice: Interpersonal Stress and Gender
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Imagine that you are a middle school student. Some classmates are talking in the hallway. When you say “hi,” they ignore you. Why? Did you do something wrong? Did you say something stupid? Did you wear the wrong clothes to school that day?
Researchers found that adolescent girls are especially sensitive to interpersonal situations like these—much more than adolescent boys. When girls interpret these situations negatively (e.g., “They’re mad at me”), blame themselves (e.g., “I must have said something wrong”), and ruminate or think about the situation over and over, they can become depressed. In fact, adolescent girls are twice as likely as boys to develop depression.
Cognitive therapy is based on the premise that if adolescents can change the way they think about situations like these, they will feel better. A cognitive therapist would likely ask her client to look for alternative explanations for her classmates’ behavior. Is it possible that your classmates didn’t hear you say “hi” or they were busy doing something else? Generating alternative explanations for events like these can improve adolescents’ mood.
Note: Based on J. L. Hamilton and colleagues (2015).
Socioeconomic Status
Socioeconomic status (SES) is a variable that reflects three aspects of a child’s environment: (1) parents’ levels of education, (2) parents’ employment, and (3) family income. As you might expect, these three variables are correlated; parents with greater educational attainment tend to work more complex, higher-paying jobs. Overall, children from lower-SES families are at greater risk for developing mental disorders than children from middle- or high-SES families (Kessler et al., 2012a).
There are at least two explanations for the association between SES and risk for psychological disorders. First, higher-SES parents may be less likely to experience psychological problems themselves. They pass on genes conducive to better mental health to their children. Second, higher-SES parents may be better able to provide environments for their children that protect them from psychological problems. For example, parents with higher incomes may be better able to afford higher-quality health care, nutrition, or schooling for their children. These early experiences, in turn, can protect their children from the emergence of mental health problems.
Of course, genetic and environmental factors often interact to place children at risk for disorders. For example, in one large study, researchers examined the prevalence of ADHD in children from low- and high-income families (Rowland et al., 2019). Children from low-income families were 6 times more likely than children from high-income families to have ADHD if neither parent had the disorder. However, if a parent also had ADHD, low-income children were 10 times more likely than high-income children to have the disorder. These findings suggest that both genetic risk and environmental quality affect prevalence.
A related predictor of children’s mental health is family composition. Recent research indicates that youths living with only one biological parent are twice as likely to develop an anxiety or mood disorder as youths living with both biological parents. Furthermore, adolescents living in single-parent homes may be 6 times more likely to develop a behavior or substance use disorder as youths living in a two-parent household (Kessler et al., 2012a). The association between single-parent families and increased mental health problems is partially explained by SES; single parents often earn lower family incomes than two-parent families. However, single parents also report greater stress and may have more difficulty monitoring their children’s behavior than two-parent families. These factors, in turn, can contribute to their children’s behavior problems (Frick, 2013).
Race and Ethnicity
The relationship between ethnicity and childhood disorders is complex. Certain disorders are more commonly diagnosed in non-Latino White families. For example, the prevalence of autism spectrum disorder is approximately twice as high among young non-Latino White children (1.1%) compared to Latino (0.5%) or African American (0.4%) youths. Similarly, ADHD is more frequently diagnosed in non-Latino White youths (9.1%) than in African American (8.0%) or Latino (4.1%) children. Anxiety disorders are also slightly more common among White youths compared to their non-White peers (Perou et al., 2016).
On the other hand, African American youths are more likely to develop conduct problems than White youths. Specifically, approximately 8.1% of African American youths will develop oppositional defiant behavior or conduct disorder at some point in childhood, compared to 4.2% of White and 3.9% of Latino youths (Perou et al., 2016).
What explains these differences? One possibility is that differences in SES partially explain these differences in mental disorders across ethnicities. Sadly, members of many minority groups in the United States disproportionately come from lower-SES families (Taylor & Wang, 2013). Consequently, minority families often face many of the same risks confronted by low-SES families: reduced access to high-quality health care and nutrition, less optimal child care, impoverished educational experiences, and higher family stress. Immigrant families also face special risks, such as stress associated with language differences and acculturation (Coll & Magnuson, 2014). These risk factors might explain the higher prevalence of conduct problems among some minority youths. Indeed, when researchers control for SES, there are fewer differences in the percentage of children diagnosed with mental disorders across ethnic groups (Hayden & Mash, 2014).
Another possibility is that children’s racial or ethnic background might partially determine the likelihood that their disorders are identified and treated. For example, African American and Latino children tend to be diagnosed with autism much later than non-Latino White children (Ratto, Reznick, & Turner-Brown, 2015). Research indicates that minority parents are often less able to recognize the early signs of autism; consequently, their children’s disorder may remain undiagnosed and untreated (Magaña, Lopez, Aguinaga, & Morton, 2013). Similarly, recent research has found that many Latino parents regard the hyperactive–impulsive symptoms of ADHD to be developmentally normative. Consequently, they may be less likely to view their children’s symptoms as problematic and less likely to seek treatment (Gerdes, Lawton, Haack, & Hurtado, 2014).
A third possibility is that these differences in prevalence reflect cultural values across racial and ethnic groups. For example, African American adolescents are much less likely to develop alcohol and other drug use problems than non-Latino White adolescents (Kessler et al., 2012a). Some experts have argued that African American culture, which tends to discourage heavy alcohol use, protects many of these youths from substance use problems (Zapolski, Pedersen, McCarthy, & Smith, 2014). Furthermore, the more African American adolescents endorsed these cultural beliefs, the more likely they were to avoid alcohol and other drugs (Stock et al., 2013).
Review
The prevalence of mental health problems is higher among adolescents than among prepubescent children.
In childhood, boys are more likely to experience a mental health problem than girls. In adolescence, girls are more likely to experience a mental health problem than boys.
SES reflects parents’ education, employment status, and income. Children from low-SES families are at increased risk for mental health problems.
Certain disorders, like ADHD and anxiety disorders, are most often diagnosed in non-Latino White children. Other disorders, like conduct problems, are most often diagnosed in children from other racial or ethnic backgrounds. These differences might reflect family SES, cultural factors that affect help-seeking, and/or actual differences in prevalence as a function of race and ethnicity.
Do Most Children With Mental Health Problems Receive Treatment?
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