Risk Factors Related to Children's Mental Health

Research provides evidence that biological factors and adverse psychosocial experiences influence mental disorders of childhood and on into adulthood. Caution is warranted in assigning these factors as the cause of mental disorders in children due to the uniqueness of each child, the age a child is exposed to the factor, and the possibility that a combination of factors may be involved. Also, it is difficult to address various risk factors due to the ongoing development which takes place in each child.

Risk Factors

• Biological Influences
• Psychosocial Influences
• Family and Genetic Factors
• Stressful Life Events
• Childhood Maltreatment
• Peer and Sibling Influences

Children experiencing any of or a combination of risk factors may exhibit an ability to cope and overcome them. However, some children appear to be more susceptible to these risk factors and the result of exposure may lead to a mental disorder. In many cases research indicates that the cumulative effect of several risk factors is more likely to lead to a mental disorder. "For example, children who have a biological parent with a mental disorder may be at both genetic and environmental risk. Similarly, infants who experience obstetrical complications are at especially heightened risk for adjustment problems if they are reared in an impoverished environment (and babies born into impoverished environments are more likely to have obstetrical complications)" (American Psychological Association [APA], 1996).

Risk factors that influence the development of a mental disorder or problems in social-emotional development include:

• Biological Influences: It is important to recognize that biological influences "are not necessarily synonymous with those of genetics or inheritance. Biological abnormalities of the central nervous system that influence behavior, thinking, or feeling can be caused by injury, infection, poor nutrition, low birth weight, prenatal damage from exposure to alcohol or other drugs, or exposure to toxins, such as lead in the environment. These abnormalities are not inherited. Mental disorders most likely to have genetic components include: autism, bipolar disorder, schizophrenia, and attention-deficit/hyperactivity disorder" (USDHHS, 1999). Both biological and environmental influences are interrelated and are not considered independent of each other. An environmental influence can lead to a biological response and vice versa. (USDHHS, 1999).
• Psychosocial Influences: Various psychosocial influences impact children's mental health. Some of these influences are severe parental relationship problems, large families, overcrowded homes, a parent's psychopathology or criminality, abuse, exposure to acts of violence, etc. These factors are significantly relevant if a child does not have a loving relationship with at least one of the parents. Relationships between infants or children and their primary caregiver are significant to the development of good mental health. The "chances of developing mental health problems are much reduced if a child grows up in a family in which there are clear rules and consistent enforcement, while a child exposed to inconsistent discipline is at greater risk for later behavioral problems." A family's economic situation such as poverty can "indirectly increase the risk of developing a behavioral disorder, because it may cause behavioral problems in the parents or increase the risk of child abuse" (USDHHS, 1999).

• Family and Genetic: Twenty to fifty percent of children and adolescents with depression have a history of depression in their family.

Twenty to fifty percent of children and adolescents with depression have a history of depression in their family.

In addition, children of depressed parents are more than three times as likely of those with non-depressed parents to experience a depressive disorder. "Parental depression also increases the risk of anxiety disorders, conduct disorder, and alcohol dependence. The risk is greater if both parents have had a depressive illness, if the parents were depressed when they were young, or if a parent had several episodes of depression." Parents with depression may exhibit some of the following behaviors: being emotionally withdrawn, lacking energy to pay attention to or provide adequate supervision of their children; excessive irritability, being overcritical, demoralizing, pessimistic, tearful, threatening suicide, displaying poor coping strategies for stress; etc. "The consequences of maternal depression vary with the state of development of the child, and some of the effects are quite subtle. For example, in infancy, a withdrawn or unresponsive depressed mother may increase an infant's distress, and an intrusive or hostile depressed mother may lead the infant to avoid looking at and communicating with her. Other studies have shown that if infants' smiles are met with a somber or gloomy face, they respond by showing a similarly somber expression and then by averting their eyes" (USDHHS, 1999).

• Stressful Life Events: Parental death(s), divorce, and other life events have shown a causal relationship to the onset of major depression in young children. However, these findings are not as clear for depression in mid-childhood or adolescence (USDHHS, 1999). A new study reveals that 28 percent of children in Texas lived in stressful home situations, second to California's 30 percent (see Figure 7-8). These children living with stressful family situations are linked to behavioral and emotional difficulties.

It was determined that "children in families that move often and have health or financial problems are more likely to have behavioral, emotional and school-related problems than are children growing up in homes with fewer risks." The analysis reports that it is not just poor children, but families that are struggling just above the government's poverty line (Health Central, 2000, July 27).

• Childhood Maltreatment: It is estimated that over 3 million children are maltreated every year in the United States. Child abuse is a national, state, and local problem. Related to mental health, maltreatment is associated with insecure attachment, psychiatric disorders such as post-traumatic stress disorder, conduct disorder, ADHD, depression, and impaired social functioning with peers. Psychological maltreatment is believed to occur more frequently than physical maltreatment. It is associated with depression, conduct disorder, and delinquency and can impair social and cognitive functioning in children (USDHHS, 1999). Sixty-four percent of child abuse cases have alcohol or drug use as a factor. Sixty-two percent of cases with foster care referrals have alcohol or drug use as a factor (Substance Abuse Planning Partnership, 1997, August).
• Peer and Sibling Influences: Maladaptive peers and sibling rivalry are two factors that influence poor mental health in children and adolescents. These influences increase the likelihood of delinquency, antisocial behaviors, aggressive behaviors, and others (USDHHS, 1999).

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