Prevalence and community variation in harmful levels of family conflict witnessed by children: implications for prevention.

Children's reports of high family conflict consistently predict poor outcomes. The study identified criteria for high family conflict based on prospective prediction of increased risk for childhood depression. These criteria were subsequently used to establish the prevalence of high family conflict in Australian communities and to identify community correlates suitable for targeting prevention programs. Study 1 utilised a longitudinal design. Grade 6 and 8 students completed a family conflict scale (from the widely used Communities That Care survey) in 2003 and depression symptomotology were evaluated at a 1-year follow-up (International Youth Development Study, N = 1,798). Receiver-operating characteristic analysis yielded a cut-off point on a family conflict score with depression symptomatology as a criterion variable. A cut-off score of 2.5 or more (on a scale of 1 to 4) correctly identified 69 % with depression symptomology, with a specificity of 77.2 % and sensitivity at 44.3 %. Study 2 used data from an Australian national survey of Grade 6 and 8 children (Healthy Neighbourhoods Study, N = 8,256). Prevalence estimates were calculated, and multivariate logistic regression with multi-level modelling was used to establish factors associated with community variation in family conflict levels. Thirty-three percent of Australian children in 2006 were exposed to levels of family conflict that are likely to increase their future risk for depression. Significant community correlates for elevated family conflict included Indigenous Australian identification, socioeconomic disadvantage, urban and state location, maternal absence and paternal unemployment. The analysis provides indicators for targeting family-level mental health promotion programs.