Katherine M Keyes1, Ezra Susser2, Daniel J Pilowsky2, Ava Hamilton1, Adina Bitfoi3, Dietmar Goelitz4, Rowella C W M Kuijpers5, Sigita Lesinskiene6, Zlatka Mihova7, Roy Otten5, Viviane Kovess8. 1. Mailman School of Public Health, Columbia University, Department of Epidemiology, New York, United States. 2. Mailman School of Public Health, Columbia University, Department of Epidemiology, New York, United States; New York State Psychiatric Institute, New York, United States. 3. The Romanian League for Mental Health, Bucharest, Romania. 4. Center for Applied Sciences of Health, Leuphana University of Luneburg, Luneburg, Germany. 5. Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands. 6. Clinic of Psychiatry, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania. 7. New Bulgarian University, Sofia, Bulgaria. 8. École des Hautes Études en Santé Publique, Department of Epidemiology and Biostatistics, Paris, France. Electronic address: Viviane.Kovess@ehesp.fr.
Abstract
OBJECTIVE: Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. METHODS: Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past-year injuries serious enough to seek medical attention were reported by mothers. Child mental health problems were assessed using validated measures and reported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. RESULTS: Children with attention-deficit/hyperactivity symptoms and oppositional defiant symptoms had a higher risk of injury compared to other children whether based on parent report (OR=1.47, 95% C.I. 1.2-1.9), teacher report (OR=1.36, 95% C.I. 1.1-1.7), or parent and teacher report combined (OR=1.53, 95% C.I. 1.1-2.1). Children who self-reported oppositional symptoms also had higher risk of injury (OR=1.6, 95% C.I. 1.1-2.4). Low-caring behavior of parents increased the risk of injury (OR=1.4, 95% C.I. 1.1-1.9). CONCLUSION: Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent-child relationships and prevention as well as focused treatment for externalizing problems may reduce the burden of injury.
OBJECTIVE:Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. METHODS: Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past-year injuries serious enough to seek medical attention were reported by mothers. Child mental health problems were assessed using validated measures and reported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. RESULTS:Children with attention-deficit/hyperactivity symptoms and oppositional defiant symptoms had a higher risk of injury compared to other children whether based on parent report (OR=1.47, 95% C.I. 1.2-1.9), teacher report (OR=1.36, 95% C.I. 1.1-1.7), or parent and teacher report combined (OR=1.53, 95% C.I. 1.1-2.1). Children who self-reported oppositional symptoms also had higher risk of injury (OR=1.6, 95% C.I. 1.1-2.4). Low-caring behavior of parents increased the risk of injury (OR=1.4, 95% C.I. 1.1-1.9). CONCLUSION:Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent-child relationships and prevention as well as focused treatment for externalizing problems may reduce the burden of injury.
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