Abstract
The overall aim of the current study was to extend the knowledge of externalizing problems in non-Western immigrant children in Europe. More specifically, the research was aimed at assessing whether the expression, treatment rates, prevalence estimates, parental detection and screening validity of externalizing disorders differed between native Western and non-Western
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immigrant children in the Netherlands. In general, the results show the expression, the prevalence and the screenings validity of externalizing disorders to be similar across ethnicity, whereas the rates of parental detection and treatment are lower for Moroccans, Turks and Surinamese, as compared to Dutch.
The study consisted of two stages. In the first phase, teachers completed the Strengths and Difficulties Questionnaire (SDQ) (Goodman 1994, Goodman 1997) for 2185 children enrolled in grade 3 through 5 of mainstream schools in low SES inner-city areas in Amsterdam and Utrecht. In the second phase, a subsample of 270 children were administered the Semi-structured Interview for Children and Adolescents (SCICA) (McConaughy & Achenbach 2001), while their parents were interviewed using the Diagnostic Interview Schedule for Children-Parent Version (DISC-P). In addition, teachers completed a short questionnaire which consisted of 10 DSM-IV items (American Psychiatric Association 1994).
The same two factor model of Hyperactivity-Inattention and Conduct Problems as assessed by the teacher version of the SDQ appeared to be valid in all ethnic groups. Moreover, it was shown that only four items on these scales were needed to predict an externalizing disorder with a discriminative power of 0.84 (95%CI: 0.79-0.89), which was similar across all ethnic groups.
The results of current study also confirm the expectation that non-Dutch immigrant children in the Netherlands are less likely to be treated for externalizing disorders than Dutch children. As the detection rate of externalizing disorders was lower among non-Dutch parents, the observed discrepancy in treatment rates may partly be explained by a difference in detection rate between Dutch and non-Dutch parents. Several explanations may account for the lower detection rate among non-Dutch parents, among which are: 1) differences in social desirability; 2) differences in monitoring children’s behaviour, or 3) differences in the discrepancy between children’s indoors and outdoors behaviour. Future research should clarify the mechanisms underlying this underdetection by non-Dutch parents.
Whereas teachers reported more problem behaviour for Moroccan boys and less for Turkish boys than for Dutch boys, the prevalence of psychiatric disorders in general and externalizing disorders in particular as assessed by the best-estimate procedure was similar across ethnicity. An explanation for this divergence in findings may be that Moroccan boys display more problem behaviour at school than in other situations, whereas the opposite is true for Turkish boys. Although the higher problem scores for Moroccan boys at school may also be explained by a teacher bias in ratings, it seems unlikely that teacher ratings were strongly biased, as Turkish boys obtained lower problems scores than Dutch boys.
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