Category: Child / Adolescent - Externalizing

Symposium

Chronic Irritability in Children and Parental Motivation for Mental Health Service Engagement

Friday, November 17
12:00 PM - 1:30 PM
Location: Cobalt 501, Level 5, Cobalt Level

Keywords: Anger / Irritability | Externalizing | Change Process / Mechanisms
Presentation Type: Symposium

BACKGROUND: Parental motivations for service engagement for child psychopathology are strongly influenced by behavioral disorders. Parents describe high levels of burden and stress associated with oppositional defiant disorder (ODD) and attention deficit-hyperactivity disorder (ADHD). Parents also advance in stages of change towards mental health service seeking (SOC) due to lower family resources and poorer family function. Some evidence shows that parents’ sense of burden may be associated with the behavioral (BEH) and not the irritability (IRR) dimension of ODD. Thus, it may be that service engagement is influenced by BEH and not IRR, increasing the risk for distinct outcomes for children with IRR.  

METHODS: Data came from 148 families recruited from new mental health clinic intakes or from first-time juvenile court contacts and included two years of follow up.  Regression models were used to test hypotheses regarding ODD dimensions, SOC, burden and service use, controlling for other psychopathology and family functioning.

RESULTS: IRR was not associated with advanced SOC (OR = 0.90, p = .58), while BEH was (OR = 1.41, p = .037). These results held while controlling for CD, which was inversely related to SOC (OR = .66, p = .005), and ADHD, depression and anxiety, which were not related to SOC. IRR was not predictive of future mental health service engagement (OR = .95, p = .82), whereas BEH, ADHD and CD (inversely related) were.  However, at baseline, IRR was associated with elevated ratings of parental burden (b = .31, p = .03), and post hoc analyses suggested that among those in the juvenile justice cohort, IRR was associated with elevated scores in the Contemplation stage.

CONCLUSIONS: As hypothesized, parental motivations for service engagement and actual future service use were enhanced by BEH symptoms and not IRR, even though IRR was associated with parent burden. Further, for some parents, parental contemplation of services was associated with higher IRR. It may be that psychoeducation on the risks associated with IRR, or the use of motivational interviewing, could help to encourage parents to move from contemplation to advanced efforts at service engagement for irritability concerns.

Oliver G. Johnston

Doctoral Candidate
University of Connecticut

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