Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-12-01T01:23:37.042Z Has data issue: false hasContentIssue false
  • English
  • Français

‘Too many BeEPs in our teens!’ Behavioral and emotional problems in a large group of Italian adolescents

Published online by Cambridge University Press:  11 August 2020

Giulia Lisi Open the ORCID record for Giulia Lisi [Opens in a new window] ,
Rodolfo Rossi ,
Michele Ribolsi ,
Giorgio Di Lorenzo ,
Carla Parisi ,
Martina Siracusano ,
Laura Morciano ,
Alberto De Stefano ,
Alessia Pesaresi  and
Cinzia Niolu
...Show all authors
Giulia Lisi*
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
Rodolfo Rossi
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
Michele Ribolsi
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
Giorgio Di Lorenzo
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy IRCCS Fondazione Santa Lucia, Rome, Italy
Carla Parisi
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
Martina Siracusano
Affiliation:
Chair of Child Neuropsychiatry, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
Laura Morciano
Affiliation:
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
Alberto De Stefano
Affiliation:
ONLUS Volontari del Policlinico Tor Vergata, Rome, Italy
Alessia Pesaresi
Affiliation:
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
Cinzia Niolu
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
Leonardo Palombi
Affiliation:
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
Alberto Siracusano
Affiliation:
Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
*
Author for correspondence: Giulia Lisi, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

One in six adolescents suffers from mental health problems. Despite the presence of general information on Italian adolescents' mental health, researches conducted with standardized assessment tools are scarce in the literature. We evaluated the prevalence of self-reported behavioral and emotional problems in a group of Italian adolescents and examined their relation to socio-demographical variables.

Methods

This population-based sampling survey was conducted on high school students aged 14–18 from urban areas of Rome and Latina. Participants completed Youth Self-Report (YSR) and a socio-demographic schedule to collect information on age, gender, type of school attended, socio-economic status, urbanicity.

Results

Final sample consisted of 1400 adolescents (38.61% male, mean age 16 years, s.d. 1.42). Prevalence of Internalizing Problems, Externalizing Problems and Total Problems was 29.55%, 18.34% and 24.13%. In our multivariable model, Internalizing Symptoms were not explained by sociodemographic variables while Externalizing Symptoms were explained by Male Gender [OR = 1.53 (1.14–2.06)], older age [OR = 2.06 (1.52–2.79)] and attending a Technical and Professional Institute [OR = 2.15 (1.53–3.02)], with an adjusted R2 = 4.32%. Total Problems were explained by School Type [Technical and Professional Institutes and Art and Humanities v. Grammar and Science School; OR respectively 1.93 (1.40–2.67) and 1.64 (1.08–2.47)], adjusted R2 = 1.94.

Conclusions

The study provides, for the first time, evidence of a great prevalence of self-reported behavioral and emotional problems in a large sample of Italian adolescents, highlighting the role of different socio-demographic variables as risk factors for externalizing behaviors. Our results emphasize the urgent need for implementing prevention programs on mental health in adolescence.

Keywords

Adolescenceemotional and behavioral problemsepidemiologypreventionyouth self-report
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 6 , April 2022 , pp. 1040 - 1049
Check for updates
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., Bird, H. R., Canino, G., Phares, V., Gould, M. S., & Rubio-Stipec, M. (1990). Epidemiological comparisons of Puerto Rican and U.S. Mainland children: Parent, teacher, and self-reports. Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 84–93. doi:10.1097/00004583-199001000-00014.CrossRefGoogle ScholarPubMed
Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101(2), 213–232. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/3562706.CrossRefGoogle ScholarPubMed
Achenbach, T. M., & Rescorla, L.A. (2001). Manual for the ASEBA school-Age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth and Families.Google Scholar
Achenbach, T. M., Verhulst, F. C., Baron, G. D., & Althaus, M. (1987). A comparison of syndromes derived from the child behavior checklist for American and Dutch boys aged 6–11 and 12–16. Journal of Child Psychology and Psychiatry, 28(3), 437–453. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/3597566.CrossRefGoogle ScholarPubMed
Ackerman, B. P., & Brown, E. D. (2006). Income poverty, poverty co-factors, and the adjustment of children in elementary school. Advances in Child Development and Behavior, 34, 91–129. doi:10.1016/s0065-2407(06)80005-4.CrossRefGoogle ScholarPubMed
Azzolini, D., & Vergolini, L. (2014). Tracking inequality and education policy. Looking for a recipe for the Italian case. Scuola democratica, 2(maggio-agosto).Google Scholar
Bach, M., & Bach, D. (1996). Alexithymia in somatoform disorder and somatic disease: A comparative study. Psychotherapy and Psychosomatics, 65(3), 150–152. doi:10.1159/000289067.CrossRefGoogle ScholarPubMed
Balazs, J., Miklosi, M., Kereszteny, A., Hoven, C. W., Carli, V., Wasserman, C., … Wasserman, D. (2013). Adolescent subthreshold-depression and anxiety: Psychopathology, functional impairment and increased suicide risk. Journal of Child Psychology and Psychiatry, 54(6), 670–677. doi:10.1111/jcpp.12016.CrossRefGoogle ScholarPubMed
Ballarino, G., Bernardi, F., Requena, M., & Schadee, H. (2008). Persistent inequalities? Expansion of education and class inequality in Italy and Spain. European Sociological Review, 25(1), 123–138. doi:10.1093/esr/jcn031.CrossRefGoogle Scholar
Bowles, S., & Gintis, H. (2002). The inheritance of inequality. Journal of Economic Perspectives, 16(3), 3–30. doi:10.1257/089533002760278686.CrossRefGoogle Scholar
Brown, R. C., & Plener, P. L. (2017). Non-suicidal self-injury in adolescence. Current Psychiatry Reports, 19(3), 20. doi:10.1007/s11920-017-0767-9.CrossRefGoogle ScholarPubMed
Burnett, S., & Blakemore, S. J. (2009). The development of adolescent social cognition. Values, Empathy, and Fairness across Social Barriers, 1167, 51–56. doi:10.1111/j.1749-6632.2009.04509.x.Google ScholarPubMed
Canino, G. (2007). 25 Years of child and adult psychiatric epidemiology studies in Puerto Rico. Puerto Rico Health Sciences Journal, 26(4), 385–394. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18246967.Google ScholarPubMed
Christie, K. A., Burke, J. D. Jr, Regier, D. A., Rae, D. S., Boyd, J. H., & Locke, B. Z. (1988). Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults. American Journal of Psychiatry, 145(8), 971–975. doi:10.1176/ajp.145.8.971.Google ScholarPubMed
Collishaw, S., Maughan, B., Natarajan, L., & Pickles, A. (2010). Trends in adolescent emotional problems in England: A comparison of two national cohorts twenty years apart. Journal of Child Psychology and Psychiatry, 51(8), 885–894. doi:10.1111/j.1469-7610.2010.02252.x.CrossRefGoogle ScholarPubMed
Conway, K. P., Swendsen, J., Husky, M. M., He, J. P., & Merikangas, K. R. (2016). Association of lifetime mental disorders and subsequent alcohol and illicit drug use: Results from the national comorbidity survey-adolescent supplement. Journal of the American Academy of Child and Adolescent Psychiatry, 55(4), 280–288. doi:10.1016/j.jaac.2016.01.006.CrossRefGoogle ScholarPubMed
Dhingra, S. S., Strine, T. W., Holt, J. B., Berry, J. T., & Mokdad, A. H. (2009). Rural-urban variations in psychological distress: Findings from the Behavioral Risk Factor Surveillance System, 2007. International Journal of Public Health, 54, 16–22. doi:10.1007/s00038-009-0002-5.CrossRefGoogle ScholarPubMed
Dustmann, C. (2004). Parental background, secondary school track choice, and wages. Oxford Economic Papers, 56(2), 209–230.CrossRefGoogle Scholar
Fett, A. J., Lemmers-Jansen, I. L. J., & Krabbendam, L. (2019). Psychosis and urbanicity: A review of the recent literature from epidemiology to neurourbanism. Current Opinion in Psychiatry, 32(3), 232–241. doi:10.1097/YCO.0000000000000486.CrossRefGoogle ScholarPubMed
Fitzpatrick, C., & Deehan, A. (1999). Competencies and problems of Irish children and adolescents. European Child & Adolescent Psychiatry, 8(1), 17–23. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10367737.CrossRefGoogle ScholarPubMed
Freeman, A., Tyrovolas, S., Koyanagi, A., Chatterji, S., Leonardi, M., Ayuso-Mateos, J. L., … Haro, J. M. (2016). The role of socio-economic status in depression: Results from the COURAGE (aging survey in Europe). BMC Public Health, 16, 1098. doi:ARTN 1098 10.1186/s12889-016-3638-0.Google Scholar
Frigerio, A., Rucci, P., Goodman, R., Ammaniti, M., Carlet, O., Cavolina, P., … Molteni, M. (2009). Prevalence and correlates of mental disorders among adolescents in Italy: The PrISMA study. European Child & Adolescent Psychiatry, 18(4), 217–226. doi:10.1007/s00787-008-0720-x.CrossRefGoogle ScholarPubMed
Frigerio, A., Vanzin, L., Pastore, V., Nobile, M., Giorda, R., Marino, C., … De Girolamo, G. (2006). The Italian preadolescent mental health project (PrISMA): Rationale and methods. International Journal of Methods in Psychiatric Research, 15(1), 22–35. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16676683.CrossRefGoogle ScholarPubMed
Galobardes, B., Shaw, M., Lawlor, D. A., Lynch, J. W., & Smith, G. D. (2006). Indicators of socioeconomic position (part 2). Journal of Epidemiology and Community Health, 60(2), 95–101. doi:10.1136/jech.2004.028092.CrossRefGoogle Scholar
Gatta M, I. N., Del Col, L., Testa, P. C., Svanellini, L., & Battistella, P. A. (2012). Alexithymia and psychopathology in adolescence: A case-control study. Psichiatria dell'infanzia e adolescenza, 79, 547–567.Google Scholar
Hawton, K., Saunders, K. E., & O'Connor, R. C. (2012). Self-harm and suicide in adolescents. Lancet (London, England), 379(9834), 2373–2382. doi:10.1016/S0140-6736(12)60322-5.CrossRefGoogle ScholarPubMed
Heyerdahl, S., Kvernmo, S., & Wichstrom, L. (2004). Self-reported behavioural/emotional problems in Norwegian adolescents from multiethnic areas. European Child & Adolescent Psychiatry, 13(2), 64–72. doi:10.1007/s00787-004-0359-1.Google ScholarPubMed
Hicks, B. M., Blonigen, D. M., Kramer, M. D., Krueger, R. F., Patrick, C. J., Iacono, W. G., & Mcgue, M. (2007). Gender differences and developmental change in externalizing disorders from late adolescence to early adulthood: A longitudinal twin study. Journal of Abnormal Psychology, 116(3), 433–447. doi:10.1037/0021-843x.116.3.433.CrossRefGoogle ScholarPubMed
House, J. S., Lepkowski, J. M., Williams, D. R., Mero, R. P., Lanz, P. M., Robert, S. A., & Chen, J. M. (2000). Excess mortality among urban residents: How much, for whom, and why? American Journal of Public Health, 90(12), 1898–1904. doi:10.2105/Ajph.90.12.1898.Google Scholar
Kapi, A., Veltsista, A., Sovio, U., Jarvelin, M. R., & Bakoula, C. (2007). Comparison of self-reported emotional and behavioural problems in adolescents from Greece and Finland. Acta Paediatrica, 96(8), 1174–1179. doi:10.1111/j.1651-2227.2007.00370.x.CrossRefGoogle Scholar
Kerckhoff, A. C. (2001). Education and social stratification processes in comparative perspective. Sociology of Education, 74, 3–18.CrossRefGoogle Scholar
Kessler, R. C., Angermeyer, M., Anthony, J. C., De Graaf, R., Demyttenaere, K., Gasquet, I., … Ustun, T. B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry, 6(3), 168–176. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18188442.Google ScholarPubMed
Keyes, K. M., Gary, D., O'Malley, P. M., Hamilton, A., & Schulenberg, J. (2019). Recent increases in depressive symptoms among US adolescents: Trends from 1991 to 2018. Social Psychiatry and Psychiatric Epidemiology, 54(8), 987–996. 10.1007/s00127-019-01697-8.CrossRefGoogle ScholarPubMed
Kim-Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003). Prior juvenile diagnoses in adults with mental disorder: Developmental follow-back of a prospective-longitudinal cohort. Archives of General Psychiatry, 60(7), 709–717. doi:10.1001/archpsyc.60.7.709.CrossRefGoogle ScholarPubMed
Konowalek, L., & Wolanczyk, T. (2018). Changes in emotional and behavioral problems between 2000 and 2011 Among 16-year-old polish children: A cross-sectional study. Child Psychiatry & Human Development, 49(5), 757–765. doi:10.1007/s10578-018-0791-y.CrossRefGoogle ScholarPubMed
Kusevic, Z., Civljak, M., Rukavina, T. V., Babic, G., Loncar, M., Cusa, B. V., & Gregurek, R. (2013). The connection between alexithymia and somatic morbidity in a population of combat veterans with chronic PTSD. Acta Informatica Medica, 21(1), 7–11. doi:10.5455/AIM.2013.21.7-11.CrossRefGoogle Scholar
Lahelma, E., Martikainen, P., Laaksonen, M., & Aittomaki, A. (2004). Pathways between socioeconomic determinants of health. Journal of Epidemiology and Community Health, 58(4), 327–332. doi:10.1136/jech.2003.011148.CrossRefGoogle ScholarPubMed
Lee, S. J., Park, S. H., Cloninger, C. R., & Chae, H. (2018). Behavior problems and personality in Korean high school students. PeerJ, 6, e6106. doi:10.7717/peerj.6106.CrossRefGoogle ScholarPubMed
Levant, R. F., & Parent, M. C. (2019). The development and evaluation of a brief form of the Normative Male Alexithymia Scale (NMAS-BF). Journal of Counseling Psychology, 66(2), 224–233. doi:10.1037/cou0000312.CrossRefGoogle Scholar
Luminet, O., Rime, B., Bagby, R. M., & Taylor, G. J. (2004). A multimodal investigation of emotional responding in alexithymia. Cognition & Emotion, 18(6), 741–766. doi:10.1080/02699930341000275.CrossRefGoogle Scholar
Lund, C., & Cois, A. (2018). Simultaneous social causation and social drift: Longitudinal analysis of depression and poverty in South Africa. Journal of Affective Disorders, 229, 396–402. doi:10.1016/j.jad.2017.12.050.CrossRefGoogle ScholarPubMed
Lundh, L. G., & Simonsson-Sarnecki, M. (2001). Alexithymia, emotion, and somatic complaints. Journal of Personalized Medicine, 69(3), 483–510. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11478734.Google ScholarPubMed
Manninen, M., Therman, S., Suvisaari, J., Ebeling, H., Moilanen, I., Huttunen, M., & Joukamaa, M. (2011). Alexithymia is common among adolescents with severe disruptive behavior. The Journal of Nervous and Mental Disease, 199(7), 506–509. doi:10.1097/NMD.0b013e3182214281.CrossRefGoogle ScholarPubMed
Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. doi:10.1016/j.jaac.2010.05.017.CrossRefGoogle Scholar
Mojtabai, R., Olfson, M., & Han, B. (2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6). doi:10.1542/peds.2016-1878.CrossRefGoogle ScholarPubMed
Paus, T., Keshavan, M., & Giedd, J. N. (2008). Why do many psychiatric disorders emerge during adolescence? Nature Reviews Neuroscience, 9(12), 947–957. doi:10.1038/nrn2513.CrossRefGoogle ScholarPubMed
Peen, J., Dekker, J., Schoevers, R. A., ten Have, M., de Graaf, R., & Beekman, A. T. (2007). Is the prevalence of psychiatric disorders associated with urbanization? Social Psychiatry and Psychiatric Epidemiology, 42(12), 984–989. doi:10.1007/s00127-007-0256-2.CrossRefGoogle ScholarPubMed
Peen, J., Schoevers, R. A., Beekman, A. T., & Dekker, J. (2010). The current status of urban-rural differences in psychiatric disorders. Acta Psychiatrica Scandinavica, 121(2), 84–93. doi:10.1111/j.1600-0447.2009.01438.x.CrossRefGoogle ScholarPubMed
Philipp, J., Zeiler, M., Waldherr, K., Truttmann, S., Dur, W., Karwautz, A. F. K., & Wagner, G. (2018). Prevalence of emotional and behavioral problems and subthreshold psychiatric disorders in Austrian adolescents and the need for prevention. Social Psychiatry and Psychiatric Epidemiology, 53(12), 1325–1337. doi:10.1007/s00127-018-1586-y.CrossRefGoogle ScholarPubMed
Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365. doi:10.1111/jcpp.12381.CrossRefGoogle ScholarPubMed
Rescorla, L., Achenbach, T. M., Ivanova, M. Y., Dumenci, L., Almqvist, F., Bilenberg, N., … Verhulst, F. (2007). Epidemiological comparisons of problems and positive qualities reported by adolescents in 24 countries. Journal of Consulting and Clinical Psychology, 75(2), 351–358. doi:10.1037/0022-006X.75.2.351.CrossRefGoogle ScholarPubMed
Rescorla, L. A., Ginzburg, S., Achenbach, T. M., Ivanova, M. Y., Almqvist, F., Begovac, I., … Verhulst, F. C. (2013). Cross-informant agreement between parent-reported and adolescent self-reported problems in 25 societies. Journal of Clinical Child & Adolescent Psychology, 42(2), 262–273. doi:10.1080/15374416.2012.717870.CrossRefGoogle ScholarPubMed
Rescorla, L., Ivanova, M. Y., Achenbach, T. M., Begovac, I., Chahed, M., Drugli, M. B., … Zhang, E. Y. (2012). International epidemiology of child and adolescent psychopathology ii: Integration and applications of dimensional findings from 44 societies. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1273–1283, e1278. doi:10.1016/j.jaac.2012.09.012.CrossRefGoogle Scholar
Roberts, R. E., Attkisson, C. C., & Rosenblatt, A. (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155(6), 715–725. doi:10.1176/ajp.155.6.715.Google ScholarPubMed
Robinson, M., Doherty, D. A., Cannon, J., Hickey, M., Rosenthal, S. L., Marino, J. L., & Skinner, S. R. (2018). Comparing adolescent and parent reports of externalizing problems: A longitudinal population-based study. British Journal of Developmental Psychology, 37(2), 247–268. doi:10.1111/bjdp.12270..CrossRefGoogle ScholarPubMed
Schizzerotto, A., & Barone, C. (2006). Sociologia dell'istruzione (Il Mulino Ed.). Bologna: Il Mulino.Google Scholar
Schreier, H. M., & Chen, E. (2013). Socioeconomic status and the health of youth: A multilevel, multidomain approach to conceptualizing pathways. Psychological Bullettin, 139(3), 606–654. doi:10.1037/a0029416.CrossRefGoogle ScholarPubMed
Smalley, K. B., Warren, J. C., & Klibert, J. (2012). Health risk behaviors in insured and uninsured community health center patients in the rural US South. Rural and Remote Health, 12(4), Retrieved from <Go to ISI>://WOS:000318413700014.Google ScholarPubMed
Smith, L. (2011). Experiential ‘hot’ knowledge and its influence on low-SES students’ capacities to aspire to higher education. Critical Studies in Education, 52(2), 165–177. doi:10.1080/17508487.2011.572829.CrossRefGoogle Scholar
Statistica, I. I. N. d. (2018). Mental Health in various stages of life.Google Scholar
Sullivan, L., Camic, P. M., & Brown, J. S. (2015). Masculinity, alexithymia, and fear of intimacy as predictors of UK men's attitudes towards seeking professional psychological help. British Journal of Health Psychology, 20(1), 194–211. doi:10.1111/bjhp.12089.CrossRefGoogle ScholarPubMed
Taycan, O., Ozdemir, A., & Erdogan Taycan, S. (2017). Alexithymia and somatization in depressed patients: The role of the type of somatic symptom attribution. Nöropsikiyatri Arşivi, 54(2), 99–104. doi:10.5152/npa.2016.12385.CrossRefGoogle ScholarPubMed
Taylor, G. J., Parker, J. D., Bagby, R. M., & Acklin, M. W. (1992). Alexithymia and somatic complaints in psychiatric out-patients. Journal of Psychosomatic Research, 36(5), 417–424. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1619582.CrossRefGoogle ScholarPubMed
Tick, N. T., van der Ende, J., & Verhulst, F. C. (2008). Ten-year trends in self-reported emotional and behavioral problems of Dutch adolescents. Social Psychiatry and Psychiatric Epidemiology, 43(5), 349–355. doi:10.1007/s00127-008-0315-3.CrossRefGoogle ScholarPubMed
van Os, J., Hanssen, M., Bijl, R. V., & Vollebergh, W. (2001). Prevalence of psychotic disorder and community level of psychotic symptoms - An urban-rural comparison. Archives of General Psychiatry, 58(7), 663–668. doi:10.1001/archpsyc.58.7.663.CrossRefGoogle ScholarPubMed
Verhulst, F. C., Prince, J., Vervuurt-Poot, C., & de Jong, J. (1989). Mental health in Dutch adolescents: Self-reported competencies and problems for ages 11–18. Acta Psychiatrica Scandinavica, 356(Supplementum), 1–48. https://www.ncbi.nlm.nih.gov/pubmed/2618795.CrossRefGoogle ScholarPubMed
Weaver, A., Himle, J. A., Taylor, R. J., Matusko, N. N., & Abelson, J. M. (2015). Urban vs rural residence and the prevalence of depression and mood disorder Among African American Women and Non-Hispanic White Women. JAMA Psychiatry, 72(6), 576–583. doi:10.1001/jamapsychiatry.2015.10.CrossRefGoogle Scholar
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., … Vos, T. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. Lancet (London, England), 382(9904), 1575–1586. doi:10.1016/S0140-6736(13)61611-6.CrossRefGoogle ScholarPubMed
Young, A. M., Havens, J. R., & Leukefeld, C. G. (2012). A comparison of rural and urban nonmedical prescription opioid users’ lifetime and recent drug use. American Journal of Drug and Alcohol Abuse, 38(3), 220–227. doi:10.3109/00952990.2011.643971.CrossRefGoogle Scholar
Zimmermann, G. (2006). Delinquency in male adolescents: The role of alexithymia and family structure. Journal of Adolescence, 29(3), 321–332. doi:10.1016/j.adolescence.2005.08.001.CrossRefGoogle ScholarPubMed