Are American children's problems getting worse? A 13-year comparison

J Am Acad Child Adolesc Psychiatry. 1993 Nov;32(6):1145-54. doi: 10.1097/00004583-199311000-00006.


Objective: To determine whether the prevalence of children's behavioral/emotional problems changed significantly over a 13-year period.

Method: Problems and competencies reported by parents and teachers for a random sample of 7 to 16 years old assessed in 1989 were compared with those reported by parents for a 1976 sample and by teachers for a 1981 to 1982 sample. Parent reports were obtained with the Child Behavior Checklist; teacher reports were obtained with the Teacher's Report Form.

Results: Problem scores were higher and competence scores were lower in 1989 than in the earlier assessments. The secular changes were small but included diverse problems, syndromes, and competencies. Changes did not differ significantly by age, gender, socioeconomic status, nor black/white ethnicity. Correlations of 0.97 to 0.99 between rankings of item scores across 7.5- and 13-year intervals support the stability of the assessment procedures. Despite increases in problem scores, the 1989 U.S. scores were not higher than those in several other cultures.

Conclusions: Viewed categorically in terms of caseness, more untreated children in the 1989 than the 1976 sample would be considered to need help. Multicohort longitudinal studies now in progress will test predictors of within- and between-cohort change.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Adolescent Psychiatry
  • Child
  • Child Behavior
  • Cohort Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Disorders / epidemiology*
  • Mental Health Services / statistics & numerical data*
  • Patient Acceptance of Health Care
  • Surveys and Questionnaires
  • United States / epidemiology