Internalizing problems among primary school children in Hong Kong: Prevalence and treatment
- Internalizing problems among primary school children in Hong Kong: Prevalence and treatment
- Hong Kong
- 1997.7 onwards
- Primary Education
- Early identification of internalizing problems in young children is important as internalizing behaviour may intensify over time and lead to psychiatric disorders (e.g., Seligman & Ollendick, 1998), or even suicide (e.g., Lewinshon, Rohde, & Seeley, 1998). The internalizing problems of Hong Kong young children also reached an alarming point. A recent survey released by the Hong Kong Association for Careers Masters and Guidance Masters (HKACMGM) in late 2005 indicated that around 75 percent of primary school children considered themselves unhappy in their daily life. The present research looked into the internalizing problems among Hong Kong primary school children. It consisted of two studies. Study One was on the prevalence of childhood internalizing problems, and its association with mother-child relationship. Study Two was a treatment outcome research on the effectiveness of different intervention programs for these children. Three interventions were compared with the waitlist control group in order to identify the effectiveness of interventions on reducing internalizing symptoms, enhancing mother-child relationship, and increasing self-esteem. These interventions were: FRIENDS (cognitive-behavioural approach), THERAPLAY (relationship-based approach), and COPE (an integrative approach).
1598 students (from Primary 2 to Primary 4) participated in Study One on prevalence. Data on internalizing problems were collected using the Child Behaviour Checklist (CBCL). The overall prevalence rate in the current sample was 11.4 percent. Association between children's internalizing problem and mother-child relationship was assessed using the Parent-Child Relationship Questionnaire (PCRQ). Warmth in PCRQ had the highest negative correlation with Anxious/Depressed in CBCL.
Study Two included 92 children whose CBCL score reached at least the cutoff point (i.e., they were considered as "high risk" for having internalizing disorders) and met the selection criteria for the treatment groups. These children and their mothers were randomly allocated either to one of the three treatment conditions (n=23, 22, 23 respectively) and completed an 8-session intervention program, or to a wait-list control condition (control group, n=24). Children completed the Reynold's Child Depression Scale (RCDS), Screening for Children Anxiety-Related Disorders (SCARED) Culture-free Self-Esteem Inventory (CFSEI) at pre- and post-intervention while mothers completed the Child Behaviour Checklist (CBCL) and the Parent-Child Relationship Questionnaire (PCRQ) at post-intervention. 1-month follow-up assessment on the above measures was conducted. Peer nomination was done at pre- and post-intervention as well as at 1-month follow-up time points to explore more on the impact of these interventions on children's social world. Results showed that intervention of any kind could help to reduce children's internalizing problems. Such reduction could, in general, be maintained to the follow-up period despite fluctuations in between. Three major findings on the intervention programs were highlighted. First, COPE, using an integrative approach, had the biggest drop in internalizing problems as measured by CBCL. Second, FRIENDS and COPE were particularly effective in enhancing warmth, disciplinary warmth (as seen by mothers) and personal relations (as reported by children). Third, THERAPLAY was reported to be effective in reducing children's social anxiety and in enhancing children's social self-esteem.
In general, this research was among the first few in Hong Kong on assessing the prevalence rate of internalizing problem and its association with mother-child relationship. The results on the impact of different interventions on children provided further insight to local practitioners in evaluating the characteristics of their intervention programs on these children. Limitations of this research were also discussed.
- Chinese University of Hong Kong
- Hong Kong
- Source: Dissertation Abstracts International, Volume: 69-01, Section: A, page: 0115
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