Persistence and change in behavioral/emotional problems reported by parents of children aged 4–14: an epidemiological study

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Abstract
Crucial to our understanding of psychopathology in children is information on the stability and change of behavioral/emotional problems and competencies across time. Existing studies, reviewed in this article, provide only limited answers due to one or more of the following factors: restriction of the sample to a single locality, the use of selected samples, large sample attrition, the use of different assessment instruments at different times, the small number of specific behavioral/emotional problems or the use of very broad categories of functioning. The present study was designed to test the persistence and change of behavioral/emotional problems and competencies as reported by parents of 1,412 children aged 4-14 over a two-year period in a representative sample of the general population. At both points, standardized parents'' reports were obtained using the Achenbach Child Behavior Checklist (CBCL). A recovery rate of 80.2% was obtained. Our study is the only one, as far as we know, to present follow-up data separately for ages covering the preschool period to adolescence, making it possible to compare stabilities in the occurrence of behavioral/emotional problems across various developmental levels. Over the two-year follow-up period, there was a significant decrease in problem scores. Although possible, it is unlikely that the mental health of children in our sample increased very much. A decrease in problem scores over time has been demonstrated for clinical as well as general population samples in other studies as well. No satisfactory explanations are available for this phenomenon. It is important, however, that studies employing a retest design take account of this phenomenon. Our findings underscore the notion that behavioral/emotional problems should not be regarded static. The study of child psychopathology should take account of the many variations in the types and level of pathological manifestations across time. It is therefore important that changes in behavioral/emotional problems be viewed against a background of normative data such as we have presented.