Skip to main content
Articles

A Nationally Representative Epidemiological and Risk Factor Assessment of Child Mental Health in Vietnam

Published Online:https://doi.org/10.1037/ipp0000016

As part of the global mental health movement’s focus on identifying and reducing international disparities, this study conducted the first nationally representative child mental health epidemiological survey in Vietnam. We assessed as risk/protective factors several family social structure characteristics (e.g., presence of grandparents, number of siblings in the home) of particular relevance to non-Western countries. Epidemiological data using the Child Behavior Checklist and the Strengths and Difficulties Questionnaire were collected at 60 sites in 10 of Vietnam’s 63 provinces selected to provide a nationally representative sample, which included 1,314 adult informants of children 6 to 16 years of age, and 591 children aged 12 to 16. Vietnamese children’s mental health functioning was reported overall to be better by approximately a third standard deviation than the international average; this international difference was particularly large for externalizing (behavior) problems as compared with internalizing (emotional) problems, suggesting that a cultural problem suppression model may be operating in Vietnam. Significant variability in mental health problems was found across provinces, emphasizing the need for nationally representative samples when conducting child mental health epidemiological surveys. Contrary to many other studies, in Vietnam higher SES was found to be a risk factor for attention/hyperactivity problems.

References

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age form & profiles. Burlington, VT: University of Vermont Research Center for Children, Youth, & Families. First citation in articleGoogle Scholar

  • Achenbach, T. M., & Rescorla, L. A. (2012). Sach huong dan su dung phieu hoi he thong danh gia Achenbach (ASEBA) [Instruction manual for using the Achenbach Assessment System (ASEBA) questionnaires]. Hanoi, Vietnam: Vietnam National University Press. First citation in articleGoogle Scholar

  • Amstadter, A. B., Richardson, L., Meyer, A., Sawyer, G., Kilpatrick, D. G., Tran, T. L., … Acierno, R. (2011). Prevalence and correlates of probable adolescent mental health problems reported by parents in Vietnam. Social Psychiatry and Psychiatric Epidemiology, 46, 95–100. doi: 10.1007/s00127-009-0172-8 First citation in articleCrossrefGoogle Scholar

  • Anh, H., Minh, H., & Phuong, D. (2006). Social and behavioral problems among high school students in Ho Chi Minh City. In L. B. DangB. Weiss (Eds.), Research findings from the Vietnam Children’s Mental Health Research Training Program (pp. 111–196). Hanoi, Vietnam: Educational Publishing House. First citation in articleGoogle Scholar

  • Becker, A. E., & Kleinman, A. (2013). Mental health and the global agenda. The New England Journal of Medicine, 369, 66–73. doi: 10.1056/NEJMra1110827 First citation in articleCrossrefGoogle Scholar

  • Central Intelligence Agency. (2012). World Fact Book - Vietnam. Washington, DC: Author. First citation in articleGoogle Scholar

  • Cohen, J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1, 98–101. doi: 10.1111/1467-8721.ep10768783 First citation in articleCrossrefGoogle Scholar

  • Curry, L. A., Luong, M. A., Krumholz, H. M., Gaddis, J., Kennedy, P., Rulisa, S., … Bradley, E. H. (2010). Achieving large ends with limited means: Grand strategy in global health. International Health, 2, 82–86. doi: 10.1016/j.inhe.2010.02.002 First citation in articleCrossrefGoogle Scholar

  • Deng, C., Chen, G., & Shi, Z. (2003). Behavior problems of children reared by grandparents: Assessment and intervention. Chinese Mental Health Journal, 17, 196–203. First citation in articleGoogle Scholar

  • Du, Y., Kou, J., & Coghill, D. (2008). The validity, reliability and normative scores of the parent, teacher and self-report versions of the Strengths and Difficulties Questionnaire in China. Child and Adolescent Psychiatry and Mental Health, 2, 2–8. doi: 10.1186/1753-2000-2-8 First citation in articleCrossrefGoogle Scholar

  • Elgar, F. J., Craig, W., & Trites, S. J. (2013). Family dinners, communication, and mental health in Canadian adolescents. Journal of Adolescent Health, 52, 433–438. doi: 10.1016/j.jadohealth.2012.07.012 First citation in articleCrossrefGoogle Scholar

  • Gabriele, A. (2006). Social services policies in a developing market economy oriented towards socialism: The case of health system reforms in Vietnam. Review of International Political Economy, 13, 258–289. doi: 10.1080/09692290600625504 First citation in articleCrossrefGoogle Scholar

  • General Statistics Office of Vietnam. (2014, February 17). Statistical censuses and surveys. Retrieved from http://www.gso.gov.vn First citation in articleGoogle Scholar

  • Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586. doi: 10.1111/j.1469-7610.1997.tb01545.x First citation in articleCrossrefGoogle Scholar

  • Goodman, R. (2013, June 20). Scoring the informant-rated Strengths and Difficulties Questionnaire. Retrieved from http://www.sdqinfo.org/py/sdqinfo/c0.py First citation in articleGoogle Scholar

  • Graham, E., & Jordan, L. P. (2011). Migrant parents and the psychological well-being of left-behind children in Southeast Asia. Journal of Marriage and Family, 73, 763–787. doi: 10.1111/j.1741-3737.2011.00844.x First citation in articleCrossrefGoogle Scholar

  • Graves, S. L., Jr., Blake, J., & Kim, E. S. (2012). Differences in parent and teacher ratings of preschool problem behavior in a national sample: The significance of gender and SES. Journal of Early Intervention, 34, 151–165. doi: 10.1177/1053815112461833 First citation in articleCrossrefGoogle Scholar

  • Hinton, D. E., Kredlow, M. A., Pich, V., Bui, E., & Hofmann, S. G. (2013). The relationship of PTSD to key somatic complaints and cultural syndromes among Cambodian refugees attending a psychiatric clinic: The Cambodian Somatic Symptom and Syndrome Inventory (CSSI). Transcultural Psychiatry, 50, 347–370. doi: 10.1177/1363461513481187 First citation in articleCrossrefGoogle Scholar

  • Kieling, C., & Rohde, L. A. (2012). Going global: Epidemiology of child and adolescent psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1236–1237. doi: 10.1016/j.jaac.2012.09.011 First citation in articleCrossrefGoogle Scholar

  • Krieger, N. (2011). Epidemiology and the people’s health: Theory and context. New York, NY: Oxford University Press. doi: 10.1093/acprof:oso/9780195383874.001.0001 First citation in articleCrossrefGoogle Scholar

  • Lansford, J. E., Malone, P. S., Dodge, K. A., Chang, L., Chaudhary, N., Tapanya, S., … Deater-Deckard, K. (2010). Children’s perceptions of maternal hostility as a mediator of the link between discipline and children’s adjustment in four countries. International Journal of Behavioral Development, 34, 452–461. doi: 10.1177/0165025409354933 First citation in articleCrossrefGoogle Scholar

  • Macera, C. A., Ham, S. A., Yore, M. M., Jones, D. A., Ainsworth, B. E., Kimsey, C. D., & Kohl, H. W. (2005). Prevalence of physical activity in the United States: Behavioral Risk Factor Surveillance System, 2001. Preventing Chronic Disease, 2, 1–10. First citation in articleGoogle Scholar

  • Martel, M. M. (2013). Individual differences in attention deficit hyperactivity disorder symptoms and associated executive dysfunction and traits: Sex, ethnicity, and family income. American Journal of Orthopsychiatry, 83, 165–175. doi: 10.1111/ajop.12034 First citation in articleCrossrefGoogle Scholar

  • McKelvey, R. S., Davies, L. C., Sang, D. L., Pickering, K. R., & Tu, H. C. (1999). Problems and competencies reported by parents of Vietnamese children in Hanoi. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 731–737. doi: 10.1097/00004583-199906000-00021 First citation in articleCrossrefGoogle Scholar

  • Ngoc, H. (2012). Wandering through Vietnamese culture. Hanoi, Vietnam: The Gioi Publishers. First citation in articleGoogle Scholar

  • Prentice, D. A., & Miller, D. T. (2003). When small effects are impressive. In A. E. Kazdin (Ed.), Methodological issues and strategies in clinical research (3rd ed., pp. 127–146). Washington, DC: APA. First citation in articleGoogle Scholar

  • Rescorla, L., Achenbach, T., Ivanova, M. Y., Dumenci, L., Almqvist, F., Bilenberg, N., … Verhulst, F. (2007). Behavioral and emotional problems reported by parents of children ages 6 to 16 in 31 societies. Journal of Emotional and Behavioral Disorders, 15, 130–142. doi: 10.1177/10634266070150030101 First citation in articleCrossrefGoogle Scholar

  • 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, 1273–1283. doi: 10.1016/j.jaac.2012.09.012 First citation in articleCrossrefGoogle Scholar

  • Rogers, M. A., Wiener, J., Marton, I., & Tannock, R. (2009). Supportive and controlling parental involvement as predictors of children’s academic achievement: Relations to children’s ADHD symptoms and parenting stress. School Mental Health, 1, 89–102. doi: 10.1007/s12310-009-9010-0 First citation in articleCrossrefGoogle Scholar

  • Rommel, A. S., Halperin, J. M., Mill, J., Asherson, P., & Kuntsi, J. (2013). Protection from genetic diathesis in attention-deficit/hyperactivity disorder: Possible complementary roles of exercise. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 900–910. doi: 10.1016/j.jaac.2013.05.018 First citation in articleCrossrefGoogle Scholar

  • Ruiz-Casares, M., & Heymann, J. (2009). Children home alone unsupervised: Modeling parental decisions and associated factors in Botswana, Mexico, and Vietnam. Child Abuse and Neglect, 33, 312–323. doi: 10.1016/j.chiabu.2008.09.010 First citation in articleCrossrefGoogle Scholar

  • Silverman, L. R. (2011). Thriving with or without them: The presence of siblings and its relation to adolescent adjustment (Doctoral dissertation), New York University, NY. First citation in articleGoogle Scholar

  • Stern, L. M. (1998). The Vietnamese Communist Party’s agenda for reform: A study of the eighth national party congress. Jefferson, NC: McFarlane. First citation in articleGoogle Scholar

  • Tran, N. T. (2001). Discovering the identity of Vietnamese culture (3rd ed.). Ho Chi Minh City, Vietnam: Ho Chi Minh City Publishing House. First citation in articleGoogle Scholar

  • Trang, N. H., Hong, T. K., Dibley, M. J., & Sibbritt, D. W. (2009). Factors associated with physical inactivity in adolescents in Ho Chi Minh City, Vietnam. Medicine and Science in Sports and Exercise, 41, 1374–1383. doi: 10.1249/MSS.0b013e31819c0dd3 First citation in articleCrossrefGoogle Scholar

  • Tu, H. C. (1994). Psychological assessment of school-children. Monographs from the XVIth National Congress of Pediatrics (pp. 218–219). Hanoi, Vietnam: Institute for Protection of Children’s Health. First citation in articleGoogle Scholar

  • Vaughn, M. G., Wexler, J., Beaver, K. M., Perron, B. E., Roberts, G., & Fu, Q. (2011). Psychiatric correlates of behavioral indicators of school disengagement in the United States. Psychiatric Quarterly, 82, 191–206. doi: 10.1007/s11126-010-9160-0 First citation in articleCrossrefGoogle Scholar

  • Verhulst, F. C., Achenbach, T. M., van der Ende, J., Erol, N., Lambert, M. C., Leung, P. W. L., … Zubrick, S. R. (2003). Comparisons of problems reported by youths from seven countries. The American Journal of Psychiatry, 160, 1479–1485. doi: 10.1176/appi.ajp.160.8.1479 First citation in articleCrossrefGoogle Scholar

  • Weiss, B., Ngo, V. K., Dang, H. M., Pollack, A., Trung, L. T., Tran, C. V., … Do, K. N. (2012). A model for sustainable development of child mental health infrastructure in the LMIC world: Vietnam as a case example. International Perspectives in Psychology: Research, Practice, Consultation, 1, 63–77. doi: 10.1037/a0027316 First citation in articleLinkGoogle Scholar

  • Weisz, J. R., & Kazdin, A. E. (2010). Evidence-based psychotherapies for children and adolescents (2nd ed.). New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Weisz, J. R., Suwanlert, S., Chaiyasit, W., Weiss, B., Achenbach, T. M., & Eastman, K. L. (1993). Behavioral and emotional problems among Thai and American adolescents: Parent reports for ages 12–16. Journal of Abnormal Psychology, 102, 395–403. doi: 10.1037/0021-843X.102.3.395 First citation in articleCrossrefGoogle Scholar

  • World Bank. (2010). Gross national income per capita 2009. Washington, DC: Author. First citation in articleGoogle Scholar

  • Yi, H., Zhang, L., Luo, R., Shi, Y., Mo, D., Chen, X., … Rozelle, S. (2012). Dropping out: Why are students leaving junior high in China’s poor rural areas? International Journal of Education Development, 32, 555–563. doi: 10.1016/j.ijedudev.2011.09.002 First citation in articleCrossrefGoogle Scholar