摘要：Objectives. We compared the prevalence of serious psychological distress among parenting adults with the prevalence among nonparenting adults and the sociodemographic correlates of serious psychological distress between these 2 populations. Methods. We drew data from 14240 parenting adults and 19224 nonparenting adults who responded to the 2002 National Survey on Drug Use and Health. We used logistic regression procedures in our analysis. Results. An estimated 8.9% of parenting adults had serious psychological distress in the prior year compared with 12.0% of nonparenting adults of similar age. In both groups, the adjusted odds of having serious psychological distress were higher among adults who were women, younger (between the ages of 18 and 44 years), low income, or receiving Medicaid. We found some differences in the correlates of serious psychological distress between parenting adults and nonparenting adults. The odds of having serious psychological distress were lower among parenting adults after we controlled for demographic characteristics. Conclusions. Serious psychological distress is fairly prevalent among parenting adults, and high-risk sociodemographic groups of parenting adults should be targeted to ensure access to coordination of services. The public health burden of mental illness is significant. Mental illness among parenting adults has potential negative effects on child-rearing practices, overall family functioning, and children’s development. Mentally ill parents raising children are at high risk of being hostile, insensitive, unresponsive, and of using harsh, coercive, or inconsistent disciplinary methods, 1 – 5 all of which have been linked to psychological and behavioral problems in children later in life. 6 – 13 Parental mental illness is especially important to identify and treat, because 23% to 50% of adults with psychiatric disorders have co-occurring substance use problems, 14 , 15 which have also been linked to a plethora of poor child-rearing practices, family problems, and negative child development outcomes. 16 – 27 Children of parents with psychiatric disorders experience elevated risks for psychiatric disturbance and academic, social, and emotional impairments. 3 , 13 , 28 – 32 Rates of psychiatric disorders among children with mentally ill parents range from 30% to 50%, 33 , 34 compared with 20% among children overall. 35 Consequences of parental mental health problems include insecure mother–child attachment and delayed development in infants; aggression, destructive behavior, and impaired development in toddlers; and physical and psychological problems, school failure, substance use, suicidal behaviors, social withdrawal, cognitive impairment, and poor overall adjustment for school-aged children. 28 Unfortunately, many mental health agencies do not collect basic information on clients’ parenting status, which could be used to assess potential risk to their children, 36 and assistance with appropriate parenting skills is rarely provided. 30 , 37 – 41 Mental illness among parents has drawn national attention in recent years. 36 , 42 – 44 Data from the National Comorbidity Survey (NCS) show that the lifetime prevalence of psychiatric disorders is similar for mothers and for all women in the general population, but the prevalence for fathers is lower than for all men in the general population. 40 , 44 However, parents in the NCS were older and more educated than the general population, and the data examined biological parents, regardless of the child’s age or whether the child lived with the parent; step-parents, adoptive parents, and foster parents raising children were not included. Another recent analysis of parenting and mental illness used 1987–1988 data, 43 which could not address changes in family demographics, social policy, and mental health treatment practices that have occurred during the past 19 years. Identifying subgroups of parenting adults most vulnerable to mental illness is important for prioritizing risk factors for targeted interventions; it can also be a first step toward identifying parents with co-occurring mental illness and substance use problems. However, correlates of mental illness among parenting adults have not been examined. Among the general population, the prevalence of mental illness is significantly higher among women, young adults (those aged 18–34 years), those with lower income or education, divorced or separated individuals, and Medicaid recipients. 40 , 41 , 45 – 48 Findings about the prevalence of mental health problems by race/ethnicity, employment status, and urbanicity have been mixed. 41 , 46 , 49 – 51 A recent analysis using a national sample considered multiple risk factors in a regression model and identified younger age (ages 18–49 years), divorced or never married status, poorer perceived overall health, and lack of social support as correlates of mental illness; Black or Hispanic race/ethnicity was a protective factor. 14 To better plan for mental health services for parenting adults, we examined the prevalence and sociodemographic correlates of serious psychological distress, which is highly correlated with affective and anxiety disorders, 52 among adults interviewed in a nationally representative survey of the US population. We sought to answer 5 questions: (1) What is the prevalence of past-year serious psychological distress among parenting adults? (2) Among parenting adults, what subgroups were most likely to have serious psychological distress? (3) Were there differences between parenting and nonparenting adults in the prevalence of serious psychological distress? (4) Were there differences between parenting and nonparenting adults in the correlates of serious psychological distress? (5) Do differences in prevalence of serious psychological distress between parenting and nonparenting adults exist after control for sociodemographic characteristics? We were particularly interested in comparisons between parenting and nonparenting adults by race/ethnicity, employment status, and urbanicity, because the literature on the general population is inconclusive about these potential correlates. On the basis of NCS findings, we hypothesized that any differences between parenting and nonparenting adults would not be statistically significant after we controlled for sociodemographic differences. To our knowledge, comparisons between parenting and nonparenting adults regarding past-year risk of serious psychological distress and high-risk subgroups have not been addressed in previous research.
