Change in psychopathology in referred children: the role of life events and perceived stress.

BACKGROUND This study examined the relation between stress and change in emotional and behavioural problems in children and adolescents referred for mental health services. METHOD At three waves across four years, children and their parents (N = 310, mean age at the first wave = 11.26 years, SD = 3.18) reported emotional and behavioural problems, as well as stressful life events (parent report) and perceived stress (child report). RESULTS Major life events before referral were associated with higher levels of parent-reported internalising and externalising problems at referral. Life events after referral were associated with a slower recovery from internalising problems. The associations between stressful life events and the course of parent- and self-reported problems were mediated by children's subjective feelings of stress. CONCLUSION Stressful life events appear to interfere with recovery from internalising problems in the years after referral through increasing the experience of stress in daily life.