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Objective: To determine the distribution of behavioral and emotional problems and competencies among a sample of Vietnamese children aged 4
through 18 years living in Hanoi. Method: A representative community sample of 1,526 children and adolescents was selected from 2 precincts in
Hanoi. Problems and competencies were assessed with the Child Behavior Checklist (CBCL). Results: Vietnamese children had lower mean raw scores
than U.S. norms on the CBCL's Total, Externalizing, Internalizing, and Competence scales. Boys were reported to have more externalizing problems
and girls more internalizing problems. Girls' levels of internalizing problems increased significantly with age. Conclusion: The lower levels of problems
and competencies reported in Vietnamese children may represent differences in the prevalence of psychiatric disorders, in parental perceptions of
what constitutes deviant behavior, or in parental comfort with reporting psychopathological behaviors. Further research is needed to clarify the
relationship between the reported behavioral and emotional problems of Vietnamese children and the presence of psychiatric disorders. From a clinical
perspective, the study's results suggest that levels of problems and competencies may vary significantly between different ethnic and cultural groups.
Specific clinical cutoffs used to identify children requiring further psychiatric assessment need to be established separately for different ethnic groups.
J. Am. Acad. Child Adolesc. Psychiatry,
Key Words: behavior problems, emotional problems, psychiatric disorders, Vietnam.
The children of Vietnam have been, and continue to be, exposed to much trauma and adversity. Decades of war, disastrous postwar economic
policies, and the U.S. trade embargo left Vietnam impoverished and unable to meet the basic nutritional needs of its young and rapidly growing
population (Duiker, 1985; National Institute of Nutrition of Vietnam, 1993; San, 1991). Widespread infectious diseases, and a lack of effective
antibiotics and vaccines, left Vietnamese children vulnerable to the direct effects of insults to their developing central nervous systems and to the
indirect effects of parental loss and morbidity (Ahn and Tram, 1995; UNICEF, 1995). Economic reform and the introduction of a market economy have
led to a gradual improvement in Vietnam's standard of living, but rapid socioeconomic change has also brought new problems. As job seekers leave
the countryside for Vietnam's swelling cities, the protective structure of the traditional Vietnamese extended family is undermined, leading to an
expanding population of poorly supervised young people and street children and a sharp rise in rates of alcohol and drug abuse, conduct disorder, and
human immunodeficiency virus infection (Nhan, 1995; Trong, 1995).
Poverty, poor nutrition, chronic illness, and parental separation and loss would appear to place the children of Vietnam at high risk for the