Skip to main content
PMC home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2013 Nov 7.
Published in final edited form as: Learn Disabil Q. 2012 Feb 1;35(1):10.1177/0731948711428772. doi: 10.1177/0731948711428772

Anxiety, Depression, and Coping Skills Among Mexican School Children: A Comparison of Students With and Without Learning Disabilities

Julia Gallegos 1, Audra Langley 2, Diana Villegas 1
PMCID: PMC3820485  NIHMSID: NIHMS430450  PMID: 24223470

Abstract

The purpose of this study was to compare severity and risk status for anxiety and depression with coping skills among 130 Mexican school children with learning disabilities (LD) and 130 school children without LD. This research is the first to explore the emotional difficulties of Mexican children with LD. Children completed the Spanish version of the Spence Children’s Anxiety Scale and Children’s Depression Inventory, and the Cuestionario de Afrontamiento (Coping Skills Questionnaire). Results indicated that a higher percentage of children with LD were at risk for anxiety (22.3% vs. 11.5%) and depression (32% vs. 18%). No statistically significant differences were found for coping skills. Results support the idea that there is an increased awareness of comorbid depression and anxiety among students with LD and a need to promote early identification and intervention in schools. Efforts should focus on better understanding the relationship between social-emotional difficulties and academic achievement and on developing effective interventions to support children with LD.

Keywords: anxiety, depression, learning disabilities, elementary school

Anxiety disorders, which affect 10% to 20% of children, are the most prevalent form of psychopathology in childhood. They have been identified as a salient mental health concern, particularly because anxiety can be associated with depression, deviant conduct, and substance abuse (Caraveo-Anduaga & Comenares-Bermúdez, 2002; Costello et al., 2002; Kendall & Suveg, 2006), as well as interference with school, social, and familial functioning (Langley, Bergman, McCracken, & Piacentini, 2004). According to a recent study conducted in Mexico, approximately 40% of Mexican adolescents, ages 12 to 17, have a mental health disorder, with anxiety disorders being most commonly reported, followed by impulse-control disorders, mood disorders, and substance abuse (Benjet, Borges, Medina-Mora, Zambrano, & Aguilar-Gaxiola, 2009). During adulthood, anxiety disorders have also been reported as the most prevalent form of psychopathology both in the United States and in Mexico (Kessler et al., 2005; Medina-Mora et al., 2003). Medina-Mora et al. (2003) reported that after anxiety disorders, affective disorders (e.g., depression) and substance abuse are the most common mental health problems experienced in Mexico.

Children with learning disabilities (LD) perform substantially lower than what is expected based on intelligence and age (Fletcher, Morris, & Lyon, 2004), and previous studies suggest that children with LD are predisposed to social and emotional difficulties (Elksnin & Elksnin, 2004; Forness, Walker, & Kavale, 2003; Kavale & Moster, 2004; Margalit & Zak, 1984; Sharma, 2004; Svetaz, Ireland, & Blum, 2000). Therefore, this group of children may be at greater risk for anxiety and depressive disorders when compared with their typically developing peers.

Low achievement has been related to school failure and poor academic and emotional skills (Margalit & Zak, 1984; Patten, 1983), and school failure is a distinct characteristic of children with LD (Martinez & Semrud-Clikerman, 2004. Different explanations have been raised for the relationship between school failure and poor academic and emotional functioning (Greenham, 1999; Sundheim & Voeller, 2004). Some researchers suggest that both social and learning impairments are caused by a deviation in the functioning of the central nervous system called atypical brain development (Kaplan, Dewey, Crawford, & Wilson, 2001; Rourke & Fuerst, 1991); others suggest that chronic school failure triggers emotional difficulties (Patten, 1983). There is also the hypothesis that the problems compound one another (Al-Yagon & Mikulincer, 2004; Martinez & Semrud-Clikerman, 2004).

Affective variables such as self-concept, attributions, motivation, anxiety, temperament, loneliness, and depression have been studied in children with LD, with most studies reporting that children with LD experience difficulties in these areas (Bender & Wall, 1994; Lackaye, Margalit, Ziv, & Ziman, 2006; LaGreca & Stone, 1990; Manassis & Young, 2004; Margalit & Al-Yagon, 2002; Mayron, 1978; Sundheim & Voeller, 2004). Children with LD frequently show characteristics such as behavioral inhibition and maladaptive cognition, which lead to anxiety (Al-Yagon & Mikulincer, 2004). Expressions of anxiety in the form of crying and worrying, symptoms of somatic distress, and avoidant behavior have often been reported for students with LD (Margalit & Heiman, 1986). Several studies have concluded that children with LD, when compared to typically developing peers, show higher levels of anxiety and helplessness (Margalit & Zak, 1984; Rodriguez & Routh, 1989; Sharma, 2004). Similarly, research suggests that children with LD are more likely to show higher levels of loneliness and depression than their typically developing peers (Margalit, 2006; Newcomer & Barenbaum, 1995). Studies have found that children with LD, particularly girls, frequently experience higher levels of negative mood, lower levels of positive mood, and higher levels of depression (Heath & Ross, 2000; Lackaye et al., 2006; Maag & Reid, 2006; Martinez & Semrud-Clikerman, 2004; Sundheim & Voeller, 2004).

Rodriguez and Routh (1989) investigated depression, anxiety, and attributional style in children with LD and typically developing children. Sixty-two children, ranging from 8 to 13 years old, were assessed with the Children’s Attributional Style Questionnaire (CASQ), the Children’s Depression Inventory (CDI), the Revised Children’s Manifest Anxiety Scale (RCMAS), the Anxiety-Withdrawal of the Revised Behavior Problem Checklist (RBPC), and the Peer Nomination Inventory of Depression. Results showed that children with LD reported significantly more anxiety on both anxiety measures than the control group. Furthermore, children who were diagnosed with LD for a longer period of time reported higher levels of anxiety and peer-nominated depression when compared to both control group and children who were recently diagnosed with LD (Rodriguez & Routh, 1989).

The literature on coping skills of children with LD is scarce, but the characteristics of these children suggest that they may have difficulties using proactive coping skills when facing problems and challenges (Mohr et al., 1980). A study by Dietrich and Kelly (1993) concluded that high school students with learning disabilities reported inconsistent effort and inadequate use of compensatory skills. The academic skills reported by the participants of this study ranged from sporadic to absent, as when experiencing a difficulty they made little effort to contact a high school teacher (Dietrich & Kelly, 1993).

Although learning disabilities account for about 50% of the cases referred to special education in Mexico (Fletcher, 1990; Secretaría de Educación Pública, 2002), so far there has been no investigation published in a peer-reviewed journal concerning anxiety, depression, and coping skills among Mexican children with LD. The purpose of this study was to compare the severity of anxiety symptoms and risk status for anxiety, the severity of depressive symptoms and risk status for depression, and coping skills among Mexican students with learning disabilities and their peers without learning disabilities.

Method

Participants

Participants were fourth- and fifth-grade children 9 to 12 years old (M = 9.9 years) attending eight schools in a city of the northern region of Mexico. Schools were randomly selected and were all representative of Level 6 socioeconomic status (SES), a metric used by the Instituto Nacional de Estadística y Geografía (National Institute of Geography and Information in Mexico) and accounting for 70% of the population. Level 6 represents low SES.

Socioeconomic status

Level 6. In Level 6, 91.83% of the population can read and write, 91.85% of the population ages 6 to 14 go to school, 69.82% of the population ages 12 to 17 go to school, 49.91% of the population over 15 years old have post primary education, 30.73% of the working population earns more than two and a half minimum salary wages per day (the minimum salary is $53.26 Mexican pesos, which equals $4.23 USD), and only 9.24% of the population earns more than five salary wages per day (Instituto Nacional de Estadística y Geografía, 2006). Schools were coeducational, inclusive settings for students with LD, had at least two classrooms at each grade 4 and 5, and were served by the Gabinetes de Servicios Educativos (Office of Educational Services), a unit within the Special Education Department of the State that provides services to the regular primary schools. The sample for this study was part of a larger study (see Gallegos, 2008).

Identification of learning disabilities

Children with LD were identified through school records. In Mexico, students are identified as LD if (a) they are below the 25th percentile in academic achievement, (b) the learning disability is not due to other conditions such as sensory or physical handicaps, (c) academic difficulties persist after the classroom teacher provides adequate instruction, and (d) students are referred, evaluated, and identified with LD by the Gabinetes de Servicios Educativos. The cases referred to Gabinetes de Servicios Educativos are evaluated by a multidisciplinary team composed of a psychologist, an educator, a speech therapist, a social worker, and a medical doctor. The assessment conducted by the educator is based on the Psychogenetic Theory of Jean Piaget, where the educator determines the developmental level, especially in reading and mathematics. The educator also takes into account the academic history through a semistructured interview with parents.

A student is identified as having LD if his or her performance is below his or her developmental level. The psychologist conducts an interview with the student and the parents to gather information about his or her clinical history, emotional state, psychomotor development, and interpersonal relationships. The psychological tests applied are the Bender Visual Motor Gestalt Test and the Draw a Person Test by Karen Machover. In the psychology area they analyze the emotional factors that might affect learning. The speech therapist evaluates the pragmatic, syntactic, semantic, and phonological aspects of language. The social worker revises the family and community aspects that might be affecting the student’s learning. And finally, the medical doctor analyzes if the student presents a visual, hearing, or other impairment. With this information, the multidisciplinary team gets together to provide the diagnosis of having a “learning disability” (Secretaría de Educación Pública, 2002).

sample selection

For this study, only those participants who had completed the three self-report questionnaires of anxiety, depression, and coping skills were included. There were initially 831 children without LD and 130 children with LD. Before doing the random assignment to select 130 children without LD, chi-square analyses were conducted to ensure that there were no statistically significant differences between children with and without LD for age, grade, and gender. Chi-square analyses revealed that there were no statistically significant differences for age, x2(3, n = 961) = 3.45, p > .05, and grade, x2(1, n = 961) = 0.72, p > .05. There were statistically significant differences for gender, x2(1, n = 961) = 16.20, p < .05.

Therefore, the random selection of the 130 cases from the group without LD was conducted within gender cells. The final sample consisted of 260 children: 130 children with LD and 130 children without LD. Eighty-three of the children with LD were boys (63.85%) and 47 were girls (36.15%); 63 were in Grade 4 (48.5%) and 67 were in Grade 5 (51.5%). The age range of children with LD was from 9 to 12 years, with a mean age of 9.97 years (SD = 0.82). Eighty-three children without LD were boys (63.85%) and 47 were girls (36.15%); 76 were in Grade 4 (58.5%) and 54 were in Grade 5 (41.5%). The age range of children without LD was from 9 to 12 years, with a mean age of 9.91 years (SD = 0.82). Chi-square analyses for the final sample reported that both groups were comparable in age, x2(1, n = 260) = 2.61, p > .05; grade, x2(1, n = 260) = 0.40, p > .05; and gender, x2(1, n = 260) = 0, p > .05. Children in both groups, with LD and without LD, were Mexican, were from a low SES family, and lived in an urban area.

Measures

Three measures were administered collectively to all children during school time to determine the severity of anxiety and depressive symptoms if present, the risk status for anxiety and depression, and coping skills. Trained teachers and psychologists from the office of Gabinetes de Servicios Educativos read the instructions and test items aloud to all students and answered questions. Anonymity was assured.

Spence Children’s Anxiety Scale

The Spanish version of the Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a self-report measure of anxiety designed for use with children from 8 to 12 years old. The SCAS consists of 44 items, 38 of which assess specific anxiety symptoms (e.g., symptoms of social phobia, separation anxiety, panic attack, and agoraphobia). The remaining 6 items serve as positive “filter items” to reduce negative response bias. Children are asked to rate, on a 3-point scale (0 = never to 2 = always), the frequency with which they experience each symptom. The total score of this measure was used in the current study. Spence (1997) has reported high internal consistency (r = 0.92), high split-half reliability (r = 0.90), adequate test–retest reliability (r = 0.60), and support for convergent and divergent validity. This measure has been translated into Spanish and standardized with a normative sample of students from Mexico showing sound psychometric properties including a reliability coefficient of 0.91 on the SCAS scores (Bermúdez-Ornelas & Hernández-Guzmán, 2002; Hernández-Guzmán et al., 2010). For the current study, participants were categorized as either high or low risk for anxiety using a cutoff score of 41, determined by adding 1 standard deviation (10.95) to the SCAS mean score (30.22) of the sample from the larger study (N = 931; Gallegos, 2008).

Cuestionario de Depresión Infantil

The Spanish version of the Children’s Depression Inventory (CDI; Kovacs, 1981) is a self-report measure used for depressive symptoms in children ages 7 to 17 years. The CDI has 27 items related to the cognitive, affective, and behavioral signs of depression. Each item contains three statements, and children select the one that best describes them in the past 2 weeks. Statements within each item are scored according to the severity of child’s symptoms (0 = no symptomatology present, 1 = mild symptomatology, 2 = severe symptomatology). A total score is calculated by adding the statements chosen by the students. The statement (Item 9) that assessed suicidality was removed. The CDI has shown good psychometric properties: a Cronbach’s alpha reliability coefficient of 0.94 and a test–retest reliability coefficient of 0.87, and adequate construct and content validity (Del Barrio, Moreno-Rosset, & López-Martínez, 1999; Saylor, Finch, Spirito, & Bennett, 1984). For purposes of the current study, participants were categorized as either high or low risk for depression using a cutoff score of 15, determined by adding 1 standard deviation (5.36) to the CDI mean score (9.39) of the sample from the larger study (N = 931; Gallegos, 2008).

Cuestionario de Afrontamiento

The Coping Skills Questionnaire (CA; Hernández-Guzmán, 2003) is a Spanish measure developed and standardized in Mexico to assess coping skills in children. It is a self-report measure for children aged 6 to 12 years. The scale has 12 items related to the child’s interpretation and reactions when facing a problem, and the things he or she does to cope with and/or solve the problem. Lower scores reflect high proactive positive coping. Children are asked to rate the frequency with which they experience each statement on a 3-point scale (0 = never to 2 = always). The questionnaire assesses coping responses to situations perceived as stressful and provides information on three factors: active coping, emotional coping, and passive or avoidant coping. The Cuestionario de Afrontamiento has demonstrated adequate psychometric properties including a Cronbach’s alpha reliability coefficient of 0.67 (Hernández-Guzmán, 2003).

Statistical Analyses

To compare severity of anxiety and depressive symptoms and coping skills between children with LD and their peers without LD, independent samples t tests were performed for each outcome measure. Chi-square analyses were conducted on the SCAS and CDI to examine the differences in the percentages of children at risk for anxiety and at risk for depression. All data analyses were performed using SPSS version 11.5.

Results

Means and standard deviations for each outcome measure are presented in Table 1 for participants with and without LD. The results from the independent samples t tests revealed a statistically significant difference between children with and without LD on the severity of their anxiety symptoms based on the SCAS mean score, t(258) = −2.42, p < .05, with children with LD reporting higher anxiety scores than children without LD. Similar results were found for depression, with the independent samples t tests revealing a statistically significant difference between children with and without LD on the severity of their depressive symptoms based on the CDI mean score, t(258) = −2.23, p < .05; the severity of the depressive symptoms of children with LD was higher when compared with the children without LD.

Table 1.

Means and Standard Deviations for Participants With and Without Learning Disabilities (LD) on Three Measures

Measure Group n M SD SE
SCAS children w/o LD 130 28.88 9.46 0.83
children w/ LD 130 31.95 10.89 0.95
CDI children w/o LD 130 9.36 5.60 0.49
children w/ LD 130 10.97 6.00 0.53
CA children w/o LD 130 10.18 2.52 0.22
children w/ LD 130 10.01 2.57 0.23
Open in a new tab

Note: SCAS = Spence Children’s Anxiety Scale (Spence, 1997); CDI = Children’s Depression Inventory (Kovacs, 1981); CA = Cuestionario de Afrontamiento [Coping Skills Questionnaire] (Hernández-Guzmán, 2003).

Statistically significant differences were also found in the frequency of children at risk for anxiety and depression, with 22.3% of the children with LD at risk for anxiety compared to only 11.5% of the children without LD. The chi-square analysis reported that this difference was statistically significant, x2(1, n = 259) = 5.36, p < .05. With regard to risk for depression, frequencies showed that 32% of children with LD were at risk for depression when compared to only 18% of those children without LD. The chi-square analysis reported that this difference was statistically significant, x2(1, n = 259) = 4.85, p < .05. No statistically significant differences were found between children with and without LD on their coping skills based on the Cuestionario de Afrontamiento, t(258) = 0.56, p > .05.

Discussion

Anxiety and depression are common problems experienced by children and adolescents and, if untreated, may lead to a broad range of negative consequences for the child and his or her family (World Health Organization, 2004); hence, early identification and intervention programs are critical. Providing such programs in schools may increase access to children in need of mental health services by overcoming issues of stigma, transportation, and so on and reduce the number of youth whose mental health issues go untreated.

The purpose of this study was to compare the severity of anxiety symptoms and risk status for anxiety, the severity of depressive symptoms and risk status for depression, and coping skills among Mexican students with LD and their typically developing peers. In line with results of previous studies (i.e., Manassis & Young, 2004; Margalit & Zak, 1984; Svetaz et al., 2000), the results from the current study demonstrate that Mexican children with LD are at higher risk for anxiety and depression than their typically developing peers.

Some studies have shown that children with LD have major difficulties in social information processing and reported consistent difficulties understanding complex emotions (Bauminger, Schorr Edelsztein, & Morash, 2005; Margalit, 2004). Therefore, it is likely that they might experience a low ability and avoidance to cope with unpleasant feelings such as anxiety and depression (Margalit & Al-Yagon, 2002; Rock, Fessler & Church, 1997).

Also, due to their poor social adjustment, children with LD are at risk for victimization and bullying (Greenham, 1999). They are more likely to be bullied due to the stigma associated with LD and to have fewer friends and are frequently teased (Martinez & Semrud-Clikerman, 2004; Minsha, 2003). Peer victimization may create adjustment problems and anxiety; rejection from their peers may create a sense of loneliness that, when taken in a passive way, can raise a depressive disorder (Minsha, 2003; Weiner, 2004).

Some children with LD also exhibit an apprehensive temperament (Margalit & Al-Yagon, 2002), which has been shown to be less persistent as a result of school frustration, showing limited flexibility and adaptability and increased risk for anxiety and depression (Rock et al., 1997; Teglasi, Cohn, & Meshbesher, 2004).

The finding that coping skills did not appear to differ between children with and without LD may support recent research that has found that the style of response to difficulty of a student who has LD is independent of his or her level of learning disability (Nuñez et al., 2005; Sideridis, Mouzaki, Simos, & Protopapas, 2006). In their study, Nuñez et al. (2005) obtained data showing that students with LD are not homogeneous with respect to their attributions for academic successes and failures, as some students reported an adaptive profile and some a helplessness profile. Sideridis et al. (2006) explored how motivation, emotions, and psychopathology play a pivotal role in explaining the achievement tendencies of students with LD. In their study there were two groups of students with reading comprehension difficulties; half of them appeared to be motivated and to have high levels of positive affect and low levels of psychopathology. The other half of the students was lacking the motivation to achieve and had high levels of negative affect and psychopathology. Nuñez et al. (2005) reported that these differences can be explained by the different profiles of the children with LD, where personal characteristics play a very important role for the development of adaptation and coping skills.

Limitations

The results of this study should not be overgeneralized as there are several limitations encountered in this research. First, the sample size included only Grade 4 and 5 students; therefore, further replications are needed with students of other grade levels and also comparing the results by gender. Second, the study included only self-report measures, thus relying only on the children’s subjective experience. Children may find it difficult to report, in an accurate way, their thoughts and emotions and may not want to disclose this information. Third, only one protective factor measure was incorporated.

Further Research

Further research should incorporate a broader range of ages and include multiple informants to analyze high concordance and to increase the external validity of the findings. Assessments should incorporate more protective measures such as positive future outlook, self-esteem, and social support, keeping in mind the importance of resilience research (Margalit, 2006). It will be interesting to closely explore the coping styles among children with LD. Comparisons of risk and protective factors between genders should also be explored. This study would have benefited from a qualitative component concerning children’s experiences on aspects such as friendships, family dynamics, coping with daily stressors, and bullying, among others. Focus groups and narratives could be used to explore these interesting topics.

Implications for Practice

The current study provides evidence that the percentage of children with LD experiencing risk for anxiety (22.3%) and risk for depression (32%) is high, thus highlighting the importance of early identification and intervention. Given that children with LD account for approximately 50% of the cases referred to the Special Education Department in Mexico (Secretaría de Educación Pública, 2002), it is imperative that awareness be raised among educators and special education teachers about these issues. This may be accomplished by including some of the work from prevention and mental health professions in the pre-service and ongoing in-service training for teachers and rehabilitation professionals in the field of special education (McReynolds & Garske, 2003). The field of LD should envision the possibility of integrating social-emotional and academic interventions, as treating the affective, cognitive, and academic abilities as separate domains has not been effective (Price, Johnson, & Evelo, 1994).

Educating the school community about the prevention of these problems and the importance of social and emotional well-being is imperative not only because many children with LD are struggling with these problems but also because teachers and parents often have difficulty noticing these problems, as they are not as visible as conduct disorders or attention-deficit/hyperactivity disorder (Dadds, Spence, Holland, Barrett, & Laurens, 1997; Lowry-Webster, Barrett, & Dadds, 2001).

Early identification and intervention is critical as, world-wide, very few of those who experience difficulties with anxiety and depression receive treatment (Lowry-Webster et al., 2001; Patel & Moss, 1993). In fact, Benjet et al. (2009) found that less than 14% of those Mexican adolescents in need of mental health services over the past 12 months had actually received any treatment for their disorder (treatment was defined as psychological treatment, calling a telephone helpline, visiting a medical doctor, or relying on a self-help book). Early identification and referral in schools may affect the lives of children with LD experiencing anxiety or depressive symptoms, as it would be more likely that their developmental pathways for anxiety and/or depression could be altered.

Children with LD should be an important target population for selective prevention programs. It is evident that these children may benefit from extra support related to their social and emotional functioning, which could be implemented via individual, small group, or even class room wide programs and involve parents to the extent possible. It is clear that effective interventions are critical in that the longer children with LD continue experiencing feelings of frustration and disappointment, as well as potential anxiety and depression, the higher the risk for academic difficulties in the future (Lackaye et al., 2006).

Acknowledgments

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Biographies

Julia Gallegos, PhD, is a professor in the Center for Treatment and Research on Anxiety (CETIA) and the Department of Psychology at the University of Monterrey in Mexico. Gallegos is also de Director of the Mexican Center for Emotional and Social Intelligence (CIES). The work of Gallegos focuses on the prevention of anxiety and depression in children and adolescents, early intervention for groups at risk, and the promotion of resilience through evidence-based intervention for school communities. juliagallegos@centrocies.com.mx

Audra Langley, PhD, is an assistant professor in the Division of Child and Adolescent Psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior. Langley is also the Director of Training for the Trauma Services Adaptation Center for Resiliency, Hope, and Wellness in Schools and serves as Chair of the NCTSN School Committee. Langley is a clinician and researcher who specializes in cognitive behavioral treatment for children and adolescents with PTSD, anxiety, and related disorders, and her work seeks to increase school-based access to evidence-based interventions for underserved populations of children.

Diana Villegas, MS (Master of Science in Health Psychology), is currently a PhD student in the Program of Methodology of Behavior and Health Sciences at Universidad Complutense of Madrid, Spain. Villegas has worked as a researcher at the Research Center and Development in Health Science of Universidad Autónoma of Nuevo León, México in the Health Psychology Department. Villegas also has been research assistant at the University of Monterrey, México at the Psychology Department.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interests with respect to the research, authorship, and/or publication of this article.

References

  1. Al-Yagon M, Mikulincer M. Patterns of close relationships and socioemotional and academic adjustment among school-aged children with learning disabilities. Learning Disabilities Research & Practice. 2004;19:12–19. [Google Scholar]
  2. Bauminger N, Schorr Edelsztein H, Morash J. Social information processing and emotional understanding in children with LD. Journal of Learning Disabilities. 2005;38:45–61. doi: 10.1177/00222194050380010401. [DOI] [PubMed] [Google Scholar]
  3. Bender WN, Wall ME. Social-emotional development of students with learning disabilities. Learning Disability Quarterly. 1994;17:323–341. [Google Scholar]
  4. Benjet C, Borges G, Medina-Mora ME, Zambrano J, Aguilar-Gaxiola S. Youth mental health in a populous city of the developing world: Results from the Mexican adolescent health survey. Journal of Child Psychology and Psychiatry. 2009;50:386–395. doi: 10.1111/j.1469-7610.2008.01962.x. [DOI] [PubMed] [Google Scholar]
  5. Bermúdez-Ornelas G, Hernández-Guzmán L. La medición de la fobia específica en niños y adolescentes [The measurement of a specific phobia in children and adolescents] Revista Mexicana de Psicología. 2002;19:119–225. [Google Scholar]
  6. Caraveo-Anduaga JJ, Comenares-Bermúdez E. Los trastornos psiquiátricos y el abuso de substancias en México: Panorama epidemiológico [Psychiatric disorders and substance abuse in Mexico: Epidemiological overview] Salud Mental. 2002;25:9–15. [Google Scholar]
  7. Costello EJ, Pine DS, Hammen C, March J, Plotsky PM, Weissman M, et al. Development and natural history of mood disorders. Biological Psychiatry. 2002;52:529–542. doi: 10.1016/s0006-3223(02)01372-0. [DOI] [PubMed] [Google Scholar]
  8. Dadds MR, Spence SH, Holland DE, Barrett P, Laurens KR. Prevention and early intervention for anxiety disorders: A controlled trial. Journal of Consulting & Clinical Psychology. 1997;65:627–635. doi: 10.1037//0022-006x.65.4.627. [DOI] [PubMed] [Google Scholar]
  9. Del Barrio MV, Moreno-Rosset C, López-Martínez R. The Children’s Depression Inventory (CDI: Kovacs, 1992) in a Spanish sample. Clínica y Salud. 1999;10:393–416. [Google Scholar]
  10. Dietrich AP, Kelly SM. Academic coping skills and college expectations of learning disabled high school students; Paper presented at the annual meeting of the Mid-South Educational Research Association.1993. [Google Scholar]
  11. Elksnin LK, Elksnin N. The socio-emotional side of learning disabilities. Learning Disability Quarterly. 2004;27:3–8. [Google Scholar]
  12. Fletcher JM, Morris RD, Lyon RD. Classification and definition of learning disabilities: An integrative perspective. In: Swanson HL, Harris KR, Graham S, editors. Handbook of learning disabilities. New York: Guilford; 2004. pp. 30–56. [Google Scholar]
  13. Fletcher TV. A Mexican perspective on learning disabilities. Journal of Learning Disabilities. 1990;28:530–534. doi: 10.1177/002221949502800901. [DOI] [PubMed] [Google Scholar]
  14. Forness SR, Walker HM, Kavale KA. Psychiatric disorders and treatments: A primer for teachers. Teaching Exceptional Children. 2003;36:42–49. [Google Scholar]
  15. Gallegos J. Preventing childhood anxiety and depression: Testing the effectiveness of a school-based program in Mexico. 2008. Available from ProQuest Dissertation and Theses database. (UMI No. 3341564) [Google Scholar]
  16. Greenham SL. Learning disabilities and psychosocial adjustment: A critical review. Child Neuropsychology. 1999;5:171–196. [Google Scholar]
  17. Heath NL, Ross S. Prevalence and expression of depressive symptomatology in students with and without learning disabilities. Learning Disability Quarterly. 2000;23:24–36. [Google Scholar]
  18. Hernández-Guzmán L. Escala de afrontamiento (versión infantil). Proyecto de investigación DGAPA IN-302600, evaluación y categorización de los trastornos de ansiedad en niños y adolescentes. México, D.F.: Universidad Autónoma de México (UNAM), Facultad de Psicología; 2003. [Coping scale (child version). Research project DGAPA IN 302600, evaluation and classification of anxiety disorders in children and adolescents]. [Google Scholar]
  19. Hernández-Guzmán L, Bermúdez-Ornelas G, Spence SH, Montesinos MJ, Martínez-Guerrero JI, Aguilar-Villalobos J, et al. Versión en Español de la Escala de Ansiedad para Niños de Spence (SCAS) [Spanish version of the Anxiety Scale for Children by Spence] Revista Latino-americana de Psicología. 2010;42:13–24. [Google Scholar]
  20. Instituto Nacional de Estadística y Geográfica. [Retrieved May 19, 2006];Regiones socioeconómicas de México. 2006 [Socioeconomic regions of Mexico]. from http://www.inegi.gob.mx/est/contenidos/espanol/sistemas/regsoc/default.asp?c=5688.
  21. Kaplan BJ, Dewey DM, Crawford SG, Wilson BN. The term comorbidity is of questionable value in reference to developmental disorders: Data and theory. Journal of Learning Disabilities. 2001;34:555–565. doi: 10.1177/002221940103400608. [DOI] [PubMed] [Google Scholar]
  22. Kavale KA, Moster MP. Social skills interventions for individuals with learning disabilities. Learning Disability Quarterly. 2004;27:31–44. [Google Scholar]
  23. Kendall PC, Suveg C. Treating anxiety disorders in youth. In: kendall PC, editor. Child and adolescent therapy. New York: Guilford; 2006. pp. 243–296. [Google Scholar]
  24. Kessler RC, Berglund P, Bemler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry. 2005;62:593–768. doi: 10.1001/archpsyc.62.6.593. [DOI] [PubMed] [Google Scholar]
  25. Kovacs M. Inventario de Depresión Infantil. Madrid, España: TEA Ediciones; 1981. [Child Depression Inventory] [Google Scholar]
  26. Lackaye T, Margalit M, Ziv O, Ziman T. Comparisons of self-efficacy, mood, effort, and hope between students with learning disabilities and their non-LD-matched peers. Learning Disabilities Research and Practice. 2006;21:111–121. [Google Scholar]
  27. LaGreca AM, Stone WL. LD status and achievement: Confounding variables in the study of children’s social status, self-esteem and behavioral functioning. Journal of Learning Disabilities. 1990;23:483–490. doi: 10.1177/002221949002300806. [DOI] [PubMed] [Google Scholar]
  28. Langley AK, Bergman RL, McCracken J, Piacentini JC. Impairment in childhood anxiety disorders: Preliminary examination of the Child Anxiety Impact Scale–Parent Version. Journal of Child and Adolescent Psychopharmacology. 2004;14:105–114. doi: 10.1089/104454604773840544. [DOI] [PubMed] [Google Scholar]
  29. Lowry-Webster HM, Barrett P, Dadds MR. A universal prevention trial of anxiety and depressive symptomatology in childhood: Preliminary data from an Australian study. Behaviour Change. 2001;18:36–50. [Google Scholar]
  30. Maag JW, Reid R. Depression among students with learning disabilities: Assessing the risk. Journal of Learning Disabilities. 2006;39:3–10. doi: 10.1177/00222194060390010201. [DOI] [PubMed] [Google Scholar]
  31. Manassis K, Young A. Perception of emotions in anxious and learning disabled children. Depression & Anxiety. 2004;12:209–216. doi: 10.1002/1520-6394(2000)12:4<209::AID-DA4>3.0.CO;2-A. [DOI] [PubMed] [Google Scholar]
  32. Margalit M. Second-generation research on resilience: Social-emotional aspects of children with learning disabilities. Learning Disabilities Research and Practice. 2004;19:45–48. [Google Scholar]
  33. Margalit M. Loneliness, the salutogenic paradigm and learning disabilities: Current research, further directions and interventional implications. Boulder, CO: 2006. Unpublished manuscript. [Google Scholar]
  34. Margalit M, Al-Yagon M. The loneliness experience of children with learning disabilities. In: Wong BYL, Donahue M, editors. The social dimensions of learning disabilities. Mahwah, NJ: Lawrence Erlbaum; 2002. pp. 53–75. [Google Scholar]
  35. Margalit M, Heiman T. Learning-disabled boys’ anxiety, parental anxiety, and family climate. Journal of Clinical Child Psychology. 1986;15:248–253. doi: 10.1016/s0002-7138(09)60204-1. [DOI] [PubMed] [Google Scholar]
  36. Margalit M, Zak I. Anxiety and self-concept of learning-disabled children. Journal of Learning Disabilities. 1984;17:537–539. doi: 10.1177/002221948401700906. [DOI] [PubMed] [Google Scholar]
  37. Martinez RS, Semrud-Clikerman M. Emotional adjustment and school functioning of young adolescents with multiple versus single learning disabilities. Journal of Learning Disabilities. 2004;37:411–420. doi: 10.1177/00222194040370050401. [DOI] [PubMed] [Google Scholar]
  38. Mayron LW. Ecological factors in learning disabilities. Journal of Learning Disabilities. 1978;11:40–50. doi: 10.1177/002221947801100806. [DOI] [PubMed] [Google Scholar]
  39. McReynolds CJ, Garske GG. Psychiatric disabilities: Challenges and training issues for rehabilitation professionals. Journal of Rehabilitation. 2003;69:13–18. [Google Scholar]
  40. Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J, Fleiz C, et al. Prevalencia de trastornos mentales y uso de servicios: Resultados de la encuesta nacional de epidemología psiquiátrica en México [Prevalence of mental disorders and service use: Results from a national survey of psychiatric epidemiology in Mexico] Salud Mental. 2003;26:1–16. [Google Scholar]
  41. Minsha F. Learning disabilities and bullying: Double jeopardy. Journal of Learning Disabilities. 2003;61:335–372. doi: 10.1177/00222194030360040501. [DOI] [PubMed] [Google Scholar]
  42. Mohr LL, D’ntoni AC, Moreno-Milne N, McIntosh DK, Miano K, Raymond G. Life coping skills for exceptional children; Paper presented at the 58th Annual International Convention of The Council for Exceptional Children.1980. [Google Scholar]
  43. Newcomer PL, Barenbaum E. Depression and anxiety in children and adolescents with learning disabilities, conduct disorders, and no disabilities. Journal of Emotional and Behavioral Disorders. 1995;13:27–40. [Google Scholar]
  44. Nuñez CJ, Gonzalez-Pineda JA, Gonzalez-Pumariega S, Roces C, Alvarez L, Gonzalez P. Subgroups of attributional profiles in students with learning disabilities and their relation to self-concept and academic goals. Learning Disabilities Research and Practice. 2005;20:86–97. [Google Scholar]
  45. Patel P, Moss S. Psychiatric morbidity in older people with moderate and severe learning disability. British Journal of Psychiatry. 1993;163:481–491. doi: 10.1192/bjp.163.4.481. [DOI] [PubMed] [Google Scholar]
  46. Patten MD. Relationships between self-esteem, anxiety, and achievement in young learning disabled students. Journal of Learning Disabilities. 1983;16:43–45. doi: 10.1177/002221948301600117. [DOI] [PubMed] [Google Scholar]
  47. Price LA, Johnson JM, Evelo S. When academic assistance is not enough: Addressing the mental issues of adolescents and adults with learning disabilities. Journal of Learning Disabilities. 1994;27:82–90. doi: 10.1177/002221949402700203. [DOI] [PubMed] [Google Scholar]
  48. Rock EE, Fessler MA, Church RP. The concomitance of learning disabilities and emotional/behavioral disorders: A conceptual model. Journal of Learning Disabilities. 1997;30(3):245–163. doi: 10.1177/002221949703000302. [DOI] [PubMed] [Google Scholar]
  49. Rodriguez CM, Routh DK. Depression, anxiety, and attributional style in learning-disabled and non-learning disabled children. Journal of Clinical Child Psychology. 1989;18:299–304. [Google Scholar]
  50. Rourke BP, Fuerst DP. Learning disabilities and psychosocial functioning: A neuropsychological perspective. New York: Guilford; 1991. [Google Scholar]
  51. Saylor CF, Finch AJ, Spirito A, Bennett B. The Children’s Depression Inventory: A systematic evaluation of psychometric properties. Journal of Consulting & Clinical Psychology. 1984;52:955–967. doi: 10.1037//0022-006x.52.6.955. [DOI] [PubMed] [Google Scholar]
  52. Secretaría de Educación Pública. Programa nacional de fortalecimiento de la educación especial y de la integración educativa. Distrito Federal, México: Secretaría de Educación Pública; 2002. [National program to strengthen special education and educational integration] [Google Scholar]
  53. Sharma G. A comparative study of personality characteristics of primary-school students with learning disabilities and their non-learning disabled peers. Learning Disability Quarterly. 2004;27:127–140. [Google Scholar]
  54. Sideridis GD, Mouzaki A, Simos P, Protopapas A. Classification of students with reading comprehension difficulties: The role of motivation, affect and psychopathology. Learning Disability Quarterly. 2006;29:159–170. [Google Scholar]
  55. Spence SH. Structure of anxiety symptoms in children: A confirmatory factor-analytic study. Journal of Abnormal Psychology. 1997;106:280–297. doi: 10.1037//0021-843x.106.2.280. [DOI] [PubMed] [Google Scholar]
  56. Sundheim S, Voeller KS. Psychiatric implications of language disorders and learning disabilities: Risk and management. Journal of Child Neurology. 2004;19:814–827. doi: 10.1177/08830738040190101001. [DOI] [PubMed] [Google Scholar]
  57. Svetaz MV, Ireland M, Blum R. Adolescents with learning disabilities: Risk and protective factors associated with emotional well-being. Findings from the National Longitudinal Study of Adolescent Health. Journal of Adolescent Health. 2000;27:340–348. doi: 10.1016/s1054-139x(00)00170-1. [DOI] [PubMed] [Google Scholar]
  58. Teglasi H, Cohn A, Meshbesher N. Temperament and learning disability. Learning Disability Quarterly. 2004;27:9–20. [Google Scholar]
  59. Weiner J. Do peer relationships foster behavioral adjustment in children with learning disabilities. Learning Disability Quarterly. 2004;27:21–30. [Google Scholar]
  60. World Health Organization. Prevention of mental disorders: Effective interventions and policy options: Summary report. Geneva, Switzerland: World Health Organization, Department of Mental Health and Substance Abuse, in collaboration with the Prevention Research Centre of the Universities of Nijmegen and Maastricht; 2004. [Google Scholar]

RESOURCES