{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:05Z","timestamp":1787014085124,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["90AR5020\u20100200"],"award-info":[{"award-number":["90AR5020\u20100200"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5 UL1 TR002240\u201005"],"award-info":[{"award-number":["5 UL1 TR002240\u201005"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To examine how social factors might mitigate the elevated risk of mental health disorders in children with cerebral palsy (\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study included 6\u2010 to 17\u2010year\u2010olds with (\n                      <jats:italic>n<\/jats:italic>\n                      =111; 40.4% 6\u201311y, 59.6% 12\u201317y) and without (\n                      <jats:italic>n<\/jats:italic>\n                      =29\u00a0909; 50.2% 6\u201311y, 49.8% 12\u201317y)\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      from the 2016 National Survey of Children's Health. Mental health disorders included depression, anxiety, behavior\/conduct problems, and attention\u2010deficit\/hyperactivity disorder. Social factors included participation in activities, bully victimization, and difficulty with friendships.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for sociodemographic factors and the presence of chronic pain, children with\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      had higher odds of anxiety (odds ratio [\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ] 4.4; 95% confidence interval [\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ] 1.9\u20138.5), behavior\/conduct problems (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      3.9; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.4\u201311.3), and multimorbidity (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      2.8; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.1\u20137.0), but not depression (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.4; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.6\u20133.8) or attention\u2010deficit\/hyperactivity disorder (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.7; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.6\u20134.6), compared to controls. With adjustment for participation in activities, the odds of anxiety, behavior\/conduct problems, and multimorbidity remained increased in children with\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      . With adjustment for difficulty with friendships, the odds of anxiety, behavior\/conduct problems, and multimorbidity were no longer increased in children with\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      . With adjustment for bully victimization, the odds of behavior\/conduct problems and multimorbidity were attenuated in children with\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      ; however, the odds of anxiety remained increased.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>\n                      The elevated prevalence of certain mental health disorders in children with\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      is partly associated with modifiable social factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What this paper adds<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Difficulty with friendships predicts an elevated prevalence of psychiatric conditions in children with cerebral palsy (CP).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Bully victimization predicts an elevated prevalence of behavior\/conduct problems in children with CP.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Low participation does not predict mental health disorders in this population.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  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