RESUMO
BACKGROUND: Children exposed to substance use in their families are vulnerable to multiple risk factors in their development and at increased risk for emotional and behavioral problems. The aims of the study were as follows 1) estimate the prevalence of emotional and behavioral problems among children aged 6-11 years old, living with addicted family members in a low-income urban community of São Paulo, Southeastern Brazil; 2) evaluate the children's exposure to family psychosocial stressors and substance use; and 3) investigate the factors related to the increased risk of emotional and behavioral problems and substance use. METHODS: A cross-sectional study was conducted among 101 children aged 6-11 years old (M = 9.16 years, SD = 1.61). The instruments used were a sociodemographic questionnaire, the Child Behavior Checklist (CBCL) and the Psychosocial Stress Factors (PSF). RESULTS: High prevalence of problems was found for this sample: the CBCL showed 26.7% of clinical scores for Internalizing Problems, 40.6% for Externalizing Problems, and 40.6% for Total Problems. Exposure to family psychosocial stressors was also high, including severe disease (33%), physical aggression (28.9%), death (27.8%), psychiatric hospitalization (16.7%), suicide attempts (15.5%), and suicide (9.3%). Exposure to these family stressors was associated with an increase of two to four times in the prevalence of internalizing and externalizing problems. CONCLUSIONS: Children exposed to substance abusers have more mental health problems than general population, even when compared to peers living in similar low-income areas. This is a group that should be target of a selective preventive intervention.