Epidemiological comparisons of American and Dutch adolescents' self-reports

The good, the bad, and the ugly: a comprehensive study of temperament and personality traits as correlates of self-reported disruptive behavior problems in male and female adolescents

Purpose

The aim of the present study was to provide a comprehensive picture of temperament and personality traits as correlates of self-reported disruptive behavior problems in male and female adolescents.

Methods

Two-hundred-and-sixty-three non-clinical adolescents aged 12-18 years completed a survey containing standardized scales to measure the HEXACO personality traits, impulsivity, effortful control, Dark Triad traits, and symptoms of oppositional-defiant disorder (ODD) and conduct disorder (CD).

Results

The results showed that good traits (in particular, honesty-humility, agreeableness, and the regulative trait of effortful control) were negatively associated, while bad and ugly traits (especially impulsivity and the Dark Triad traits of psychopathy and Machiavellianism) were positively associated with symptoms of ODD and CD. In addition, regression analyses indicated that both types of disruptive behavior problems were associated with a unique set of temperament and personality correlates, and that specific correlates also differed for both genders.

Conclusions

It is concluded that research on the role of temperament and personality should adopt a broad perspective, taking good, bad, and ugly traits from various theoretical models as well as gender differences into account.

Smoking During Adolescence as a Risk Factor for Attention Problems

BACKGROUND

Cigarette smoking and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid. One explanation is that individuals with ADHD use cigarettes as "self-medication" to alleviate their attention problems. However, animal studies reported that exposure to nicotine during adolescence influences the developing brain and negatively affects attention. This is the first human study exploring the effects of smoking during adolescence on attention problems.

METHODS

Longitudinal data on smoking and attention problems were available for 1987 adult and 648 adolescent monozygotic twin pairs from the Netherlands Twin Register. Twin pairs were classified as concordant/discordant for smoking and compared on attention problems. Within adult discordant pairs, the difference in attention problems between the smoking and never-smoking twins was first assessed cross-sectionally. In longitudinal analyses, the increase in attention problems from adolescence, when neither twin smoked, to adulthood was compared within discordant pairs. In subgroups with longitudinal data from childhood and adolescence, changes in smoking concordance and subsequent changes in attention problems were explored.

RESULTS

Adult twins who ever smoked reported significantly more attention problems than their never-smoking co-twin. Longitudinal analyses showed a larger increase in attention problems from adolescence to adulthood in smoking twins than their never-smoking co-twin (p < .05). In childhood and adolescence, smoking twins had more attention problems than their never-smoking co-twin, whereas scores were similar before smoking was initiated or after both twins started smoking (not significant in all groups).

CONCLUSIONS

Results from this genetically informative study suggest smoking during adolescence leads to higher attention problem scores, lasting into adulthood.

Gender differences in factors associated with perceived need and use of Korean adolescents mental health services

This study investigated the socio-demographic characteristics and emotional and behavioral factors associated with the perceived need and actual use of adolescent mental health services according to genders in Korea. We assessed 1,857 middle school students aged 14-16 years. We administered a self-reported questionnaire including questions on their socio-demographic data, Korean Youth Self Report, and self perceived need and actual use of mental health services. Overall, 11.6 % of the adolescents demonstrated a self perceived need for mental health services regarding their emotional or behavioral problems, while 2.1 % had sought mental health services. There were discrepancies between the perceived need and actual use. Most adolescents (81.6 %) used mental health services without self-perceived need, and only 3.3 % of adolescents with self-perceived need utilized mental health services. The perceived need of mental health services is positively influenced by the adolescent's anxious/depressed problems in both genders. The use of them is negatively influenced by the withdrawn problem in adolescent boys, while positively influenced by the aggressive behavior in adolescent girls. To increase the actual use of mental health services more attention needs to be focused on their internalizing problems, such as anxious/depressed and withdrawn problems, in addition to externalizing problems in both genders.

A clinical study of attention-deficit/hyperactivity disorder in preschool children--prevalence and differential diagnoses

OBJECTIVE

We aimed to examine (1) the prevalence and characteristics of ADHD in preschool children, and (2) differential diagnoses among children who display symptoms of inattention and hyperactivity-impulsivity in early childhood.

METHODS

The participants were children living in Kanie-cho, in Japan's Aichi Prefecture, who underwent their age 5 exams at the municipal health center between April 2009 and March 2011. We first extracted children who were observed to be inattentive or hyperactive-impulsive during their age 5 exams and considered as possibly having ADHD. We conducted follow-ups with these children using post-examination consultations, visits to preschools, and group rehabilitation. The results of the age 5 exams were combined with behavior observations and interview content obtained during subsequent follow-ups. A child psychiatrist and several clinical psychologists discussed these cases and made a diagnosis in accordance with the DSM-IV-TR.

RESULTS

91 (15.6%) of the 583 children selected were considered as possibly having ADHD; we were able to conduct follow-ups with 83 of the 91 children. Follow-up results showed that 34 children (5.8% of all participants) remained eligible for a diagnosis of ADHD. Diagnoses for the remaining children included: pervasive developmental disorders (six children, or 6.6% of suspected ADHD children), intellectual comprehension problems (four children, or 4.4%), anxiety disorders (seven children, or 7.7%), problems related to abuse or neglect (four children, or 4.4%), a suspended diagnosis for one child (1.1%), and unclear diagnoses for 29 children (31.9%).

CONCLUSIONS

ADHD tendencies in preschool children vary with changing situations and development, and the present study provides prevalence estimates that should prove useful in establishing a diagnostic baseline.

Legal substance use and the development of a DSM-IV cannabis use disorder during adolescence: the TRAILS study

AIMS

To examine whether early onset of tobacco or alcohol use, and continued use of tobacco or alcohol in early adolescence, are related to a higher likelihood of developing a cannabis use disorder during adolescence.

DESIGN AND SETTING

Data were used from four consecutive assessment waves of the TRacking Adolescents' Individual Lives Survey (TRAILS), a general Dutch population study. TRAILS is an ongoing longitudinal study that will follow the same group of adolescents from the ages of 10 to 24 years.

PARTICIPANTS

The sample consisted of 1108 (58% female) adolescents (mean ages at the four assessment waves are 11.09, 13.56, 16.27 and 19.05 years, respectively)

MEASUREMENTS

Cannabis use disorders were assessed using the Composite International Diagnostic Interview 3.0 (CIDI). Adolescent tobacco and alcohol use were assessed using self-report questionnaires.

FINDINGS

Early-onset tobacco use [odds ratio (OR) = 1.82, confidence interval (CI) = 1.05-3.14, P < 0.05], but not early-onset alcohol use (OR = 1.33, CI = 0.84-2.12, P > 0.05), was associated with a higher likelihood of developing a cannabis use disorder. Similarly, adolescents who reported continued use of tobacco (OR = 2.47, CI = 1.02-5.98, P < 0.05), but not continued use of alcohol (OR = 1.71, CI = 0.87-3.38, P > 0.05), were more likely to develop a cannabis use disorder.

CONCLUSIONS

Early-onset and continued tobacco use appear to predict the development of a cannabis use disorder in adolescence, whereas early onset and continued alcohol use do not.

The use of mental health services by adolescent smokers: a nationwide Israeli study

In this study, we aimed to evaluate the utilization of mental health services by adolescent smokers, the presence of untreated mental disorders in this young population and the associated emotional and behavioral difficulties. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their mothers. Mental disorders were assessed using the Development and Well-Being Assessment (DAWBA) Inventory. Emotional and behavioral difficulties were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Mental health services use and smoking habits were evaluated by relevant questionnaires. Adolescent smokers were using significantly more mental health services than non-smokers (79% vs. 63%, respectively, P<0.001), independently of their mental health status or ethnic group. Adolescent smokers also reported more emotional and behavioral difficulties in most areas (P<0.001), which are consistent with their mothers' reports, except in the area of peer relationships. The treatment gap for the smoking adolescents was 53% compared to 69% in the non-smokers (P<0.001). This is the first study characterizing the use of mental health services and the related emotional and behavioral difficulties in a nationally-representative sample of adolescents. The findings of a wide treatment gap and the rates of the associated emotional and behavioral difficulties are highly relevant to the psychiatric assessment and national treatment plans of adolescent smokers.

Gender differences in emotional and behavioral disorders and service use among adolescent smokers: a nationwide Israeli study

Marked gender differences have been identified in cigarette smoking. In this study, we aimed to identify the gender-specific emotional and behavioral disorders among adolescent smokers and their consequent utilization of mental health services. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their mothers. Mental disorders were assessed using the Development and Well-Being Assessment (DAWBA) Inventory. Levels of emotional and behavioral difficulties were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Mental health services use and smoking habits were also assessed. Among non-smoker adolescents there were significant gender differences in almost all SDQ scales: emotional problems, pro-social, hyperactivity/inattention and conduct problems, whereas in the smoker group there was a difference only in the SDQ emotional problems scale (both self- and maternal-rated, P<0.001 and P=0.002, respectively). Only marginal difference was noted between males and females in help-seeking for emotional or behavioral problems. Over 50% of both male and female smokers in the study had untreated mental disorders (non-significant gender difference). The well-established gender differences in psychiatric symptomatology narrowed markedly in adolescent smokers; the typical gender difference in disruptive behaviors was lost in the adolescent smoking population. The implications of these findings are particularly relevant to developing more effective gender-specific programs to prevent youth smoking, to facilitate quitting and prepare primary care practitioners to identify mental disorders and behavioral problems in adolescents with a smoking history.

Can the gateway hypothesis, the common liability model and/or, the route of administration model predict initiation of cannabis use during adolescence? A survival analysis--the TRAILS study

PURPOSE

There is substantial research linking tobacco and alcohol use to subsequent cannabis use, yet the specificity of this relationship is still under debate. The aim of this study was to examine which substance use model--the gateway hypothesis, the common liability (CL) model and/or the route of administration model--best explains the relationship between early onset of tobacco and alcohol use and subsequent cannabis use initiation.

METHODS

We used data from 2,113 (51% female) Dutch adolescents who participated in three consecutive assessment waves (mean age: 11.09, 13.56, and 16.27 years, respectively) of the TRacking Adolescents' Individual Lives Survey study. (Pre)adolescent cannabis, tobacco and alcohol use was assessed using the Youth Self-Report and a TRacking Adolescents' Individual Lives Survey developed questionnaire.

RESULTS

We found that, during adolescence, early onset of tobacco use does not pose a significantly higher risk of initiating cannabis use than early onset alcohol use. Therefore, we can rule out the route of administration model. Moreover, we found that adolescents who reported early onset comorbid use of both tobacco and alcohol have a higher likelihood to initiate cannabis use than adolescents who have tried either tobacco or alcohol. The gateway hypothesis is not broad enough to explain this finding. Therefore, the CL model best predicts our findings.

CONCLUSION

Future research on adolescent cannabis initiation should focus on testing the robustness of the CL model. Furthermore, identifying adolescents who use both tobacco and alcohol, before the age of 13, may help to curtail the onset of cannabis use.

Children and adolescents with congenital heart disease: assessment of behavioural and emotional problems

OBJECTIVE

The objective of the study was to assess behavioural and emotional problems in children and adolescents with congenital cardiac disease.

DESIGN

From the database of Paediatric Heart Section, Rikshospitalet University Hospital, Norway, 430 patients and their parents were included and received questionnaires of youth self-report and child behavior checklist. The response rate was 71.4%.

RESULTS

Compared to their parents children with congenital heart disease reported more behavioural and emotional problems. Boys scored significantly higher than girls in total problem score and externalising scores with more social problems, attention problems, delinquent behaviour and aggressive behaviour. No gender difference was found regarding internalising problem score. Compared to healthy boys, no differences were found in total problem, externalising or internalising score. In girls lower values were found in patients than healthy children for total problem, externalising and internalising scores.

CONCLUSIONS

In the present study boys scored themselves higher with regard to total problem score than girls. No effect was found of due to different diagnoses. The data indicate that the children experience more problems than the parents are aware of. However, the behaviour problem scores in children with cardiac disease are significantly lower than in healthy children. A close parental follow-up and an experience of being exposed to life-threatening situation may play a role for the latter results.

The relation between self-concept and social functioning in adolescence

A model of the relation between self-concept and internalizing and externalizing problem behaviours in adolescence, with the self-concept influencing problem behaviours (S-->IE), was assessed using a sample of 277 Swedish adolescents. The model was tested in a path analysis with data from Youth Self Report (YSR) and Structural Analysis of Social Behaviour (SASB) questionnaires. Consistent with the model, a positive self-concept was found to be the most important factor for adjustment and for protection against common problem behaviour. A negative self-concept combined with female gender were risk factors for internalized problems. Self-control had only a direct effect on externalizing behaviour for boys. Adolescents of 15, 16 years of age had a stronger relationship between a negative self-concept and externalizing problem behaviour than younger and older adolescents. Internalizing problem behaviours such as anxiety and depression predicted aggressive and delinquent behaviour. These findings highlight the importance of promoting of a positive self-concept in every adolescent in various psychosocial contexts.

Reliability, validity, and utility of instruments for self-report and informant report concerning symptoms of ADHD in adult patients

OBJECTIVE

To study the correlation between symptoms of ADHD in adults, obtained with different methods and from different sources.

METHOD

Information was obtained from 120 adults with ADHD, their partners, and their parents, using the ADHD Rating Scale, the Conners' Adult ADHD Rating Scales (CAARS), the Brown Attention-Deficit Disorder Scale (BADDS), and the structured interview Diagnostic Interview Schedule-IV, section L (DIS-L).

RESULTS

All self-report rating scales can be used to assess ADHD symptoms in clinical samples of adults. The BADDS and the ADHD Rating Scale proved best in predicting the clinical diagnosis. The DSM-IV factors, originally developed for children, achieve lower patient-informant agreement than the other factors.

CONCLUSION

Adults with ADHD appear to be the best informants with regard to their symptoms but tend to underreport the severity of their symptoms. Informant report may be used to get additional information on symptoms and impairment.

Comparison of self-reported emotional and behavioural problems in adolescents from Greece and Finland

AIM

To compare self-reported emotional and behavioural problems among Greek and Finnish adolescents.

METHODS

Youth Self-Report scores were analysed for 3373 Greek adolescents aged 18 years and 7039 Finnish adolescents aged 15-16 years from the general population in both countries. The impact of country, gender, place of residence, socioeconomic status (SES) and family stability on the scores was evaluated.

RESULTS

Only country and gender yielded small to medium effect on the scores. Greek boys scored significantly higher than Finns on 10 of the 11 YSR syndromes, particularly on the anxious/depressed scale. Greek girls scored significantly lower than Finnish girls on the somatic complaints and delinquent behaviour scales. In general, girls scored higher than boys on both internalising and externalising problems. The gender by country interaction revealed that Finnish girls reported more externalising problems.

CONCLUSION

The main differences marked in this comparison were the higher level of anxiety and depression in Greeks than Finns and the higher level of externalising problems in Finnish girls than boys. Cultural standards could play an important role in explaining these differences. Overall, it seems that only a small number of differences exist between a northern and southern European region.

Psychosocial aspects of health in adolescence: the influence of gender, and general self-concept

PURPOSE

The aim of this study was to describe age and gender differences in psychosocial aspects of health in adolescents. A further aim was to explore if self-rated behavior problems varied with the adolescents' general self-concept and sense of coherence.

METHODS

Questionnaires on self-rated psychosocial aspects of health were answered by 282 (n = 282/390) randomly selected adolescents, aged 13-22 years (M 17.9/18.0). The instruments used were "I think I am (ITIA)," "Youth Self Report (YSR)," "Sense of coherence (SOC)," and "Family APGAR." Differences between males and females (cross-individual grouping) were analyzed using nonparametric tests. A cluster analysis was performed using a three-cluster solution to identify and describe profiles (person-centered grouping).

RESULTS

Compared with males, adolescent females scored less favorably on self-esteem (ITIA) (p = .028), reported more behavior problems (YSR) (p = .000), and showed a lower sense of coherence (SOC) (p = .003). The differences were most evident in the age group 15-17 years. The three clusters significantly differed from each other regarding how high proportions of problems the adolescents of each profile reported.

CONCLUSIONS

Compared with male adolescents, adolescent females experienced a poorer psychosocial health in somatic, depressive, and internalizing areas. The result indicated that psychological factors had a major impact on the proportions of problems that the adolescents reported.

Emotional and behavioral outcomes among adolescents with mild developmental deficits in early childhood

PURPOSES

To evaluate emotional and behavioral outcomes in adolescents who in early childhood were treated for mild developmental deficits; and to identify predictive factors in early childhood, for future emotional and social competence abnormalities.

METHODS

The records of children referred to Hanna Khoushi Child Development Center in Haifa for mild developmental delay were reviewed. Parents and adolescents were requested to complete the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) 12 to 16 years after discharge from the Child Development Center. Analysis of the two questionnaires and identification of predictive variables in early childhood for emotional problems and social competence difficulties during adolescence were performed, using ANOVA Student's T-test, Chi-square, and multiple regression.

RESULTS

The most frequent developmental diagnoses on admission to the Child Development Center were mild motor (27.3%) or language (23.2%) deficits. Of the treated children, 53.4% were discharged without any developmental deficit. All CBCL and YSR T-scores were within the nonpsychopathology range. No notable differences were found between the study scores and the scores regarding typical Israeli and American youths. Significant differences were, however, observed in self-perception of internalizing emotional problems between male and female adolescents: T-scores of 51.9 +/- 8.0 vs. 47.4 +/- 10.8, respectively (p < .05). Motor and language deficits were associated with lower general competence than general developmental delay and emotional developmental disturbances (T-scores: 47.9 vs. 49.1 and 50.9, p< .05). Admission to the Center after the age of 18 months was associated with higher T-scores for general as well as externalizing problems when compared with scores associated with admission before the age of 18 months (by 5.75 points for both parameters, p < .001).

CONCLUSION

The perception of parents and children with minor developmental deficits observed in early childhood regarding their emotional and social competence during adolescence is similar to typical youths.

Health-related quality of life in youth: a comparison between adolescents and young adults with uncomplicated epilepsy and healthy controls

PURPOSE

To describe health-related quality of life (HRQOL) in adolescents and young adults with uncomplicated epilepsy and to compare it with a random sample of the general population.

METHODS

Young people, aged 13-22 years, meeting the criteria and registered in four Swedish hospitals answered questionnaires (n = 158/193) on HRQOL together with 282 (n = 282/390) random controls living in the same areas in Sweden. The instruments used were "I think I am," "Youth Self Report," "Sense of coherence," and "Family APGAR." Data were analyzed by using factorial analysis of variance.

RESULTS

Girls had a poorer HRQOL than boys. The epilepsy group reported lower competence (i.e., they were less active, had lower social competence and poorer school achievement). Both groups had an overall positive self-esteem. Differences between girls in the epilepsy and control groups were small, whereas differences among boys were more evident. Older age was related to poorer HRQOL in both groups.

CONCLUSIONS

This study points out the importance of being observant of signs of stigmatization in adolescents with epilepsy.

Factors associated with adolescent mental health service need and utilization

OBJECTIVE

To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization.

METHOD

Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of 1,120 Dutch adolescents aged 11 to 18 years (78% response rate).

RESULTS

3.1% of the sample had been referred for mental health services within the preceding year, and 3.8% reported unmet need. 7.7% of adolescents at risk for psychopathology, and 17.8% of those indicating a need for help, had been referred. Family stress and adolescent's self-reported problems were most strongly associated with service need and utilization. Internalizing problems, female gender, and low education level were associated with self-perceived unmet need. Adolescent ethnicity and competence in activities and school were associated with service use, but did not influence service need, while the opposite effect was found for adolescent age and parental psychopathology.

CONCLUSION

In designing intervention programs aimed at increasing adolescent mental health service use, distinctions should be made between efforts focused at adolescents not recognizing their problems, and those with unmet need.

Predictors of self-reported problem behaviours in Turkish immigrant and Dutch adolescents in the Netherlands

BACKGROUND

Although many studies have compared psychopathology in different cultures, not much is known about factors that contribute to the observed differences.

METHODS

We compared self-reported emotional and behavioural problems in 363 Turkish immigrant and 1098 Dutch adolescents in the Netherlands and we evaluated the contribution of adolescent, parent, family and stress-related factors to the observed ethnic differences. Data were drawn from the Dutch version of the Youth Self-Report (YSR), as well as from Dutch and Turkish parental questionnaires.

RESULTS

Turkish girls scored higher on four of the eight YSR syndrome-scales, on the Internalising broadband scale and on total problems than Dutch girls. Turkish boys scored higher on three syndrome scales and on the Internalising scale, but scored less on Delinquent Behaviour than their Dutch peers. Ethnic differences for both sexes were most pronounced on the Withdrawn and Anxious/Depressed scales. Socio-economic measures, in particular education of the parents, contributed most to the explanation of ethnic differences on the Somatic Complaints scale for girls and Social Problem and Internalising scales for boys. On most scales, however, ethnic differences could not be explained by other factors. The distribution of some factors appeared to be more favourable (i.e., less frequent) for Turkish than for Dutch youths, such as referral of family members to mental health services.

CONCLUSIONS

Low educational levels of the parents play an important, yet not an exclusive role in explaining cross-cultural differences in emotional and behavioural problems in adolescents. In particular, differences in Withdrawn and Anxious/Depressed behaviour could not be explained by non-cultural factors. This study offers starting-points for future research on cultural-specific predictors of psychopathology in immigrants.

Normative studies with the Scale for Interpersonal Behaviour (SIB): II. US students. A cross-cultural comparison with Dutch data

The Scale for Interpersonal Behaviour (SIB), a multidimensional, self-report measure of state assertiveness, was administered to a nationwide sample of 2375 undergraduates enrolled at 11 colleges and universities across the USA. The SIB was developed in the Netherlands for the independent assessment of both distress associated with self-assertion in a variety of social situations and the likelihood of engaging in a specific assertive response. This is done with four factorially-derived, first-order dimensions: (i) Display of negative feelings (Negative assertion); (ii) Expression of and dealing with personal limitations; (iii) Initiating assertiveness; and (iv) Praising others and the ability to deal with compliments/praise of others (Positive assertion). The present study was designed to determine the cross-national invariance of the original Dutch factors and the construct validity of the corresponding dimensions. It also set out to develop norms for a nationwide sample of US students. The results provide further support for the reliability, factorial and construct validity of the SIB. Compared to their Dutch equivalents, US students had meaningfully higher distress in assertiveness scores on all SIB scales (medium to large effect sizes), whereas differences on the performance scales reflected small effect sizes. The cross-national differences in distress scores were hypothesized to have originated from the American culture being more socially demanding with respect to interpersonal competence than the Dutch, and from the perceived threats and related cognitive appraisals that are associated with such demands.

Life events, locus of control, and behavioral problems among Chinese adolescents

This study examined associations of life events and locus of control with behavioral problems among 1,365 Chinese adolescents by using the Youth Self-Report (YSR), Adolescent Self-Rating Life Events Checklist (ASLEC), and the Nowicki-Strickland Locus of Control Scale for Children. Results indicated that the overall prevalence of behavioral and emotional problems was 10.7% (95% CI = 9.9-11.5%). Logistic-regression analyses showed that a total of 13 negative life events mainly coming from academic domain and interpersonal relationships, high life-stress score, and high external locus score significantly increased the risk for behavioral problems. Life stress and locus of control significantly interacted with behavioral problems. These findings support the linkage between stressful life events and psychopathology in a general population of adolescents from mainland China, and demonstrate the stress-moderating effects of locus of control on psychopathology as well.

The Child Behavior Checklist (CBCL) and related material: standardization and validation in Danish population based and clinically based samples

The Child Behavior Checklist (CBCL) and related material, developed by Achenbach and Edelbrock in Vermont, was validated in a mailed survey. A population based sample of 779 children between the age of four and 17 years was compared to a sample of 146 children referred for child psychiatric service. Danish children scored very much like our Scandinavian and German neighbours, but low compared to most others. The CBCL mean 'total behavior problem score' in the population was 17.7. The checklists, especially the parent and teacher versions, provided good construct validity. Youths generally reported more emotional problem behavior than their parents and teachers did about them. In general, parents and youths agree more, reporting emotional problems, and parents and teachers agree more, when scattering externalizing behavior. Short screening constructs are introduced, and by the use of latent trait analysis, four clinically relevant sub-scales were generated. Predictive value, sensitivity, specificity and clinical validity must be undertaken in a future two-phase study.

Epidemiology of childhood disorders in a cross-cultural context

The present report summarizes the epidemiologic research on childhood psychopathology that has been carried out in different cultural settings over the past 15 years from either an empirical or a diagnostic perspective. Prevalence and risk factor findings are summarized and contrasted. Some controversies surrounding cross-cultural research are discussed and methodological recommendations applicable to cross-cultural epidemiologic research are provided.

The prevalence of self-reported problems in young adults from the general population

This study assessed the prevalence of a wide range of behavioral and emotional problems in 706 19- to 24-year-olds from the Dutch general population using the Young Adult Self-Report (YASR). The prevalence rates found can be used to make comparisons with data from individuals or other samples. Large or medium (variance > 5.9%) sex effects were found for alcohol use, for the items 'Brags' and 'Swears' (males > females), and for the items 'Cries a lot' and 'Fears' (females > males). With respect to socially desirable items, females more often reported attitudes or behaviors pertaining to helping other people, while males more often reported competitive behaviors or attitudes. For YASR syndromes, higher mean scores for females than males were found for the Withdrawn, Somatic Complaints, and Anxious/Depressed syndromes, while mean scores on the Delinquent Behavior syndrome were higher for males than females. No age effects were found, indicating that normative data were similar across the 19- to 24-year age span. Compared to other problem areas, thought problems and delinquent behavior in males, and social problems and delinquent behavior in females were least likely to be associated with other types of problems. Hence, instruments for the assessment of psychopathology in young adults should include these areas to provide a comprehensive picture of behavioral and emotional problems.

Self-reported and parent reported problems in adolescent international adoptees

Self-reported and parent reported problem behaviors of 1,538 intercountry adopted adolescents aged 14-18 years were compared with those from general population samples; 22% of the adopted boys, and 18% of the adopted girls could be regarded deviant according to self-reports, compared with about 10% of the subjects from the general population. Parents' reports showed a slightly greater difference between adopted versus nonadopted boys. Childhood deprivation was weakly associated with later parent reported, but not with self-reported problems. Racial antagonism was not related to problem behaviors. Adolescence may constitute a period of increased vulnerability for adopted children.

Recent Developments in the Assessment and Diagnosis of Child Psychopathology

In this article, recent developments in the assessment and diagnosis of child psychopathology are discussed with an emphasis on standardized methodologies that provide data that can be scored on empirically derived groupings of problems that tend to co-occur. Assessment methodologies are highlighted that especially take account of the following three basic characteristics of child psychopathology: (1) the quantitative nature of child psychopathology; (2) the role of developmental differences in the occurrence of problem behaviors, and (3) the need for multiple informants. Cross-cultural research is needed to test the applicability of assessment procedures across different settings as well as the generalizability of taxonomic constructs. Assessments of children in different cultures can be compared or pooled to arrive at a multicultural knowledge base which may be much stronger than knowledge based on only one culture. It is essential to avoid assuming that data from any single source reveal the significance of particular problems. Instead, comprehensive assessment of psychopathology requires coordination of multisource data using a multiaxial assessment approach.

Empirically based assessment and taxonomy of psychopathology: cross-cultural applications. A review

This paper provides an overview of empirically based assessment and taxonomy, as illustrated by cross-cultural research on psychopathology. The empirically based approach uses standardized assessment procedures to score behavioral and emotional problems from which syndromes are derived by multivariate analyses. Items and syndromes are scored quantitatively to reflect the degree to which individuals manifest them, as reported by particular informants. Although the approach to assessing problems and to constructing taxonomic groupings differs from the ICD/DSM approach, there are no inherent contradictions between either their models for disorders nor the criterial features used to define disorders. Cross-cultural comparisons have yielded relatively small differences in problem rates and syndrome structure, plus considerable similarity in associations of problems with sex and SES, as well as similar correlations between reports by different types of informants. Research on variations in problems in relation to culture, sex, age, SES, and type of informant can contribute to improving both the ICD/DSM and empirically based approaches and to a more effective synthesis between them.