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Jackson ST, Jaeger AJ, Del Vecchio T. Predictors of help-seeking behavior in mothers of preschoolers. Clin Child Psychol Psychiatry 2023; 28:1495-1508. [PMID: 36876474 DOI: 10.1177/13591045231160644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Mental health difficulties in the preschool years require early intervention, but preschool children are underserved in mental healthcare. One explanation might be that parents do not seek services because their problem recognition, or labeling, ability is lacking. While previous research demonstrates that labeling is positively associated with help-seeking, interventions aimed at improving help-seeking by improving labeling are not always successful. Parental perceptions of severity, impairment, and stress also predict help-seeking, but have not been examined alongside labeling. Thus, it is unclear how much they add to the parental help-seeking process. The present study simultaneously examined labeling and parental perceptions of severity, impairment, and stress on help-seeking. Participants (82 adult mothers of children ages 3-5 years) read vignettes describing preschool-aged children with symptoms of depression, anxiety, and ADHD, and answered a series of questions to assess their labeling and likelihood of help-seeking for each of the problems presented. Help-seeking was found to be positively associated with labeling (r = .73; r = .60), severity (r = .66), impairment (r = .31), and stress (r = .25). Furthermore, severity, impairment, and stress predicted endorsements of help-seeking above and beyond what was predicted by labeling alone (R2 change = .12; χ2 (3) = 20.03, p < .01). These results underscore the importance of parental perceptions of children's behavior to the help-seeking process.
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Schniering CA, Forbes MK, Rapee RM, Wuthrich VM, Queen AH, Ehrenreich-May J. Assessing Functional Impairment in Youth: Development of the Adolescent Life Interference Scale for Internalizing Symptoms (ALIS-I). Child Psychiatry Hum Dev 2023; 54:508-519. [PMID: 34655359 DOI: 10.1007/s10578-021-01241-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 12/31/2022]
Abstract
This study described the psychometric properties of a self-report measure of functional impairment related to anxiety and depression in adolescents, the Adolescent Life Interference Scale for Internalizing symptoms (ALIS-I). A clinical sample of 266 adolescents and a community sample of 63 adolescents, aged 11 to 18 years (Mean = 14.7, SD = 1.71) completed the ALIS-I and additional measures assessing internalizing problems. Exploratory factor analyses indicated four distinct but correlated factors of life interference related to personal withdrawal/avoidance, peer problems, problems with study/work, and somatic symptoms. Reliability and retest reliability (8-12 weeks) of the total score were high and psychometric properties of the subscales were acceptable. The ALIS-I effectively discriminated between clinical and community control groups, and expected correlations were shown between ALIS-I subscales and other related symptom measures. The ALIS-I is a promising instrument for the assessment of functional impairment related to internalizing disorders in youth.
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Affiliation(s)
- Carolyn A Schniering
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia. .,Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA.
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Viviana M Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Alexander H Queen
- Department of Psychology, Tufts University, 490 Boston Avenue, Medford, MA, USA
| | - Jill Ehrenreich-May
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA
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Viswanathan P, Kishore MT, Seshadri SP, Binu VS. Developmental competencies, temperament, parenting practices and psychosocial adversities in children with internalising disorders - A pilot study. Clin Child Psychol Psychiatry 2023; 28:483-499. [PMID: 35446695 DOI: 10.1177/13591045221082745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research on the aetiology of internalising disorders has focussed on biological and environmental factors, however, the role of developmental competencies that a child acquires has not been explored much. The current report aimed to understand the association among the developmental competencies, temperament, parenting practices and psychosocial adversities in internalising disorders. The sample consisted of 30 children and adolescents with internalising disorders belonging to the age group of six to 18, and one of their parents. All the participants were assessed for functional impairment, temperament, interpersonal competence, emotion regulation, executive function, self-concept, adaptive behaviour, parenting practices, life events and family environment using standardised tools. The findings revealed that positive parenting shares a negative relationship with functional impairment(ρ=-0.62; p <.001). On comparison with non-clinical samples in previous studies, interpersonal competence and self-concept were found to be at lower levels in the current sample. In conclusion, the current study indicates that children with internalising disorders differ from control groups in specific developmental competences. These findings have specific implications for intervention and research in the area of internalising disorders in children and adolescents.
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Affiliation(s)
- Poornima Viswanathan
- PhD Scholar, Department of Clinical Psychology, 29148National Institute of Mental Health and Neurosciences(NIMHANS), Hosur Road, Bangalore
| | - M T Kishore
- Additional Professor, Department of Clinical Psychology, NIMHANS, Bangalore
| | - Shekhar P Seshadri
- Senior Professor, Department of Child and Adolescent Psychiatry, NIMHANS, Bangalore
| | - V S Binu
- Associate Professor, Department of Biostatistics, NIMHANS, Bangalore
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Dao A, Khann S, Seponski DM, Hoang-Minh D, Tran CV, Weiss B. Concurrent and convergent validity of culture-specific psychopathology syndromes among Cambodian adolescents. Transcult Psychiatry 2022; 60:332-344. [PMID: 36573014 DOI: 10.1177/13634615221140704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Psychopathology is defined in part by its impacts on life functioning (e.g., fulfillment of daily responsibilities at work or school, in family relationships). Relations to life functioning are particularly important in the validation of culture-specific syndromes (patterns of mental health symptoms specific to a particular culture), to demonstrate that culture-specific symptom patterns do in fact represent pathology. The current study's goal was to assess the construct validity of the Cambodian Somatic Symptom and Syndrome Inventory (CSSI). The study focused on the statistically unique effects of the CSSI on life functioning (i.e., effects of the CSSI on life functioning, controlling for Western psychopathology syndromes), to determine whether the CSSI contributes information beyond standard Western measures, which would support CSSI culture-specific convergent validity. Because adolescence is a key period when psychopathology often develops, study participants were 391 high-school students in one urban and one rural area of Cambodia. Participants completed the CSSI, the Western psychopathology surveys Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder questionnaire (GAD-7), and life functioning measures assessing functional impairment, quality of life, and help-seeking. Results indicated strong CSSI concurrent validity (canonical correlation = 0.75) with the PHQ-9 and GAD-7, and CSSI total effects convergent validity on life functioning indicators. All CSSI statistically unique effects (controlling for the PHQ-9 and GAD-7) on life functioning measures were non-significant indicating that the CSSI, shown to be a valid assessment measure in the current study, does not add predictive information beyond standard Western measures. A key limitation that should be considered in interpretation of these results is that the life functioning measures, although reviewed by Khmer psychologists, were Western-based, thus potentially inflating relations with Western psychopathology measures.
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Affiliation(s)
- Anh Dao
- Department of Psychology and Human Development, 5718Vanderbilt University, USA
| | - Sareth Khann
- Psychology Department, Royal University of Phnom Penh, Cambodia
| | - Desiree M Seponski
- Department of Human Development and Family Science, 1355University of Georgia, USA
| | | | | | - Bahr Weiss
- Department of Psychology and Human Development, 5718Vanderbilt University, USA
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Weiss MD, Stein MA. Measurement Informed Care in Attention-Deficit/Hyperactivity Disorder (ADHD). Child Adolesc Psychiatr Clin N Am 2022; 31:363-372. [PMID: 35697390 DOI: 10.1016/j.chc.2022.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Measurement-informed care is a cornerstone of evidence-based practice and shared decision-making. A structured diagnostic interview specific to ADHD provides a globally agreed-on standard of evaluation. These interviews are accessible in the public domain in multiple languages and are helpful to clinicians new to the diagnosis of ADHD. Broad-based rating scales looking at multiple domains of psychopathology are critical to assuring recognition of comorbid diagnoses, which might otherwise be missed, differential diagnoses, and identification of the most prominent or treatable diagnosis. Recent innovations in computerized adaptive testing have improved the efficiency and accuracy of diagnostic screening. Rating scales specific to ADHD and disruptive behavior disorders establish the severity of the disorder and response to intervention. Age- and gender-normed symptom rating scales for ADHD capture clinically salient differences between what is normative in different demographic groups. An evaluation of functional impairment in ADHD has been critical to understanding the patient's perspective of the presenting problem. Best practice care for ADHD treatment goes beyond improvement to well-defined standards for both symptom and functional remission. Studies of executive function, emotional regulation, mind-wandering, and sluggish cognitive tempo have led to a richer understanding of the breadth and depth of associated deficits commonly experienced by ADHD patients. Psychometrically validated tools are available to complement every aspect of ADHD care and provide global standards for research.
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Affiliation(s)
- Margaret Danielle Weiss
- Department of Child Psychiatry, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA.
| | - Mark A Stein
- Departments of Psychiatry and Behavioral Sciences, and Pediatrics, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195-6560, USA
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Kennedy SM, Wilkie DP, Henry L, Moe-Hartman J, President K, Townson K, Anthony LG, Hawks JL. The Unified Protocols for Children and Adolescents in Partial Hospitalization: Using Implementation Science Frameworks to Guide Adaptation. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Waxmonsky JG, Baweja R, Bansal PS, Waschbusch DA. A Review of the Evidence Base for Psychosocial Interventions for the Treatment of Emotion Dysregulation in Children and Adolescents. Child Adolesc Psychiatr Clin N Am 2021; 30:573-594. [PMID: 34053687 DOI: 10.1016/j.chc.2021.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Many children with a range of psychiatric diagnoses manifest impaired levels of emotion dysregulation (ED). Over the past decade, there has been increasing examination of psychosocial interventions for ED. We found preliminary evidence of positive effects for a wide range of psychosocial treatments that were associated with improvements in emotion recognition, emotional reactivity, and emotion regulation. More studies are needed because results are limited by the small number of controlled trials, heavy reliance on parent ratings, and heterogeneity of the samples.
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Affiliation(s)
- James G Waxmonsky
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA.
| | - Raman Baweja
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA
| | - Pevitr S Bansal
- Department of Psychology in the College of Arts and Sciences at the University of Kentucky, 171 Funkhouser Drive, Lexington, KY, USA
| | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA
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Avanci JQ, Serpeloni F, de Oliveira TP, de Assis SG. Posttraumatic stress disorder among adolescents in Brazil: a cross-sectional study. BMC Psychiatry 2021; 21:75. [PMID: 33546640 PMCID: PMC7866458 DOI: 10.1186/s12888-021-03062-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/19/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated. METHODS Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. The data were grouped in blocks regarding sociodemographic, individual, family, and community variables. For statistical analysis, chi-square, Fisher's exact test, and logistic regression were performed. RESULTS The PTSD prevalence was 7.8% among adolescents. Boys were exposed to significantly higher number of events of community violence, while girls to family violence. The adjusted odds ratio (OR) for PTSD were statistically significant for age (OR, 1.45, [95% CI, 1.043-2.007]), social functional impairment (OR, 4.82, [95% CI, 1.77-13.10]), severe maternal physical violence (OR, 2.79, [95% CI, 0.79-9.93]), psychological violence by significant people (OR, 3.96, [95% CI, 1.89-8.31]) and a high number of episodes of community violence (OR, 3.52, [95% CI, 1.47-8.40). CONCLUSIONS There was a high prevalence of PTSD within this population associated with exposure to violence. Not only physical, but also psychological violence contributed to PTSD. The results also raise awareness to the differences in life trajectories between boys and girls regarding violence. These differences need to be better understood in order to enable the development of effective preventative interventions. Treating and preventing mental health disorders presents a challenge for countries, especially those with a lower degree of social and economic development and high community violence.
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Affiliation(s)
- Joviana Quintes Avanci
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil.
| | - Fernanda Serpeloni
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil
| | - Thiago Pires de Oliveira
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil
- International Business Machines Corporation, Rio de Janeiro, Brazil
| | - Simone Gonçalves de Assis
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil
- Neurology Post-Graduate Program, Federal University of the State of Rio de Janeiro, Mariz e Barros 775, Rio de Janeiro, 20270-901, Brazil
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Villarreal V, Sullivan J, Hechler JM, Ruiz K. A Review and Psychometric Evaluation of Multidimensional Scales of Functional Impairment and Recommendations for Practice. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2020. [DOI: 10.1080/15377903.2020.1848954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Victor Villarreal
- Educational Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Jeremy Sullivan
- Educational Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Joseph M. Hechler
- Educational Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Karen Ruiz
- Educational Psychology, University of Texas at San Antonio, San Antonio, TX, USA
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10
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Cerebrovascular Disease in Children Perinatally Infected With Human Immunodeficiency Virus in Zambia. Pediatr Neurol 2020; 112:14-21. [PMID: 32871411 PMCID: PMC7554106 DOI: 10.1016/j.pediatrneurol.2020.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND High rates of cerebrovascular disease (CVD) have previously been described in pediatric human immunodeficiency virus (HIV). However, little is known about pediatric CVD in the era of antiretroviral therapy or about the contribution of CVD to HIV-associated neurocognitive disorders. METHODS We completed a neuroimaging substudy of the HIV-Associated Neurocognitive Disorders in Zambia study, a prospective cohort study of neurocognitive complications of pediatric HIV. Brain magnetic resonance imaging (1.5 T) was acquired for 34 HIV+ children on antiretroviral therapy and 17 HIV-exposed uninfected children (aged eight to 17 years). Demographics, medical history, neurological examination, and neuropsychologic testing results were collected. Two neuroradiologists, unaware of HIV status and clinical course, read the scans. RESULTS CVD was identified in seven of 34 children with HIV (HIV+ CVD+) and no HIV-exposed uninfected children (21% vs 0%, P = 0.05). Three participants had white matter changes suggestive of small vessel disease, four had infarcts, and two had evidence of intracranial artery stenosis. Age of antiretroviral therapy initiation and exposure to protease inhibitors or efavirenz was not significantly different between children with and without CVD. HIV+ CVD+ children had significantly worse scores on a summary measure of cognition than the HIV+ CVD- group (NPZ8 score -0.57 vs 0.33, P = 0.04). CONCLUSIONS This study demonstrates high rates of CVD in children with HIV despite antiretroviral therapy, and worse cognitive performance in children with CVD. Longitudinal studies are necessary to determine the mechanisms and incidence of new-onset CVD in children with HIV.
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Scheeringa MS. The Diagnostic Infant Preschool Assessment-Likert Version: Preparation, Concurrent Construct Validation, and Test-Retest Reliability. J Child Adolesc Psychopharmacol 2020; 30:326-334. [PMID: 32159386 DOI: 10.1089/cap.2019.0168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The Diagnostic Infant and Preschool Assessment was revised to include Likert ratings (DIPA-L) to give a broader range of severity ratings that may have greater utility for clinical and research purposes. In addition, the instrument was updated for Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and two types of Likert ratings-frequency versus problem intensity-were explored for posttraumatic stress disorder (PTSD) symptoms. Concurrent construct validation and test-retest reliability were examined for the five most common disorders seen in very young children in outpatient clinics: PTSD, attention-deficit/hyperactivity disorder, oppositional defiant disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). A sixth disorder, disruptive mood dysregulation disorder (DMDD), which was created in DSM-5, was tested for the first time. Functional impairment was also examined. Methods: The caregivers of 58 two- through six-year-old children (57 mothers and 1 father) were recruited from an outpatient clinic. They were interviewed at Time 1, and 52 were reinterviewed at Time 2 by research assistants (children's age M 4.7 years, standard deviation 1.2). Results: Few differences were found between the ratings of frequency versus problem intensity for PTSD symptoms. Tests of concurrent criterion validation were acceptable for all disorders when compared against disorder-specific questionnaires; the range of Pearson correlation coefficients was 0.56-0.94. A trend for attenuation of diagnoses from Time 1 to Time 2 was evident, but not statistically significant. Test-retest reliabilities were strong when examined with continuous Likert scores, except for GAD (the range of intraclass correlation coefficients values was 0.29-0.91, but were less consistent for categorical disorder-level status [the range of Cohen's κs was 0.35-0.79]). The range of internal consistencies was 0.78-0.95, excluding DMDD, which could not be calculated. Conclusions: The updated and revised DIPA-L demonstrated many acceptable features of a valid and reliable instrument for the assessment of very young children. While the findings are tentative given the small sample size, the DIPA-L is the only diagnostic instrument for young children with a replication, tested in clinic populations, updated for DSM-5, with psychometrics for functional impairment, and has Likert ratings.
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Affiliation(s)
- Michael S Scheeringa
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Erickson SJ, Hile S, Kubinec N, Annett RD. Self-reported and parent proxy reported functional impairment among pediatric cancer survivors and controls. Health Qual Life Outcomes 2020; 18:142. [PMID: 32423481 PMCID: PMC7236514 DOI: 10.1186/s12955-020-01387-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 04/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background A unique and limiting component in the research on functional impairment among children has been the exclusive use of parent proxy reports about child functioning; and there is limited information regarding the impact of pediatric cancer treatment on children’s day-to-day functioning and how this is related to neurocognitive functioning. The objective of the current study was to examine a novel measure of self-reported functional impairment, and explore the relationship between self-reported and parent-reported child functional impairment in pediatric cancer survivors compared to controls. Methods A cross-sectional cohort of survivors (n = 26) and controls (n = 53) were recruited. Survivors were off treatment an average of 6.35 years (SD = 5.38; range 1–15 years) and demonstrated an average “medium” Central Nervous System treatment intensity score. Participants completed measures of functional impairment (FI), intellectual assessment (RIST) and executive functions (NIH Examiner), while parents reported on children’s functional impairment. Results Survivors were similar to controls in functional impairment. Regardless of group membership, self-reported FI was higher than parent-reported FI, although they were correlated and parent report of FI significantly predicted self-reported FI. Across groups, increased impairment was associated with four of seven Examiner scores. Conclusions Research regarding self-reported functional impairment of cancer survivors and its association with parent-reported functional impairment and neurocognitive deficits has been limited. Our results suggest that self-reported FI appears to be a reasonable and viable outcome measure that corresponds with and adds incremental validity to parent reported FI. While low treatment intensity may confer relative sparing of functional impairment among survivors, children report higher FI levels than parents, suggesting that FI can be of clinical utility. In conclusion, pediatric cancer survivors should be screened for self-reported functional difficulties.
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Affiliation(s)
- Sarah J Erickson
- Department of Psychology, Logan Hall, University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA.
| | | | - Nicole Kubinec
- Department of Psychology, Logan Hall, University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
| | - Robert D Annett
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA
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Rey-Casserly C, McGuinn L, Lavin A, LaMonte Askew G, Baum R, Berger-Jenkins E, Gambon TB, Nasir AA, Wissow LS, Weitzman CC, Blum NJ, Childers DO, Levine JM, Peralta-Carcelen AM, Poon JK, Smith PJ, Takayama JI, Voigt RG, Bridgemohan C. School-aged Children Who Are Not Progressing Academically: Considerations for Pediatricians. Pediatrics 2019; 144:peds.2019-2520. [PMID: 31548334 DOI: 10.1542/peds.2019-2520] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pediatricians and other pediatric primary care providers may be consulted when families have concerns that their child is not making expected progress in school. Pediatricians care not only for an increasingly diverse population of children who may have behavioral, psychological, and learning difficulties but also for increasing numbers of children with complex and chronic medical problems that can affect the development of the central nervous system and can present with learning and academic concerns. In many instances, pediatric providers require additional information about the nature of cognitive, psychosocial, and educational difficulties that affect their school-aged patients. Our purpose for this report is to describe the current state of the science regarding educational achievement to inform pediatricians' decisions regarding further evaluation of a child's challenges. In this report, we review commonly available options for psychological evaluation and/or treatment, medical referrals, and/or recommendations for referral for eligibility determinations at school and review strategies for collaborating with families, schools, and specialists to best serve children and families.
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Affiliation(s)
- Celiane Rey-Casserly
- Department of Psychiatry, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Laura McGuinn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Alabama, Birmingham, and Children's of Alabama, Birmingham, Alabama; and
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Erickson SJ, Hile S, Rieger RE, Moss NC, Dinces S, Annett RD. Association Between Executive Functioning and Functional Impairment Among Pediatric Cancer Survivors and Controls. Arch Clin Neuropsychol 2019; 34:599-609. [PMID: 30307471 DOI: 10.1093/arclin/acy079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/05/2018] [Accepted: 09/14/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the impact of cancer treatment upon neurocognitive and functional impairment; and to explore the relationship between these constructs in pediatric cancer survivors compared to controls. METHOD A cross-sectional cohort of survivors (n = 26) and controls (n = 53) was included. Survivors were off treatment an average of 6.35 years (SD = 5.38; range 1-15 years) and demonstrated an average "medium" Central Nervous System (CNS) treatment intensity score. Participants completed measures of neurocognitive functions including intellectual assessment (RIST) and executive functions (NIH Examiner), while parents reported on children's functional impairment (BIS). RESULTS Survivors were similar to controls in neurocognitive ability, including intellectual and executive functions, and functional impairment. Regardless of group membership, NIH Examiner performance and functional impairment increased with age. Increased impairment was associated with different neurocognitive variables for survivors versus controls. CONCLUSIONS Research regarding functional impairment of cancer survivors and the association between neurocognitive deficits and functional impairment has been limited. Our results demonstrate that, while low treatment intensity may confer relative sparing of neurocognitive and executive functioning among survivors, functional impairment continues to be a potential risk. In conclusion, pediatric cancer survivors should be screened for functional difficulties, particularly in the areas of interpersonal relations and self-care.
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Affiliation(s)
| | | | | | | | - Sarah Dinces
- NM Legislative Finance Committee, Santa Fe, NM, USA
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Lee S, Kim B, Yoo HK, Huh H, Roh J. Cross Validation of Attention-Deficit/Hyperactivity Disorder-After School Checklist. Soa Chongsonyon Chongsin Uihak 2018; 29:129-136. [PMID: 32595305 PMCID: PMC7289462 DOI: 10.5765/jkacap.170036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/21/2018] [Accepted: 04/06/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to evaluate the efficacy of the attention-deficit/hyperactivity disorder (ADHD)-After School Checklist (ASK) by comparing the results of the Comprehensive Attention Test (CAT) and Clinical Global Impression-Severity (CGI-S) Scale and then by calculating the area under the receiver operating characteristic (ROC) curve. Methods We performed correlation analyses on the ASK and CAT results and then the ASK and CGI-S results. We created a ROC curve and evaluated performance on the ASK as a diagnostic tool. We then analyzed the test results of 1348 subjects (male 56.8%), including 1201 subjects in the general population and 147 ADHD subjects, aged 6-15 years, from kindergarten to middle school in Seoul and Gyeonggi province, South Korea. Results According to the correlation analyses, ASK scores and the Attention Quotient (AQ) of CAT scores showed a significant correlation of -0.20--0.29 (p<0.05). The t-test between ADHD scores and CGI-S also showed a significant correlation (t=-2.55, p<0.05). The area under the ROC curve was calculated as 0.81, indicating good efficacy of the ASK, and the cut-off score was calculated as 15.5. Conclusion The ASK can be used as a valid tool not only to evaluate functional impairment of ADHD children and adolescents but also to screen ADHD.
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Affiliation(s)
- Sukhyun Lee
- Division of Child & Adolescent Psychiatry, Department of Psychiatry Sanggye Paik Hospital School of Medicine Inje University, Seoul, Korea
| | - Bongseog Kim
- Division of Child & Adolescent Psychiatry, Department of Psychiatry Sanggye Paik Hospital School of Medicine Inje University, Seoul, Korea
| | - Hanik K Yoo
- Seoul Brain Research Institute, Seoul, Korea
| | - Hannah Huh
- Seoul Brain Research Institute, Seoul, Korea
| | - Jaewoo Roh
- Seoultop Psychiatric Clinic, Seoul, Korea
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Mian ND, Soto TW, Briggs-Gowan MJ, Carter AS. The Family Life Impairment Scale: Factor Structure and Clinical Utility with Young Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2018; 47:S530-S541. [PMID: 29718718 PMCID: PMC6214795 DOI: 10.1080/15374416.2018.1458313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although it is well-established that young children experience significant psychopathology, diagnostic decisions continue to be challenging, in part due to the way impairment is understood, defined, and measured. Most existing clinical tools assess impairment in an individualized manner, whereas for many young children, impairment is more accurately conceptualized as a family-oriented, multidimensional construct, impacting various parental and family activities. Two studies were completed using the Family Life Impairment Scale (FLIS), a multidimensional parent-report measure of family and associated impairment designed for young children. In Study 1, factor analysis was used in a large (n = 945) representative sample (23-48 months of age). FLIS associations with measures of parent and child well-being were explored to investigate convergent validity. Study 2 was completed in a sample (n = 174) of young children (18-33 months of age) diagnosed with autism spectrum disorders to explore factorial consistency in a clinical sample. Study 1 yielded evidence of a four-factor solution, including parent impairment (affecting parental well-being), family impairment (affecting family activities and routines), childcare impairment (affecting challenges with childcare), and positive growth (parental learning and growth associated with the child's problem). Evidence of convergent validity was also found, as factors were differentially associated with established measures of child symptoms and parent stress. Factor structure was supported in the clinical sample. Results support both the factorial structure and clinical utility of the FLIS for use across clinical and nonclinical populations of young children.
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Affiliation(s)
| | - Timothy W Soto
- b Clinical Psychology Department , William James College
| | | | - Alice S Carter
- d Department of Psychology , University of Massachusetts Boston
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Spence SH, Zubrick SR, Lawrence D. A profile of social, separation and generalized anxiety disorders in an Australian nationally representative sample of children and adolescents: Prevalence, comorbidity and correlates. Aust N Z J Psychiatry 2018; 52:446-460. [PMID: 29185356 DOI: 10.1177/0004867417741981] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine (1) the 12-month prevalence of social anxiety disorder (SOC), separation anxiety disorder (SEP) and generalized anxiety disorder (GAD) in a large, nationally representative sample of Australian youth; (2) patterns of comorbidity between these disorders; (3) demographic and socio-environmental correlates and (4) the psychosocial impact and service use associated with each condition. METHOD Data are from the 2013/2014 Australian national, face-to-face household Young Minds Matter survey of mental health and wellbeing. Informants were parents or carers reporting on 6310, 4- to 17-year-olds (55% of eligible households). The presence of each of the three anxiety disorders was determined based on the Diagnostic Interview Schedule for Children-Version IV. RESULTS In the past 12 months, 6.6% of youth had experienced at least one of SOC, SEP or GAD, with rates of 2.3% for SOC, 4.3% for SEP and 2.3% for GAD. Rates did not differ by gender but were significantly higher for SOC and GAD and lower for SEP in 12- to 17-year-olds than 4- to 11-year-olds. Comorbidity between these disorders was high, although lower for SEP. Having SOC, SEP or GAD was associated with not living with both biological parents, having a parent with a mental health problem, elevated negative family events, low carer employment and peer victimization. The association with family risk factors was greater for SEP than for SOC and GAD. Although the majority of anxious youth had received professional help, this was less likely in the younger cohort. CONCLUSION Social, separation and generalized anxiety disorders in young people are relatively common and impairing, with a high level of comorbidity. There are both commonalities and differences in socio-environmental correlates. The majority of anxious youth received some form of professional assistance, although the rate was lower among children compared to adolescents.
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Affiliation(s)
- Susan H Spence
- 1 Australian Institute for Suicide Research and Prevention (AISRAP) and School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia
| | - Stephen R Zubrick
- 2 Graduate School of Education, The University of Western Australia, Perth, WA, Australia
| | - David Lawrence
- 2 Graduate School of Education, The University of Western Australia, Perth, WA, Australia
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Murthy VS, Nayak AS, Joshi MK, Ninawe K. A study of neuropsychological profile of human immunodeficiency virus-positive children and adolescents on antiretroviral therapy. Indian J Psychiatry 2018; 60:114-120. [PMID: 29736073 PMCID: PMC5914239 DOI: 10.4103/psychiatry.indianjpsychiatry_200_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIMS The aim is to study the neuropsychological and functional profile of children and adolescents with human immunodeficiency virus (HIV) infection on antiretroviral therapy (ART) and the association between the neuropsychological status and medical illness variables, treatment variables, and functional status in the cases of the sample and compare with normal controls. MATERIALS AND METHODS Forty-two HIV-positive children and adolescents on ART were evaluated and compared with 40 matched controls not known to be HIV-positive. The tools used were the Wechsler Intelligence Scale for Children-III R for neuropsychological evaluation, the Brief Impairment Scale to assess functional impairment, and a semi-structured questionnaire to obtain other relevant details. RESULTS There were significant differences between the verbal, performance intelligence quotients (IQs), global IQ score, and several individual subtests between cases and controls. The HIV group was also found to have a significant functional impairment. CONCLUSION Our findings show that HIV infection is associated with significant cognitive and functional impairment. The role of ART in these impairments requires further study. Such understanding can help to introduce wholesome and relatively safer management strategies for youngsters with HIV infection and improve their quality of life.
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Affiliation(s)
- Vasantmeghna S Murthy
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Ajita S Nayak
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Minal K Joshi
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Kaneenica Ninawe
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Arbour M, Murray KA, Yoshikawa H, Arriet F, Moraga C, Vega MAC. Emotional, physical, and social needs among 0-5-year-old children displaced by the 2010 Chilean earthquake: associated characteristics and exposures. DISASTERS 2017; 41:365-387. [PMID: 27170477 DOI: 10.1111/disa.12197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An 8.8-magnitude earthquake occurred off the coast of Chile on 27 February 2010, displacing nearly 2,000 children aged less than five years to emergency housing camps. Nine months later, this study assessed the needs of 140 displaced 0-5-year-old children in six domains: caregiver stability and protection; health; housing; nutrition; psychosocial situation; and stimulation. Multivariate regression was applied to examine the degree to which emotional, physical, and social needs were associated with baseline characteristics and exposure to the earthquake, to stressful events, and to ongoing risks in the proximal post-earthquake context. In each domain, 20 per cent or fewer children had unmet needs. Of all children in the sample, 20 per cent had unmet needs in multiple domains. Children's emotional, physical, and social needs were associated with ongoing exposures amenable to intervention, more than with baseline characteristics or epicentre proximity. Relief efforts should address multiple interrelated domains of child well-being and ongoing risks in post-disaster settings.
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Affiliation(s)
- MaryCatherine Arbour
- MD, MPH is Associate Physician for Research in the Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Kara A Murray
- MPH is Research Assistant in the Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Hirokazu Yoshikawa
- PhD is University Professor at New York University, New York, NY, United States
| | - Felipe Arriet
- BA is Technical Advisor at Chile Crece Contigo, Ministry of Social Development, Santiago, Chile
| | - Cecilia Moraga
- MA is Technical Advisor at Chile Crece Contigo, Ministry of Health, Santiago, Chile
| | - Miguel Angel Cordero Vega
- MSc is Associate Academic at the Psychiatry Training Program, Universidad Diego Portales Medical School, Santiago, Chile
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Guan K, Park AL, Chorpita BF. Emergent Life Events During Youth Evidence-Based Treatment: Impact on Future Provider Adherence and Clinical Progress. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 48:S202-S214. [DOI: 10.1080/15374416.2017.1295382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Karen Guan
- Department of Psychology, University of California, Los Angeles
| | - Alayna L. Park
- Department of Psychology, University of California, Los Angeles
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Breistøl S, Clench-Aas J, Van Roy B, Kjærsti Raanaas R. Association Between Participating in Noncompetitive or Competitive Sports and Mental Health among Adolescents – a Norwegian Population-based Cross-sectional Study. Scand J Child Adolesc Psychiatr Psychol 2017. [DOI: 10.21307/sjcapp-2017-003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Lawrence D, Hafekost J, Johnson SE, Saw S, Buckingham WJ, Sawyer MG, Ainley J, Zubrick SR. Key findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2016; 50:876-86. [PMID: 26644606 DOI: 10.1177/0004867415617836] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To estimate the prevalence of mental disorders in children and adolescents in Australia, and the severity and impact of those mental disorders. METHOD Seven mental disorders were assessed using the parent- or carer-completed version of the Diagnostic Interview Schedule for Children Version IV, and major depressive disorder was also assessed using the youth self-report version of the Diagnostic Interview Schedule for Children Version IV. Severity and impact were assessed using an extended version of the Diagnostic Interview Schedule for Children Version IV impact on functioning questions, and days absent from school due to symptoms of mental disorders. Data were collected in a national face-to-face survey of 6310 parents or carers of children and adolescents aged 4-17 years, with 2969 young people aged 11-17 years also completing a self-report questionnaire. RESULTS Twelve-month prevalence of mental disorders was 13.9%, with 2.1% of children and adolescents having severe disorders, 3.5% having moderate disorders and 8.3% having mild disorders. The most common class of disorders was attention-deficit/hyperactivity disorder followed by anxiety disorders. Mental disorders were more common in step-, blended- or one-parent families, in families living in rented accommodation and families where one or both carers were not in employment. Mental disorders were associated with a substantial number of days absent from school particularly in adolescents. CONCLUSION Mental disorders are common in children and adolescents, often have significant impact and are associated with substantial absences from school. Child and adolescent mental disorders remain an important public health problem in Australia. Accurate information about prevalence and severity of child and adolescent mental disorders is an essential prerequisite for effective mental health policy and service planning.
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Affiliation(s)
- David Lawrence
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Jennifer Hafekost
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Sarah E Johnson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Suzy Saw
- Health Data Analysis Pty Ltd, Canberra, ACT, Australia
| | | | - Michael G Sawyer
- Discipline of Paediatrics, The University of Adelaide, Adelaide, SA, Australia
| | - John Ainley
- Australian Council for Educational Research, Melbourne, VIC, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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23
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Hafekost J, Lawrence D, Boterhoven de Haan K, Johnson SE, Saw S, Buckingham WJ, Sawyer MG, Ainley J, Zubrick SR. Methodology of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2016; 50:866-75. [PMID: 26698821 DOI: 10.1177/0004867415622270] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the study design of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing. The aims of the study, sample design, development of survey content, field procedures and final questionnaires are detailed. METHOD During 2013-2014, a national household survey of the mental health and wellbeing of young people was conducted involving a sample of 6310 families selected at random from across Australia. The survey included a face-to-face diagnostic interview with parents/carers of 4- to 17-year-olds and a self-report questionnaire completed by young people aged 11-17 years. RESULTS The overall response rate to the survey was 55% with 6310 parents/carers of eligible households participating in the survey. In addition, 2967 or 89% of young people aged 11-17 years in these participating households completed a questionnaire. The survey sample was found to be broadly representative of the Australian population on major demographic characteristics when compared with data from the Census of Population and Housing. However, adjustments were made for an over-representation of younger children aged 4 to 7 years and also families with more than one eligible child in the household. CONCLUSION Young Minds Matter provides updated national prevalence estimates of common child and adolescent mental disorders, describes patterns of service use and will help to guide future decisions in the development of policy and provision of mental health services for children and adolescents. Advancements in interviewing methodology, addition of a data linkage component and informed content development contributed to improved breadth and quality of the data collected.
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Affiliation(s)
- Jennifer Hafekost
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - David Lawrence
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | - Sarah E Johnson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Suzy Saw
- Health Data Analysis Pty Ltd, Canberra, ACT, Australia
| | | | - Michael G Sawyer
- Discipline of Paediatrics, The University of Adelaide, Adelaide, SA, Australia
| | - John Ainley
- Australian Council for Educational Research, Melbourne, VIC, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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Barch DM, Gotlib IH, Bilder RM, Pine DS, Smoller JW, Brown CH, Huggins W, Hamilton C, Haim A, Farber GK. Common Measures for National Institute of Mental Health Funded Research. Biol Psychiatry 2016; 79:e91-6. [PMID: 26903402 PMCID: PMC4968690 DOI: 10.1016/j.biopsych.2015.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/13/2015] [Accepted: 07/15/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Deanna M Barch
- Departments of Psychology, Psychiatry, and Radiology, Washington University, St. Louis, Missouri.
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Robert M Bilder
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California at Los Angeles, Los Angeles, California
| | - Daniel S Pine
- National Institute of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, and Department of Psychiatry, Massachusetts General Hospital; and Stanley Center for Psychiatric Research, Broad Institute, Boston, Massachusetts
| | - C Hendricks Brown
- Department of Psychiatry, Northwestern University, Chicago, Illinois
| | - Wayne Huggins
- RTI International, Research Triangle Park, Durham, North Carolina
| | - Carol Hamilton
- RTI International, Research Triangle Park, Durham, North Carolina
| | - Adam Haim
- Office of Clinical Research and Office of Technology, Bethesda, Maryland
| | - Gregory K Farber
- Development and Coordination, National Institute of Mental Health, Bethesda, Maryland
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Dang HM, Weiss B, Trung LT. Functional impairment and mental health functioning among Vietnamese children. Soc Psychiatry Psychiatr Epidemiol 2016; 51:39-47. [PMID: 26315942 PMCID: PMC4724307 DOI: 10.1007/s00127-015-1114-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 08/12/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low- and middle-income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family). METHODS 1314 parents of children 6-16 years old from 10 Vietnamese provinces were interviewed. RESULTS The overall rate of functional impairment among Vietnamese children was 20 %, similar to rates in high-income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550 % associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects. CONCLUSIONS Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC.
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Affiliation(s)
- Hoang-Minh Dang
- Vietnam National University, 144 Xuan Thuy Road, Cau Giay District, Hanoi, Vietnam.
| | - Bahr Weiss
- Vanderbilt University, Nashville, Tennessee, USA
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Lee C, Du YB, Christina D, Palfrey J, O'Rourke E, Belfer M. Displacement as a predictor of functional impairment in tsunami-exposed children. DISASTERS 2015; 39:86-107. [PMID: 25231556 DOI: 10.1111/disa.12088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Thirty months after the Indian Ocean tsunami of 26 December 2004, thousands of families in Aceh Province, Indonesia, remained in temporary barracks while sanitation conditions and non-governmental organisation support deteriorated. This study sought to determine the factors associated with functional impairment in a sample of 138 displaced and non-displaced Acehnese children. Using multivariate linear regression models, it was found that displacement distance was a consistent predictor of impairment using the Brief Impairment Scale. Exposure to tsunami-related trauma markers was not significantly linked with impairment in the model. Paternal employment was a consistent protective factor for child functioning. These findings suggest that post-disaster displacement and the subsequent familial economic disruption are significant predictors of impaired functioning in children's daily activities. Post-disaster interventions should consider the disruption of familiar environments for families and children when relocating vulnerable populations to avoid deleterious impacts on children's functioning.
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Affiliation(s)
- Christopher Lee
- Resident Physician in the Department of Medicine, University of California, San Francisco, United States
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Abstract
The current study sought to evaluate the validity and reliability of a brief measure of overall functioning for adolescents. Clinicians were asked to complete the Overall Functioning Scale (OFS) for 72 adolescents consecutively admitted to the adolescent psychiatric inpatient service of a community safety net medical center. The results revealed that this new measure is related to the patients' length of stay, clinician-rated measures of social cognition and object relations, Global Assessment of Functioning (GAF) score at admission, as well as global rating of engagement in individual psychotherapy. The results also showed that the OFS was related to the patients' history of nonsuicidal self-harm as well as treatment outcome as assessed by measures of psychological health and well-being as well as symptoms. Hierarchical regressions reveal that the OFS shows incremental validity greater than the admission GAF score in predicting length of stay. The results also showed that the OFS demonstrates interrater reliability in the excellent range (intraclass correlation coefficient(1,2)) of 0.88. Clinical implications of the use of this tool and areas of future research are discussed.
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Hile S, Erickson SJ, Agee B, Annett RD. Parental stress predicts functional outcome in pediatric cancer survivors. Psychooncology 2014; 23:1157-64. [DOI: 10.1002/pon.3543] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 03/11/2014] [Accepted: 03/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah Hile
- University of New Mexico; Albuquerque NM USA
| | | | | | - Robert D. Annett
- University of New Mexico Health Sciences Center; Albuquerque NM USA
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Rozemberg L, Avanci J, Schenker M, Pires T. Resiliência, gênero e família na adolescência. CIENCIA & SAUDE COLETIVA 2014; 19:673-84. [DOI: 10.1590/1413-81232014193.21902013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 11/23/2013] [Indexed: 11/22/2022] Open
Abstract
Este estudo busca identificar fatores familiares que influenciam o potencial de resiliência de adolescentes meninos e meninas. É um estudo transversal com dados de um inquérito epidemiológico que contou com a participação de 889 adolescentes do 9º ano de escolas públicas e particulares de um município da região metropolitana do Rio de Janeiro, selecionados por amostragem. Variáveis sociodemográficas do adolescente, da família, dentre os quais a violência familiar, e outros fatores são estudados segundo o potencial de resiliência. Foram feitos testes de associação entre as variáveis estudadas e a resiliência, considerados ao nível de significância de 5%. Os resultados indicam que um relacionamento difícil com a mãe ou madrasta, a ausência de supervisão familiar, a presença de depressão, além da baixa utilização de estratégias de coping de distração, ativo e de suporte são fatores associados ao baixo potencial de resiliência. As variáveis morar amontoado e ter relacionamento difícil com os irmãos se mostram nocivas apenas ao poten cial de resiliência das meninas. Programas e políticas públicas necessitam trabalhar com as famílias para que compreendam as necessidades dos adolescentes como forma de prevenção dos problemas de saúde mental e promoção da saúde desta população segundo a ótica de gênero.
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Psychiatric Symptom Impairment in Children with Autism Spectrum Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 41:959-69. [PMID: 23605958 DOI: 10.1007/s10802-013-9739-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Cleverley K, Bennett K, Duku E. Effects of functional impairment on internalizing symptom trajectories in adolescence: A longitudinal, growth curve modelling study. J Adolesc 2013; 36:45-53. [DOI: 10.1016/j.adolescence.2012.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 08/31/2012] [Accepted: 09/05/2012] [Indexed: 11/25/2022]
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Chavez L, Mir K, Canino G. Starting from scratch: the development of the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS). Cult Med Psychiatry 2012; 36:465-79. [PMID: 22528055 PMCID: PMC3416915 DOI: 10.1007/s11013-012-9264-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This article documents the initial development of a Spanish mental health quality of life (QOL) instrument based on the adolescents' own assessment of important domains to their QOL. Using a grounded theory approach, we targeted five mental health disorders: attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, generalized anxiety disorder, and major depressive disorder. In-depth interviews (n = 40) and three focus groups (n = 20) were conducted and analyzed using qualitative methods to guide the development of items. A convenient sample of island Puerto Rican adolescents aged 12-18 was recruited from outpatient mental health clinics. Qualitative analysis revealed a total of 87 themes. They were distributed based on core QOL domains such as (1) Self, (2) Peers, (3) Family, (4) School, and (5) Environment. Items were written based on prevailing themes and using as closely as possible, words and phrases used by the adolescents to describe their views and perceptions of QOL. The goal for the AQOL-MHS is to pinpoint specific areas of health-related QOL for each psychiatric diagnostic group that will provide valuable information to assist both patients and providers set, define and evaluate adequate mental health treatment goals.
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Affiliation(s)
- Ligia Chavez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, 00936-5067, USA.
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Du YB, Lee CT, Christina D, Belfer ML, Betancourt TS, O'Rourke EJ, Palfrey JS. The living environment and children's fears following the Indonesian tsunami. DISASTERS 2012; 36:495-513. [PMID: 22098206 PMCID: PMC3991231 DOI: 10.1111/j.1467-7717.2011.01271.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The tsunami that struck South-east Asia on 26 December 2004 left more than 500,000 people in Aceh, Indonesia, homeless and displaced to temporary barracks and other communities. This study examines the associations between prolonged habitation in barracks and the nature of fears reported by school-age children and adolescents. In mid-2007, 30 months after the tsunami, the authors interviewed 155 child and parent dyads. Logistic regression analysis was used to compare the fears reported by children and adolescents living in barracks with those reported by their peers who were living in villages. After adjusting for demographic factors and tsunami exposure, the data reveals that children and adolescents living in barracks were three times more likely than those living in villages to report tsunami-related fears. The study demonstrates that continued residence in barracks 30 months after the tsunami is associated with higher rates of reporting tsunami-related fears, suggesting that barracks habitation has had a significant impact on the psychological experience of children and adolescents since the tsunami.
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Affiliation(s)
- Ye Beverly Du
- Columbia-New York Presbyterian Hospital, New York, United States.
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Rapee RM, Bőgels SM, van der Sluis CM, Craske MG, Ollendick T. Annual research review: conceptualising functional impairment in children and adolescents. J Child Psychol Psychiatry 2012; 53:454-68. [PMID: 22067073 DOI: 10.1111/j.1469-7610.2011.02479.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Functional impairment is a key factor in the clinical importance of mental health problems in children. Yet, the nature of impairment and criteria for defining and assessing impairment in childhood disorders has been surprisingly overlooked in much of the literature. The current article examines the extant literature on the conceptualisation, nature and assessment of impairment in childhood disorders. Relations between diagnostic symptoms and functional impairment are discussed together with the influence of impairment on diagnostic decisions and prevalence rates. Several factors influencing impairment in childhood such as culture, development and gender are considered. This article concludes with a discussion of the utility of separating judgements of impairment from specific diagnoses, which is proposed for consideration in the forthcoming DSM-5.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia University of Amsterdam, The Netherlands
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Nauta MH, Festen H, Reichart CG, Nolen WA, Stant AD, Bockting CLH, van der Wee NJA, Beekman A, Doreleijers TAH, Hartman CA, de Jong PJ, de Vries SO. Preventing mood and anxiety disorders in youth: a multi-centre RCT in the high risk offspring of depressed and anxious patients. BMC Psychiatry 2012; 12:31. [PMID: 22510426 PMCID: PMC3403886 DOI: 10.1186/1471-244x-12-31] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 04/17/2012] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Anxiety and mood disorders are highly prevalent and pose a huge burden on patients. Their offspring is at increased risk of developing these disorders as well, indicating a clear need for prevention of psychopathology in this group. Given high comorbidity and non-specificity of intergenerational transmission of disorders, prevention programs should target both anxiety and depression. Further, while the indication for preventive interventions is often elevated symptoms, offspring with other high risk profiles may also benefit from resilience-based prevention programs. METHOD/DESIGN The current STERK-study (Screening and Training: Enhancing Resilience in Kids) is a randomized controlled clinical trial combining selected and indicated prevention: it is targeted at both high risk individuals without symptoms and at those with subsyndromal symptoms. Individuals without symptoms meet two of three criteria of the High Risk Index (HRI; female gender, both parents affected, history of a parental suicide (attempt). This index was developed in an earlier study and corresponds with elevated risk in offspring of depressed patients. Children aged 8-17 years (n = 204) with subthreshold symptoms or meeting the criteria on the HRI are randomised to one of two treatment conditions, namely (a) 10 weekly individual child CBT sessions and 2 parent sessions or (b) minimal information. Assessments are held at pre-test, post-test and at 12 and 24 months follow-up. Primary outcome is the time to onset of a mood or anxiety disorder in the offspring. Secondary outcome measures include number of days with depression or anxiety, child and parent symptom levels, quality of life, and cost-effectiveness. Based on models of aetiology of mood and anxiety disorders as well as mechanisms of change during interventions, we selected potential mediators and moderators of treatment outcome, namely coping, parent-child interaction, self-associations, optimism/pessimism, temperament, and emotion processing. DISCUSSION The current intervention trial aims to significantly reduce the risk of intergenerational transmission of mood and anxiety disorders with a short and well targeted intervention that is directed at strengthening the resilience in potentially vulnerable children. We plan to evaluate the effectiveness and cost-effectiveness of such an intervention and to identify mechanisms of change. TRIAL REGISTRATION NTR2888.
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Affiliation(s)
- Maaike H Nauta
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Helma Festen
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Catrien G Reichart
- Curium/Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK, Oegstgeest, The Netherlands
| | - Willem A Nolen
- Department of Psychiatry/Interdisciplinary Center of Pathology of Emotion, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - A Dennis Stant
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Claudi LH Bockting
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Nic JA van der Wee
- Department of Psychiatry and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Albinusfreef 2, 2333 ZA, Leiden, The Netherlands
| | - Aartjan Beekman
- Department of Psychiatry and EMGO institute, VU University Medical Center/GGZ inGeest, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands
| | - Theo AH Doreleijers
- de Bascule/Academic Medical Center Amsterdam, p/a Postbus 303, 1115 ZG, Duivendrecht, the Netherlands
| | - Catharina A Hartman
- Department of Psychiatry/Interdisciplinary Center of Pathology of Emotion, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Sybolt O de Vries
- Department of Psychiatry/Interdisciplinary Center of Pathology of Emotion, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
- Mental Health Care Friesland (GGz Friesland), Borniastraat 34B, 8934 AD, Leeuwarden, The Netherlands
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Ezpeleta L, de la Osa N, Granero R, Domènech JM, Reich W. The Diagnostic Interview of Children and Adolescents for Parents of Preschool and Young Children: psychometric properties in the general population. Psychiatry Res 2011; 190:137-44. [PMID: 21620481 DOI: 10.1016/j.psychres.2011.04.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 04/20/2011] [Accepted: 04/27/2011] [Indexed: 11/25/2022]
Abstract
There is a need for reliable and well-validated diagnostic measures for studying psychopathology in preschool and young children. The goal is to study the psychometric properties of the Diagnostic Interview for Children and Adolescents for Parents of Preschool and Young Children (DICA-PPYC) in the general population. A sample of 852 Spanish school children, aged 3 to 7 years, were randomly selected and screened for a double phase design. A total of 251 families were interviewed with the DICA-PPYC and 244 participated in a test-retest design. Different measures of psychopathology and functional impairment were also administered. Test-retest agreement with a mean interval of 8.8 days ranged from excellent to slight (kappa from 1 to 0.39) for DSM-IV-TR and from good to fair (kappa from 0.77 to 0.49) for Research Diagnostic Criteria-Preschool Age diagnoses. Attenuation between test and retest was not significant for the prevalence of diagnoses, although it was significant for the number of externalising and total symptoms in the interview. The diagnoses converged moderately with the CBCL and Dominic scores. The presence of diagnoses in the DICA-PPYC significantly differentiated preschoolers and young children who had used mental health services, were more impaired, and presented more severe psychopathology measured by dimensional scales. The DICA-PPYC is a reliable and valid semi-structured interview schedule for preschool and young children, and can serve to advance the knowledge and mental health care of this population.
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Affiliation(s)
- Lourdes Ezpeleta
- Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament. Departament de Psicologia Clínica i de la Salut. Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain.
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Ashrafioun L, Dambra CM, Blondell RD. Parental Prescription Opioid Abuse and the Impact on Children. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011; 37:532-6. [DOI: 10.3109/00952990.2011.600387] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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School-Based Mental Health Programs for Students Who Have Emotional Disturbances: Academic and Social-Emotional Outcomes. SCHOOL MENTAL HEALTH 2011. [DOI: 10.1007/s12310-011-9062-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Park JH, Lee SI, Schachar RJ. Reliability and validity of the child and adolescent functioning impairment scale in children with attention-deficit/hyperactivity disorder. Psychiatry Investig 2011; 8:113-22. [PMID: 21852987 PMCID: PMC3149105 DOI: 10.4306/pi.2011.8.2.113] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/17/2010] [Accepted: 12/18/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of the present study was to develop reliable and valid parent and teacher scales for measurement of functional impairment in children and adolescents in order to assist the diagnosis of attention-deficit/hyperactivity disorder (ADHD). METHODS Seventy-two children with ADHD fulfilling the Diagnostic and Statistical Manual of Mental Disorder, 4th Edition criteria and forty-two normal controls were enrolled in this study. Parents and teachers of the subjects completed the parent and teacher form of the preliminary items of Child and Adolescent Functioning Impairment Scale (CAFIS) made up by the authors. Based on the reliability and factor analysis, the final parent (CAFIS-parent form) and teacher version (CAFIS-teacher form) were constructed. Scales were analyzed for reliability and validity. Relative operating characteristics curve was drawn to calculate the cutoff scores of these scales for children with ADHD. RESULTS The CAFIS-parent and CAFIS-teacher forms consist of four and three factors, respectively. Internal consistency and test-retest correlation of the scales were satisfactory. The CAFIS and Children's Global Assessment Scale were significantly correlated. All scores of subscales of CAFIS in ADHD group were significantly higher than those of control group. The sensitivity and specificity of the subscales were mostly at an appropriate level. CONCLUSION The CAFIS is a brief layperson-administered scale to assess functional impairment of children and adolescents. It can be a useful tool for parents and teachers to objectively measure the functions of children at home and in school. This scale was found to be reliable and valid, and it appears to be a valuable instrument in Korean language.
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Affiliation(s)
- Joon-Ho Park
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea
| | - Russell J Schachar
- Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada
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Supporting Parents Who Have Youth with Emotional Disturbances Through a Parent-to-Parent Support Program: A Proof of Concept Study Using Random Assignment. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2010; 38:412-27. [DOI: 10.1007/s10488-010-0329-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Byoun SY, Lee SY, Lee YH. Functional Impairment across Subtypes of Attention-Deficit Hyperactivity Disorder. Soa Chongsonyon Chongsin Uihak 2010. [DOI: 10.5765/jkacap.2010.21.2.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Duarte CS, Bordin IAS, Green GR, Hoven CW. Measuring child exposure to violence and mental health reactions in epidemiological studies: challenges and current issues. CIENCIA & SAUDE COLETIVA 2009; 14:487-96. [DOI: 10.1590/s1413-81232009000200017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Indexed: 11/22/2022] Open
Abstract
This paper examines challenges and current issues involved in measuring exposure to different types of violence which are associated mental health problems in children and adolescents. Standardized measures suitable for epidemiological studies, selected based on their relevance in the current literature, are briefly described and commented. The assessment of child's exposure to violence may focus on a specific event (e.g., kidnapping), a specific context (e.g., war) or even of a certain type of exposure (e.g., intrafamilial physical violence). The assessment of child mental health after exposure to violence has traditionally focused on posttraumatic stress disorder (PTSD) - most frequently measured through non-diagnostic scales. However, other mental health reactions may be present and screening as well as diagnostic instruments which may be used to assess these reactions are also described. Two issues of emerging importance - the assessment of impairment and of traumatic grief in children - are also presented. Availability of culturally appropriate instruments is a crucial step towards proper identification of child mental health problems after exposure to violence.
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Wille N, Bettge S, Wittchen HU, Ravens-Sieberer U. How impaired are children and adolescents by mental health problems? Results of the BELLA study. Eur Child Adolesc Psychiatry 2008; 17 Suppl 1:42-51. [PMID: 19132303 PMCID: PMC2757610 DOI: 10.1007/s00787-008-1005-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The consideration of impairment plays a crucial role in detecting significant mental health problems in children whose symptoms do not meet diagnostic criteria. The assessment of impairment may be particularly relevant when only short screening instruments are applied in epidemiological surveys. Furthermore, differences between childrens' and parents' perceptions of present impairment and impairing symptoms are of interest with respect to treatment-seeking behaviour. OBJECTIVES The objectives were to assess parent- and self-reported impairment due to mental health problems in a representative sample of children and adolescents; to describe the characteristics of highly impaired children with normal symptom scores; and to investigate the associations between symptoms in different problem areas and impairment. METHODS The mental health module of the German Health Interview and Examination Survey for Children and Adolescents (the BELLA study) examined mental health in a representative sub-sample of 2,863 families with children aged 7-17. Self-reported and parent-reported symptoms of mental health problems and associated impairment were identified by the extended version of the strengths and difficulties questionnaire (SDQ) in children 11 years and older. RESULTS Considerable levels of distress and functional impairment were found with 14.1% of the boys and 9.9% of the girls being severely impaired according to the parental reports. However, self-reported data shows a reversed gender-difference as well as lower levels of severe impairment (6.1% in boys; 10.0% in girls). Six percent of the sampled children suffer from pronounced impairment due to mental health problems but were not detected by screening for overall symptoms. Childrens' and parents' reports differed in regard to the association between reported symptom scores and associated impairment with children reporting higher impairment due to emotional problems. CONCLUSIONS The assessment of impairment caused by mental health problems provides important information beyond the knowledge of symptoms and helps to identify an otherwise undetected high risk group. In the assessment of impairment, gender-specific issues have to be taken into account. Regarding the systematic differences between childrens' and parents' reports in the assessment of impairment, the child's perspective should be given special attention.
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Affiliation(s)
- Nora Wille
- Department of Psychosomatics in Children and Adolescents, Centre for Obstetrics and Paediatrics, University Clinic Hamburg-Eppendorf, Martinistrasse 52, W29, 20246, Hamburg, Germany.
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Bauermeister JJ, Shrout PE, Ramírez R, Bravo M, Alegría M, Martínez-Taboas A, Chávez L, Rubio-Stipec M, García P, Ribera JC, Canino G. ADHD correlates, comorbidity, and impairment in community and treated samples of children and adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2007; 35:883-98. [PMID: 17505876 PMCID: PMC3591788 DOI: 10.1007/s10802-007-9141-4] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patterns of correlates, comorbidity and impairment associated with attention-deficit hyperactivity disorder (ADHD) in children and youth were examined in representative samples from the community and from treatment facilities serving medically indigent youth in Puerto Rico. Information from caretakers and youths was obtained using the Diagnostic Interview Schedule for Children, (version IV), measures of global impairment, and a battery of potential correlates. In the community (N = 1,896) and the treated samples (N = 763), 7.5 and 26.2% of the children, respectively, met criteria for DSM-IV ADHD in the previous year. Although the prevalence rates and degree of impairment differed, the general patterns of correlates, comorbidity and impairment were similar in both populations. The exceptions were associated with conduct disorder, anxiety, impairment in the ADHD comorbid group, and age factors that appeared to be related to selection into treatment.
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Affiliation(s)
- José J Bauermeister
- Behavioral Sciences Research Institute (BSRI), University of Puerto Rico (UPR), San Juan, Puerto Rico.
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Are Children with Anxiety Disorders Privately Referred to a University Clinic Like Those Referred from the Public Mental Health System? ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2007; 35:168-80. [DOI: 10.1007/s10488-007-0154-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 11/07/2007] [Indexed: 10/22/2022]
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Bauermeister JJ, Shrout PE, Chávez L, Rubio-Stipec M, Ramírez R, Padilla L, Anderson A, García P, Canino G. ADHD and gender: are risks and sequela of ADHD the same for boys and girls? J Child Psychol Psychiatry 2007; 48:831-9. [PMID: 17683455 DOI: 10.1111/j.1469-7610.2007.01750.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research comparing treatment-referred boys and girls with attention-deficit/hyperactivity disorder (ADHD) has yielded equivocal results. Contradictory findings may be associated with differential referral practices or unexplored interactions of gender with ADHD subtypes. METHOD We examined possible gender differences in ADHD and its subtypes among children aged 4 to 17 in a representative community sample (N = 1896) in Puerto Rico. Caretakers provided information through the Diagnostic Interview Schedule for Children (version IV) and a battery of impairment, family relations, child problems, comorbidity and treatment measures. RESULTS ADHD was 2.3 times more common in boys than girls, but with one exception there was little evidence that the patterns of associations of ADHD with correlates were different for boys and girls. The exception was school suspension, which was more common among ADHD boys than girls. Additional gender interactions were found when ADHD subtypes were considered. Among those with combined type (n = 50), boys were more likely to be comorbid with mood disorders than girls. For those with the inattentive type (n = 47), girls were more likely to be comorbid with anxiety disorders than boys. CONCLUSIONS Our findings lend cross-cultural generalizability to recent reports that gender does not interact with correlates for ADHD overall, but that it may play a role in subtypes.
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Affiliation(s)
- José J Bauermeister
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
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Ortega AN, Chavez L, Inkelas M, Canino G. Persistence of mental health service use among Latino children: a clinical and community study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2007; 34:353-62. [PMID: 17295060 DOI: 10.1007/s10488-007-0114-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Accepted: 01/04/2007] [Indexed: 11/28/2022]
Abstract
This study examined predictors of treatment persistence (receiving mental health services at two time points one year apart) among children in Puerto Rico who had previously sought care for mental health concerns. Children and their primary caregivers completed interviews one year apart. Treatment persistence was lower among children recruited from community sampling (n = 137) than those children recruited from public and private clinics (N = 381). Persistence was associated with psychological measures of need and co-morbidity only in the clinical sample, while in both samples persistence was associated with measures of family burden and school functioning. In multivariate analyses, persistence was associated in both the clinical and community samples with a measure of school functioning but not with diagnosis, impairment, or parental concerns about the child's behavior.
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Affiliation(s)
- Alexander N Ortega
- Department of Health Services and Center for Healthier Children, Families & Communities, School of Public Health, University of California, Los Angeles, CA 90095-1772, USA.
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Lewandowski L, Lovett BJ, Gordon M, Antshel K. The Case for Clinical Impairment in the DSM–V Criteria for ADHD. ACTA ACUST UNITED AC 2006. [DOI: 10.1521/adhd.2006.14.6.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cabiya JJ, Canino G, Chavez L, Ramirez R, Alegría M, Shrout P, Hohman A, Bravo M, Bauermeister JJ, Maritínez-Taboas A. Gender disparities in mental health service use of Puerto Rican children and adolescents. J Child Psychol Psychiatry 2006; 47:840-8. [PMID: 16898998 DOI: 10.1111/j.1469-7610.2006.01623.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Differences in service utilization indicating that boys use more mental health services than girls were analyzed to see if they could be explained by known correlates of service use. These correlates were arranged into individual (severe emotional disturbance, level of impairment and externalizing disorders), family (parental education, psychopathology and parental concern) and school factors (difficulties with school work). The objectives were to understand and identify the factors accounting for gender differences in mental health service utilization in order to develop alternatives to promote equity in service delivery. METHODS A representative sample of 1,896 children 4 to 17 years of age and their primary caretakers were interviewed for this study. Reports of service use were obtained using the Service Assessment for Children and Adolescents. Logistic regression was used to assess the relationship between gender and service use, adjusting for known correlates. RESULTS Our results showed that, except for impairment, other individual, family and school factors did not explain gender differences in service utilization. Males with impairment were 2.87 times more likely to receive services than impaired females (p <or= .01), and this result continued to hold true for impaired undiagnosed boys compared to impaired diagnoses-free girls (p <or= .001). CONCLUSIONS Our findings showed a service disparity between impaired boys and girls who did not meet criteria for a DSM IV diagnosis, but no observed differences in service use between boys and girls who met criteria for severe emotional disturbance (SED). Continued investigations are necessary to analyze, assess and understand the different circumstances that bring boys and girls into treatment, followed by the development of appropriate intervention programs at the school and community levels.
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