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Olofsdotter S, Fernández-Quintana Á, Sonnby K, Vadlin S. Clinical utility of new cut-off scores for the world health organization ADHD self-report scale among adolescents in psychiatric outpatient care. Int J Clin Health Psychol 2023; 23:100391. [PMID: 37273276 PMCID: PMC10238844 DOI: 10.1016/j.ijchp.2023.100391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
Previous analyses of the proposed cut-off score for the 18-item World Health Organization ADHD Self-Report Scale (ASRS-18) among psychiatrically referred adolescents have shown limited clinical utility. This prospective study examined the diagnostic accuracy and clinical utility of new cut-off scores of the ASRS-18 in a consecutive sample of 111 Swedish adolescent psychiatric outpatients. Using the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS) as the reference standard and based on predefined sensitivity and specificity criteria, multiple new general and sex-specific cut-off scores were evaluated. Results showed that clinical utility was greater for sex-specific cut-off scores than for general cut-off scores. The greatest change in pre-test to post-test probability of ADHD diagnosis was observed with a balanced, high-specificity diagnostic cut-off score for girls, where the probability of ADHD increased from 40% pre-test to 82% post-test. The proposed new cut-off levels for the ASRS-18 are useful for the detection and identification of ADHD among adolescents in general psychiatric outpatient settings.
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Affiliation(s)
- Susanne Olofsdotter
- Center for Clinical Research, Uppsala University, Västmanland County Hospital Västerås, Västerås, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Águeda Fernández-Quintana
- Center for Clinical Research, Uppsala University, Västmanland County Hospital Västerås, Västerås, Sweden
| | - Karin Sonnby
- Center for Clinical Research, Uppsala University, Västmanland County Hospital Västerås, Västerås, Sweden
- Center for Clinical Research and Education, Central Hospital, County of Värmland, Karlstad, Sweden
| | - Sofia Vadlin
- Center for Clinical Research, Uppsala University, Västmanland County Hospital Västerås, Västerås, Sweden
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Rejbrand C, Fure B, Sonnby K. Stand-alone virtual reality exposure therapy as a treatment for social anxiety symptoms: a systematic review and meta-analysis. Ups J Med Sci 2023; 128:9289. [PMID: 37807998 PMCID: PMC10552696 DOI: 10.48101/ujms.v128.9289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 08/09/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Social anxiety is common and can have far-reaching implications for affected individuals, both on social life and working performance. Usage of virtual reality exposure therapy (VRET) has gained traction. The aim of the present systematic review was to evaluate the effect of stand-alone VRET on social anxiety symptoms. Method We searched systematically in PubMed, Embase, PSYCinfo, and ERIC in May 2022 for studies with participants with social anxiety symptoms receiving stand-alone VRET. Two reviewers independently selected relevant studies in a two-step procedure, and the risk of bias was assessed. Results Of 158 hits, 7 studies were selected for full-text reading, 6 were chosen for evaluation, and 5 were included in meta-analyses. VRET resulted in a significantly lower anxiety score in treated individuals with a standard mean difference of -0.82, 95% confidence interval -1.52 to -0.13, compared to controls. Conclusion Stand-alone VRET may reduce social anxiety symptoms. However, despite promising results, there is still uncertainty as the effect estimate is based on few studies with few participants each and a high risk of bias.
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Affiliation(s)
- Christian Rejbrand
- Faculty of Medicine and Health, School of Medical Sciences, Campus USÖ, Örebro, Sweden
| | - Brynjar Fure
- Faculty of Medicine and Health, School of Medical Sciences, Campus USÖ, Örebro, Sweden
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden
| | - Karin Sonnby
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden
- Centre for Clinical Research, Region Västmanland, Västerås, Sweden
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Sonnby K, Skordas K, Vadlin S, Olofsdotter S, Nilsson KW, Ramklint M. Psychometric validation of two versions of the adolescent Depression Self-Rating Scale (DSRS-A and DSRS-A Screener). Nord J Psychiatry 2022; 76:233-242. [PMID: 34375172 DOI: 10.1080/08039488.2021.1956583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM Examination of psychometric properties and diagnostic accuracy of the Depression Self-Rating Scale for Adolescents (DSRS-A) as well as development and evaluations of a shorter version, DSRS-A-Screener. METHODS Analyses of component structure and internal consistency were performed in a community-based sample of adolescents N = 4,506 and among consecutive outpatients from three child psychiatric settings in Sweden (n = 137). Concurrent validity was measured as a correlation between a summation index of the scale items and the total major depressive disorder (MDD) symptom severity score from the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS). Diagnostic accuracy was examined in the clinical sample, with the K-SADS interview as the reference test, by receiver operating characteristic analysis (ROC), calculations of sensitivity, specificity among other measures. With the purpose to select items for a shorter scale, associations between scale items and MDD were examined with binary logistic regression. This shorter scale was thereafter examined similarly. RESULTS Based on association with MDD, five items were selected for the brief DSRS-A Screener that showed one component structure, internal consistency Cronbach's alpha .80 and.82, respectively. In the clinical population concurrent validity was Spearman's rho .63 and ROC analysis showed AUC .84 (95% CI .78-.91; p < .001). The optimal cut-off for screening was 2 with sensitivity .85 and specificity of .64. CONCLUSION The DSRS-A Screener compared to the original scale, maintained or improved reliability, validity, and showed moderate diagnostic accuracy.
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Affiliation(s)
- Karin Sonnby
- Center for Clinical Research, Västmanlands County Hospital, Uppsala University, Västerås, Sweden
| | - Konstantinos Skordas
- Department of Neuroscience, Akademiska Sjukhuset, Uppsala University, Uppsala, Sweden
| | - Sofia Vadlin
- Center for Clinical Research, Västmanlands County Hospital, Uppsala University, Västerås, Sweden
| | - Susanne Olofsdotter
- Center for Clinical Research, Västmanlands County Hospital, Uppsala University, Västerås, Sweden
| | - Kent W Nilsson
- Center for Clinical Research, Västmanlands County Hospital, Uppsala University, Västerås, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Akademiska Sjukhuset, Uppsala University, Uppsala, Sweden
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Soler CT, Vadlin S, Olofsdotter S, Ramklint M, Sonnby K, Nilsson K. Psychometric evaluation of the Swedish Child Sheehan Disability Scale in adolescent psychiatric patients. Scand J Child Adolesc Psychiatr Psychol 2021; 9:137-146. [PMID: 34239817 PMCID: PMC8254144 DOI: 10.21307/sjcapp-2021-015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/22/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Assessment of disability is part of the psychiatric diagnostic process, and validated scales are needed for the assessment of functioning. The Swedish translations of the Child Sheehan Disability Scale (CSDS) for adolescents and parents (CSDS-P) have been adapted for use in psychiatric settings. Objective: The purpose of the study was to explore the psychometric properties of the Swedish CSDS and the CSDS-P among adolescent psychiatric patients. Method: Patients (n = 107) were assessed with the CSDS, the Strengths and Difficulties Questionnaire (SDQ adolescent), and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) diagnostic interview. Their parents participated in the interview and completed the CSDS-P and SDQ parent. Results: Internal consistency was α =.813 for the CSDS (three items) and α =.842 for the CSDS-P (five items). For both scales, principal component analyses showed one component. The correlations between the total scores of the CSDS and CSDS-P in relation to a general K-SADS-PL symptom summation index were rs = .332, p < .001 and rs = .237, p = .014, respectively. Correlations with the total K-SADS function summation index were rs < .300 for both. The correlation between the CSDS and the total difficulties score on the SDQ was rs = .433, p < .001. Conclusions: The Swedish translations of the CSDS and CSDS-P had similar psychometric properties to Whiteside’s CSDS and the Adult Sheehan Disability Scale. Concurrent validity and correlation between the CSDS and CSDS-P were weak.
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Affiliation(s)
- Catalina Tores Soler
- Center for Clinical Research, Uppsala University, Västmanlands County Hospital, Uppsala, Sweden
| | - Sofia Vadlin
- Center for Clinical Research, Uppsala University, Västmanlands County Hospital, Uppsala, Sweden
| | - Susanne Olofsdotter
- Center for Clinical Research, Uppsala University, Västmanlands County Hospital, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden
| | - Karin Sonnby
- Center for Clinical Research, Uppsala University, Västmanlands County Hospital, Uppsala, Sweden
| | - Kent Nilsson
- Center for Clinical Research, Uppsala University, Västmanlands County Hospital, Uppsala, Sweden
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Ntini I, Vadlin S, Olofsdotter S, Ramklint M, Nilsson KW, Engström I, Sonnby K. The Montgomery and Åsberg Depression Rating Scale - self-assessment for use in adolescents: an evaluation of psychometric and diagnostic accuracy. Nord J Psychiatry 2020; 74:415-422. [PMID: 32125211 DOI: 10.1080/08039488.2020.1733077] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: The Montgomery-Åsberg Depression Rating Scale - Self Assessment (MADRS-S) is used to assess symptom severity in major depressive disorder (MDD) among adolescents, but its psychometric properties and diagnostic accuracy are unclear.Aim: The aim of this study was to explore psychometric properties, including diagnostic accuracy, of the MADRS-S in adolescent psychiatric outpatients.Method: Adolescent psychiatric outpatients (N = 105, mean age 16 years, 46 boys) completed the MADRS-S and were interviewed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS).Results: In principal component analysis, two components with eigenvalues of 4.6 and 1.3 explained 51.1% and 14.4% of the variance, respectively. On the first component loaded items assessing Mood, Feelings of unease, Appetite, Initiative, Pessimism, and Zest for life. On the second component loaded items assessing Sleep, Ability to concentrate, and Emotional involvement. Cronbach's alpha (internal consistency) for all items was 0.87. Spearman's rho was 0.68 for concurrent validity (correlation between total MADRS-S-score and K-SADS MDD severity score). In receiver-operating characteristic analysis, the area under the curve was 0.86 (95% confidence interval 0.78-0.93, p < .001). For all the participants, the highest combined sensitivity and specificity were reached using cut-offs of 15 and 16 (sensitivity 0.82, specificity 0.86). Optimizing sensitivity for MDD, with specificity still ≥0.5, cut off for all was 9, for boys 7 and for girls 10.Conclusion: Psychometric properties of MADRS-S showed good reliability and validity as well as satisfying diagnostic accuracy, indicating good to excellent properties for MDD screening of adolescent psychiatric patients.
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Affiliation(s)
- I Ntini
- University Health Care Research Center, Faculty of Medicine and Health, Universitetssjukvårdens forskningscentrum (UFC), Örebro University, Örebro, Sweden
| | - S Vadlin
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
| | - S Olofsdotter
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
| | - M Ramklint
- Psychiatry - Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - K W Nilsson
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
| | - I Engström
- University Health Care Research Center, Faculty of Medicine and Health, Universitetssjukvårdens forskningscentrum (UFC), Örebro University, Örebro, Sweden
| | - K Sonnby
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
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Torres Soler C, Olofsdotter S, Vadlin S, Ramklint M, Nilsson KW, Sonnby K. Diagnostic accuracy of the Montgomery-Åsberg Depression Rating Scale parent report among adolescent psychiatric outpatients. Nord J Psychiatry 2018; 72:184-190. [PMID: 29258381 DOI: 10.1080/08039488.2017.1414873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The diagnostic accuracy of the parent report of the Montgomery-Åsberg Depression Rating Scale (MADRS-P) for the screening of major depressive disorder (MDD) in adolescents has not been evaluated. AIM The aim was to explore the psychometric properties and diagnostic accuracy of the MADRS-P in general child and adolescent psychiatric outpatient services in Sweden. METHOD The study was a validation and a diagnostic accuracy study. Consecutive adolescent psychiatric patients (n = 101, 45 males, mean age 15 years) were assessed with a diagnostic interview, the Kiddie Schedule of Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL), as a reference test. Thereafter, their parents reported on the MADRS-P. Both categorical MDD diagnoses and dimensional MDD symptom severity scores were obtained from the K-SADS-PL. RESULTS The internal consistency of the MADRS-P, measured with Cronbach's alpha, was 0.846. The concurrent validity, assessed by Spearman's rho as a correlation between the K-SADS MDD symptom severity score and the MADRS-P score, was 0.580. The area under the curve in a receiver operating characteristic analysis for all participants was 0.786 (95% confidence interval 0.694-0.877, p < .001). At a cut-off of 10, sensitivity was 0.86, specificity 0.54, positive predictive value 0.59 and negative predictive value 0.84. CONCLUSIONS The parent-rated MADRS-P showed similar psychometric properties as previously shown for the self-rated MADRS-S in adults. Although the MADRS-P has acceptable diagnostic accuracy for screening for MDD in adolescents in a general psychiatric setting, it cannot be used alone for diagnosing MDD.
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Affiliation(s)
- C Torres Soler
- a Center for Clinical Research , Västmanlands County Hospital, Uppsala University , Västerås , Sweden
| | - S Olofsdotter
- a Center for Clinical Research , Västmanlands County Hospital, Uppsala University , Västerås , Sweden
| | - S Vadlin
- a Center for Clinical Research , Västmanlands County Hospital, Uppsala University , Västerås , Sweden
| | - M Ramklint
- b Department of Neuroscience , Akademiska Sjukhuset, Uppsala University , Uppsala , Sweden
| | - K W Nilsson
- a Center for Clinical Research , Västmanlands County Hospital, Uppsala University , Västerås , Sweden
| | - K Sonnby
- a Center for Clinical Research , Västmanlands County Hospital, Uppsala University , Västerås , Sweden
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Kerstis B, Åslund C, Sonnby K. More secure attachment to the father and the mother is associated with fewer depressive symptoms in adolescents. Ups J Med Sci 2018; 123:62-67. [PMID: 29495912 PMCID: PMC5901470 DOI: 10.1080/03009734.2018.1439552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 11/01/2022] Open
Abstract
AIM To investigate whether more secure attachment to the father and the mother is associated with less depressive symptoms among adolescents, and to explore possible sex differences. METHOD A population-based sample of adolescents completed a school-based survey assessing demographic data, attachment to father and mother, as well as depressive symptoms. Participation rate was 80% of the eligible population, and 3,988 adolescents (1,937 boys and 2,051 girls) had complete data for the analyses. RESULTS Paired samples t tests showed that participants rated their attachment to mothers as slightly more secure than their attachment to fathers (t = 15.94, P < 0.001; boys: t = 5.23, P < 0.001; girls: t = 16.16, P < 0.001). In linear regression analyses there was an association between the outcome, number of depressive symptoms, and more secure attachment to the mother for boys (B = -0.532; 95% confidence interval [CI] -0.656, -0.407, P < 0.001) and for girls (B = -0.623; 95% CI -0.730, -0.516, P < 0.001). Analogous results were found for more secure attachment to the father for boys (B = -0.499; 95% CI -0.608, -0.391, P < 0.001) and for girls (B = -0.494; 95% CI -0.586, -0.401, P < 0.001). CONCLUSIONS Understanding the relationship between attachment to both father and mother and depressive symptoms in adolescent boys and girls is essential for further development of strategies for prevention and treatment of depression.
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Affiliation(s)
- Birgitta Kerstis
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Cecilia Åslund
- Centre for Clinical Research Västerås, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Karin Sonnby
- Centre for Clinical Research Västerås, Uppsala University, Västmanland County Hospital, Västerås, Sweden
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Olofsdotter S, Vadlin S, Sonnby K, Furmark T, Nilsson KW. Anxiety Disorders among Adolescents referred to General Psychiatry for Multiple Causes: Clinical Presentation, Prevalence, and Comorbidity. Scand J Child Adolesc Psychiatr Psychol 2016. [DOI: 10.21307/sjcapp-2016-010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Sjölander L, Vadlin S, Olofsdotter S, Sonnby K. Validation of the parent version of the World Health Organization Adult ADHD Self-Report Scale for adolescents. Nord J Psychiatry 2016; 70:255-61. [PMID: 26624978 DOI: 10.3109/08039488.2015.1085092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the validity of a parent version of the World Health Organization Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale for adolescents (ASRS-AP) and the 6-question screening version (ASRS-AP-S). METHODS Adolescent psychiatric outpatients (N = 112, mean age 15 years, 40% boys) and their parents were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), and the parents reported on the ASRS-AP/ASRS-AP-S. RESULTS Internal consistency (Cronbach's alpha) was 0.93 for ASRS-AP and 0.85 for ASRS-AP-S, 0.91 and 0.87 for the inattention subscale, and 0.91 and 0.72 for the hyperactivity subscale, respectively. The concurrent validity (Spearman's correlation coefficient) between the total K-SADS ADHD symptom severity score and the sum of the score on the ASRS-AP/ASRS-AP-S was 0.75 and 0.66, respectively. Diagnostic accuracy measures for the ASRS-AP and ASRS-AP-S were 78% and 80% sensitivity, 75% and 74% specificity, 73% and 71% positive predictive value (PPV), and 81% and 82% negative predictive value (NPV), respectively. CONCLUSIONS The ASRS-AP and ASRS-AP-S showed high internal consistency and concurrent validity in relation to total K-SADS ADHD symptom severity score. Both scales showed favourable diagnostic accuracy measures.
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Affiliation(s)
- Linda Sjölander
- a Centre for Clinical Research, Uppsala University, Västmanlands County Hospital , Västerås , Sweden
| | - Sofia Vadlin
- a Centre for Clinical Research, Uppsala University, Västmanlands County Hospital , Västerås , Sweden
| | - Susanne Olofsdotter
- a Centre for Clinical Research, Uppsala University, Västmanlands County Hospital , Västerås , Sweden
| | - Karin Sonnby
- a Centre for Clinical Research, Uppsala University, Västmanlands County Hospital , Västerås , Sweden
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Olofsdotter S, Sonnby K, Vadlin S, Furmark T, Nilsson KW. Assessing Adolescent Anxiety in General Psychiatric Care: Diagnostic Accuracy of the Swedish Self-Report and Parent Versions of the Spence Children's Anxiety Scale. Assessment 2015; 23:744-757. [PMID: 25934162 DOI: 10.1177/1073191115583858] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study examined the psychometric properties and diagnostic accuracy of the Swedish translations of the Spence Children's Anxiety Scale, self- and parent report versions, in a sample of 104 adolescents presenting at two general psychiatric outpatient units. Results showed high informant agreement and good internal reliability and concurrent and discriminant validity for both versions and demonstrated that this scale can distinguish between adolescents with and without an anxiety disorder in a non-anxiety-specific clinical setting. The relative clinical utility of different cutoff scores was compared by looking at the extent to which dichotomized questionnaire results altered the pretest probability of the presence of a diagnosis as defined by the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Optimized for screening and diagnostic purposes in Sweden, cutoff scores obtained in the current study outperformed a previously identified cutoff score derived from an Australian community sample. The Spence Children's Anxiety Scale is a useful clinical instrument for the assessment of anxiety in adolescents.
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Affiliation(s)
| | - Karin Sonnby
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
| | - Sofia Vadlin
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kent W Nilsson
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
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Sonnby K, Skordas K, Olofsdotter S, Vadlin S, Nilsson KW, Ramklint M. Validation of the World Health Organization Adult ADHD Self-Report Scale for adolescents. Nord J Psychiatry 2015; 69:216-23. [PMID: 25348323 DOI: 10.3109/08039488.2014.968203] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The World Health Organization Adult ADHD Self Report Scale (ASRS) is a widely used diagnostic tool for assessment of attention-deficit hyperactivity disorder (ADHD) symptoms in clinical psychiatry in Sweden. The ASRS consists of 18 questions, the first six of which can be used as a short screening version (ASRS-S). There is a version for adolescents-ASRS-Adolescent (ASRS-A)-and the corresponding screening version (ASRS-A-S), which has not been validated to date. AIM The aim was to validate the ASRS-A and the ASRS-A-S for use in adolescent clinical populations. METHODS Adolescent psychiatric outpatients (n = 134, mean age 15 years, 40% boys) reported on the ASRS-A, and were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), a semi-structured interview, together with a parent. RESULTS Internal consistency was 0.79 for the ASRS-A-S and 0.92 for the ASRS-A (Cronbach's alpha). Internal consistency values were 0.79 and 0.87 for the inattention subscale, and 0.68 and 0.89 for the hyperactivity subscale, respectively. Concurrent validity values, measured with Spearman's correlation coefficient, between the total K-SADS ADHD symptom severity score and the sum of ASRS-A-S and ASRS-A total scores were 0.51 and 0.60, respectively. Psychometric properties of the ASRS-A-S and the ASRS-A were: sensitivity 74% and 79%; negative predictive value 81% and 84%; specificity 59% and 60%; and positive predictive value 49% and 51%, respectively. Both versions showed better properties for girls than for boys. CONCLUSION Both the ASRS-A-S and the ASRS-A showed promising psychometric properties for use in adolescent clinical populations.
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Affiliation(s)
- Karin Sonnby
- Karin Sonnby, M.D., Ph.D., Centre for Clinical Research, Uppsala University, Västmanlands County Hospital , SE 721 89 Västerås , Sweden
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Sonnby K, Åslund C, Leppert J, Nilsson KW. Symptoms of ADHD and depression in a large adolescent population: co-occurring symptoms and associations to experiences of sexual abuse. Nord J Psychiatry 2011; 65:315-22. [PMID: 21189056 DOI: 10.3109/08039488.2010.545894] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Symptoms of either attention-deficit hyperactivity disorder (ADHD) or depression constitute the most common reasons for contact with child and adolescent psychiatry. The development of psychiatric symptoms can be explained by a combination of environmental stress events and genetic vulnerability. One common form of environmental stress with high impact on health is sexual abuse. AIMS To investigate the prevalence and co-occurrence of symptoms of ADHD and depression in relation to experiences of sexual abuse in a large adolescent general population. METHOD All 15- and 18-year-old students (n = 4910) in the Swedish county of Vestmanland answered a school-based screening instrument including the six-question ADHD self-rating scale (ASRS), the Depression Self-Rating Scale (DSRS) and questions relating to experiences of sexual abuse. RESULTS The prevalence of co-occurring symptoms of ADHD and depression was 2.4% (boys 1.0%, girls 3.9%). The prevalence of experience of any sexual abuse was 20.9% (boys 13.3%, girls 28.7%). Of those with co-occurring symptoms, 48% of the boys and 47% of the girls reported a history of sexual abuse. CONCLUSIONS School-based screening for co-occurring symptoms of ADHD and depression might be a method that identifies students at psychiatric and psychosocial risk.
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Affiliation(s)
- Karin Sonnby
- Centre for Clinical Research, Uppsala University, Central Hospital, 721 89 Västerås, and The Child and Adolescent Psychiatry Unit, Central Hospital, 721 89 Västerås, Sweden.
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