Harmonized Phenotypes for Anxiety,Depression, and Attention-Deficit Hyperactivity Disorder (ADHD)

In multi-cohort consortia, the problem often arises that a phenotype is measured using different questionnaires. This study aimed to harmonize scores based on the Child Behaviour Check List (CBCL) and the Strength and Difficulties Questionnaire (SDQ) for anxiety/depression and ADHD. To link the scales, we used parent reports on 1330 children aged 10–11.5 years from the Raine study on both SDQ and CBCL. Harmonization was done based on Item Response Theory. We started from existing CBCL and SDQ scales related to anxiety/depression and ADHD (theoretical approach). Next, we conducted a data-driven approach using factor analysis to validate the theoretical approach. Both approaches yielded similar scales, validating the combination of existing scales. In addition, we studied the impact of harmonized (IRT-based) scores on the statistical power of the results in meta-analytic gene-finding studies. The results showed that the IRT-based harmonized scores increased the statistical power of the results compared to sum scores, even with an equal sample size. These findings can help future researchers to harmonize data from different samples and/or different questionnaires that measure anxiety, depression, and ADHD, in order to obtain the larger sample sizes, to compare research results across subpopulations or to increase generalizability, the validity or statistical power of research results. We recommend using our item parameters to estimate harmonized scores that represent commensurate phenotypes across cohorts, and we explained in detail how other researchers can use our results to harmonize data in their studies.

     

The internal consistency and concurrent validity of a Spanish translation of the Child Behavior Checklist

The Child Behavior Checklist's applicability to a Hispanic sample was assessed by an examination of the instrument's internal consistency and concurrent validity. The CBCL and TRF were administered to a community sample representative of children of Puerto Rico aged 4 to 16. Cronbach's alpha was used to assess the internal consistency of empirically derived scales. The relation of CBCL and TRF scores to clinical diagnosis, adaptive functioning, and need for services served as indicators of the concurrent validity of the instrument's Spanish version. The results indicate that the total behavior problem scores on the instruments are good continuous measures of maladjustment for children in Puerto Rico. A child with high values on the scales has a high probability of being classified as a case by a psychiatrist. High levels of internal consistency were found in most subscales. Only scales comprising low prevalence problems showed poor internal consistency.     

Maternal Sensitivity: a Resilience Factor against Internalizing Symptoms in Early Adolescents Born Very Preterm?

Compared with full-terms, preterm individuals are more at risk from infancy to adulthood for developing internalizing symptoms. Early maternal interactive behavior, especially maternal sensitivity, has been found to be a resilience factor in the developmental outcome of preterm children. The present longitudinal study aimed at examining whether early interactive parenting behaviors have a long term impact on the internalizing symptoms of preterm-born young adolescents. A total sample of 36 very preterm and 22 full-term children participated in an 11-year follow-up study. Maternal interactive behavior was assessed during a mother–infant interaction when the infant was 18 months old. At 11 years, internalizing symptoms were assessed with the Child Behavior Checklist (CBCL). Hierarchical regression analyses revealed that the interaction between groups (preterm/full-term) and maternal sensitivity at 18 months significantly explained CBCL internalizing symptoms at 11 years (β = ?0.526; p < 0.05). Specifically, although prematurity was related to internalizing problems, preterm children with higher maternal sensitivity did not differ from their full-term-born peers on the CBCL internalizing problems domain. These results suggest that maternal sensitivity is a long-term resilience factor preventing the development of internalizing problems at early adolescence in very preterm individuals.     

Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is Small Beautiful?

The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioral screening questionnaire that can be completed in 5 minutes by the parents or teachers of children aged 4 to 16; there is a self-report version for 11- to 16-year-olds. In this study, mothers completed the SDQ and the Child Behavior Checklist (CBCL) on 132 children aged 4 through 7 and drawn from psychiatric and dental clinics. Scores from the SDQ and CBCL were highly correlated and equally able to discriminate psychiatric from dental cases. As judged against a semistructured interview, the SDQ was significantly better than the CBCL at detecting inattention and hyperactivity, and at least as good at detecting internalizing and externalizing problems. Mothers of low-risk children were twice as likely to prefer the SDQ.     

Parental ratings of son's behavior problems in high-risk families: convergent validity,internal structure,and interparent agreement

In this research, we examined the convergent validity, internal structure, and interparent agreement of the Child Behavior Checklist (CBCL; Achenbach, 1991a) using data from a community sample of 317 high-risk families. The sample consisted of 218 families with alcoholism (biological mother, father, and son) and 99 matched comparison families without alcoholism; all families were intact and included a 3- to 5-year-old son at first contact. Evidence was found for the convergent validity of the CBCL. In addition, although interparent agreement was low, the internal structure was confirmed, and structural invariance was high between mothers and fathers and in families with and without alcoholism. The effects of parental psychological and cognitive functioning on parent agreement were examined and found to have a minimal effect on parent agreement. These results demonstrate the validity of the CBCL for use by parent raters with alcoholism and their sons and emphasize the importance of including both versus only 1 parent in research using the CBCL.     

The Strengths and Difficulties Questionnaire (SDQ): the Factor Structure and Scale Validation in U.S. Adolescents

The Strengths and Difficulties Questionnaire (SDQ) is one of the most commonly used instruments for screening psychopathology in children and adolescents. This study evaluated the hypothesized five-factor structure of the SDQ and examined its convergent validity against comprehensive clinical diagnostic assessments. Data were derived from the National Comorbidity Survey - Adolescent Supplement (NCS-A), a nationally representative sample of U.S. adolescents aged 13 to 18 years. Parents/parent surrogates (n=6,483) was asked to complete a self-administered questionnaire including the SDQ and DSM-IV comprehensive diagnostic information on the participating adolescents. Confirmatory factor analysis (CFA) was conducted to assess the factor structure of the SDQ. The five-factor solution of the SDQ (including emotional, conduct, hyperactivity-inattention, peer relationship, and prosocial) provided a satisfactory fit to the data, and was invariant across sex, age, race/ethnicity and income subgroups. SDQ scores predicted a significantly increased probability of meeting criteria for a DSM-IV disorder, with better prediction for behavior disorders than for mood disorders. Decreasing the SDQ cutoffs to the 80th percentile significantly increased the sensitivity from 39% to 63% for the SDQ Total Difficulties Score, with an expected decrease in specificity from 93% to 87%. This work confirms the five-factor structure of the SDQ in an ethnically and sociodemogrpahically diverse community sample of adolescents. Our findings strengthen empirical evidence for the use of the parent-reported SDQ as a screening tool for DSM-IV behavioral and emotional disorders in adolescents identified in the general population.     

Concurrent Validity of the Strengths and Difficulties Questionnaire in an Indigenous Pre-School Population

The strengths and difficulties questionnaire (SDQ) is a frequently used tool for universal screening of pre-schoolers’ behavioural and emotional problems. However, evidence for its concurrent validity is equivocal and has not been tested in a Māori population. We aimed to evaluate the concurrent validity of the strengths and difficulties questionnaire (SDQ) in Māori pre-schoolers (tamariki), aged 4 and 5. We carried out a prospective study of 225 tamariki (46% female) for whom a recent SDQ was available from the New Zealand Ministry of Health’s Before School Check database. A trained nurse carried out a standardised wellbeing and behavioural assessment for these children. Sensitivity, specificity, positive predictive and negative predictive values were calculated, using optimal total difficulty scale threshold values published for the SDQ (parent version SDQ-P; teacher version SDQ-T). Primary outcome: an assessment-based child referral to Child and Adolescent Mental Health Services or to a Paediatric outpatient service. Secondary outcomes: assessment-based parental referral to a parenting programme and combined referral. The optimal thresholds for child referral were low for the SDQ-P (13) and SDQ-T (7). Child referral SDQ-P: sensitivity 62%, specificity 83%, positive predictive value 0.35, negative predictive value 0.94. Child referral SDQ-T: sensitivity 77%, specificity 78%, positive predictive value 0.31, negative predictive value 0.96. The findings demonstrate optimal threshold values for referral for Māori on the SDQ-P and SDQ-T are much lower when compared to published thresholds (17 vs. 16). Sensitivity values were also low. A surveillance approach for the assessment of psychosocial problems is recommended for pre-schoolers.     

External validity of the new Devereux Adolescent Behavior Rating scales

The discriminant and concurrent validity of the five new scales for the Devereux Adolescent Behavior Rating Scale (DAB) was explored using a heterogeneous sample of psychiatric and substance abuse patients. Consistent with predictions, the substance abuse patients scored higher on the Acting Out Behaviors (AOB) and Heterosexual Interests (HI) scales, and psychiatric patients scored higher on the Psychotic Behaviors scale. Gender differences also were found, including boys being rated higher on Acting Out Behaviors, and girls higher on Heterosexual Interests. The new DAB scales demonstrated sufficient concurrent validity using a thorough record review and a patient rating scale (the Child Behavior Checklist [CBCL]). The Neurotic/Dependent Behaviors scale (NDB) showed a consistent relationship with substance abuse and several other measures of more externalizing behaviors, in addition to the predicted relationships with anxious, tense, and dependent behaviors. The Withdrawn/Timid Behaviors scale (WTB) proved to be a purer measure of internalizing behaviors in both sexes.     

External Validity of the New Devereux Adolescent Behavior Rating Scales

The discriminant and concurrent validity of the five new scales for the Devereux Adolescent Behavior Rating Scale (DAB) was explored using a heterogeneous sample of psychiatric and substance abuse patients. Consistent with predictions, the substance abuse patients scored higher on the Acting Out Behaviors (AOB) and Heterosexual Interests (HI) scales, and psychiatric patients scored higher on the Psychotic Behaviors scale. Gender differences also were found, including boys being rated higher on Acting Out Behaviors, and girls higher on Heterosexual Interests. The new DAB scales demonstrated sufficient concurrent validity using a thorough record review and a parent rating scale (the Child Behavior Checklist [CBCL]). The Neurotic/Dependent Behaviors scale (NDB) showed a consistent relationship with substance abuse and several other measures of more externalizing behaviors, in addition to the predicted relationships with anxious, tense, and dependent behaviors. The Withdrawn/Timid Behaviors scale (WTB) proved to be a purer measure of internalizing behaviors in both sexes.     

Subjective Well-Being in Adolescence: The Role of Self-Control,Social Support,Age, Gender,and Familial Crisis

Focusing on adolescents’ subjective well-being, the present study comprised three parts. The first examined the role of two coping mechanisms, self-control and social support, in predicting subjective well-being. The second related to the role of age and gender in predicting adolescents’ subjective well-being. The third raised the question of whether exposure to familial crisis would predict adolescents’ subjective well-being and whether self-control and social support would moderate the link between crisis and adolescents’ subjective well-being. Participants included 380 adolescents ages 13–17 years (M = 15.32, SD = .98; 194 boys, 176 girls, 10 unspecified), from six integrative junior-high and high schools in central Israel. All schools served a heterogeneous Jewish student population. Based on responses to a questionnaire identifying adolescents who reported experiencing a severe life crisis during the last year (e.g., severe illness in family, parent death or separation/divorce), the sample was divided into two groups: exposure to familial crisis (n = 96) and no exposure to familial crisis (n = 284). Outcomes revealed that both self-control and social support predicted adolescents’ subjective well-being. As expected, older adolescents presented lower levels of subjective well-being than younger ones. In contrast to the hypothesis, gender did not predict subjective well-being. Although exposure to crisis did not predict higher negative affect or lower positive affect, an interaction emerged between self-control and crisis in predicting positive affect. Thus, among adolescents who experienced crisis, better self-control skills predicted higher levels of positive affect.     

The Social Behavior Scale for Preschool Children: Factorial Structure and Concurrent Validity

The aims of the present study were to examine the factor validity of a new social behavior assessment - the Social Behavior Scale (SBS) - using exploratory (sample 1, n = 169) and confirmatory (sample 2, n = 127) factor analysis, and to test factor invariance across gender in a sample of Italian preschoolers. The concurrent validity of the SBS was examined with measures of peer nominations and observed interactions (sample 3, n = 277). Findings confirmed the three-factor structure of the SBS: Emotional Competence, Social Engagement and Aggressiveness. Multigroup analysis provided evidence of factor invariance across gender. Concerning concurrent validity, results confirmed a great association between teacher-rating SBS and the other concurrent measures.     

Psychometric Properties of the Power of Food Scale in a Community Sample of Preadolescents and Adolescents

The Power of Food Scale (PFS) was developed to assess hedonic hunger, or how individuals think and feel about food and eating in the absence of metabolic need. The measure was originally developed and validated in two adult samples, and recent preliminary support has been provided for the validity in a sample of preadolescents. The aim of the current study was to conduct a confirmatory factor analysis (CFA) on the PFS in a community sample of preadolescents and adolescents to examine the psychometric properties in youth. Participants were 148 youth ages 11–18 (M = 12.85) from two Midwestern communities in the United States. Participants completed the PFS to assess for hedonic hunger. Structural equation modeling was used to conduct multiple CFAs to test varying factor structures of the PFS in preadolescents and adolescents. Results suggested that the scale was best represented by the previously established 15-item version of the measure with an aggregate domain and three subscales based on food proximity (i.e., food available, food present, and food tasted). Results from the CFA revealed that the measurement model had a close fit (RMSEA = 0.033, CFI = 0.985). Cronbach’s α for the total scale and the three subscales ranged from 0.86 to 0.95. Findings suggest that the previously established factor structure of the 15-item PFS best represents the factor structure of the measure in a community sample of preadolescents and adolescents.     

Psychometric properties and clinical cut-off scores of the Spanish version of the Social Anxiety Scale for Adolescents

This study examined the reliability and validity evidence drawn from the scores of the Spanish version of the Slovenian-developed Social Anxiety Scale for Adolescents (SASA; Puklek, 1997; Puklek & Vidmar, 2000) using a community sample (Study 1) and a clinical sample (Study 2). Confirmatory factor analysis in Study 1 replicated the 2-factor structure found by the original authors in a sample of Slovenian adolescents. Test-retest reliability was adequate. Furthermore, the SASA correlated significantly with other social anxiety scales, supporting concurrent validity evidence in Spanish adolescents. The results of Study 2 confirmed the correlations between the SASA and other social anxiety measures in a clinical sample. In addition, findings revealed that the SASA can effectively discriminate between adolescents with a clinical diagnosis of social anxiety disorder (SAD) and those without this disorder. Finally, cut-off scores for the SASA are provided for Spanish adolescents.     

The Construct Validity of the Strengths and Difficulties Questionnaire for Aboriginal Children Living in Urban New South Wales,Australia

The current study explores the construct validity of the standard Strengths and Difficulties Questionnaire (SDQ) for Aboriginal children living in urban communities in New South Wales, Australia. Parent report SDQ data from the first 717 Aboriginal children aged 4–17 years who participated in the baseline survey of the Study of Environment on Aboriginal Resilience and Child Health were analysed. The overall construct validity of the SDQ in our sample was acceptable but not “good.” The internal consistency reliability was excellent overall and good for all subscales with the exception of peer problems, a concept that may have a different significance for urban Aboriginal parents. Removing the peer relationships subscale, however, did not improve the fit of the model. The convergent validity of the SDQ was good. The prosocial behaviours scale and both the peer and conduct problems scales were highly correlated suggesting Aboriginal parents conceptualise these differently and that prosocial behaviours may be considered a key indicator of well‐being for Aboriginal children. Overall, the SDQ is a promising tool for urban Aboriginal children in New South Wales. Those working with Aboriginal young people should focus on the SDQ total difficulties score and limit their reliance on the peer relationships subscale.     

Factor structure of the Brief Psychiatric Rating Scale for Children (BPRS-C) among Hospital Patients and Community Clients

The factor structure, reliability and concurrent validity of the Brief Psychiatric Rating Scale for Children (BPRS-C) was examined. The BPRS-C was designed to measure child psychopathology with seven scales consisting of three items each. Two large samples of intake assessments at admission to the public mental health system of state psychiatric hospitals (n = 6712) and community mental health centers (n = 21,459) for children aged 3–17 were examined. In both samples exploratory and confirmatory factor analysis found seven factors that generally supported the BPRS-C seven scale structure. Reliability as measured by internal consistency was acceptable with an average alpha of .72 (SD = .09). Mean scale scores across diagnoses and concurrent correlations with the Child Behavior Checklist (CBCL) were consistent with expectations.     

Behavioral problems in adolescents raised by their grandparents

This research analyzes, for the first time using a Spanish sample, the behavioral problems of adolescents in the custody of their grandparents. The sample consisted of 68 adolescents (31 boys and 37 girls, with a mean age of 13.7 years) in the custody of 54 grandparents with an average age of 65.9 years for the grandfathers, and 63.6 years for the grandmothers. The instrument employed was the Child Behavior Checklist (CBCL; Achenbach, 2001). The results indicate that the majority of both boys and girls can be classified within the normal range on scales of internal behavior, external behavior and total behavioral problems. When gender and age differences were analyzed, it was found that boys had more behavioral problems than girls on scales of incompliance with rules and external behavior. Meanwhile, it was shown that older adolescents had more somatic problems, as well as more behavioral problems, as measured by both the internal scale and total scale of the CBCL, than the younger participants.     

Validation of the Italian Emotion Awareness Questionnaire for children and adolescents

This study aimed at validating the Emotion Awareness Questionnaire (EAQ, Rieffe et al., 2008) for Italian children and adolescents. Emotion awareness is a prerequisite of emotion regulation including the abilities to monitor and differentiate emotions, locate their antecedents, and value the importance of one's own and others' emotions. The EAQ consists of six scales: Differentiating Emotions, Verbal Sharing of Emotions, Not Hiding Emotions, Bodily Awareness of Emotions, Attending to Others' Emotions, and Analyses of (Own) Emotions. The questionnaire was filled in twice with a one-year time interval. At T1, 420 Italian children and adolescents took part (M = 12.65; SD = 1.41). Additionally, the Somatic Complaints List was administered to examine the concurrent validity of the EAQ. Results confirmed the six-factor structure, showed good psychometric properties of the separate scales and a good concurrent validity, which make the EAQ a reliable instrument to administer emotion awareness in Italian youth.     

Psychometric Properties of the Mental Health Continuum-Short Form: A Study of Portuguese Speaking Children/Youths

The development of measures of children and adolescents’ subjective well-being is crucial to the conceptualization and evaluation of positive mental health. The aim of this study was to investigate the factorial structure and invariance of the Mental Health Continuum-Short Form (MHC-SF—adolescents) across children and youths. Participants were from two different samples: 208 elementary school children (sample 1) and 216 middle school youths (sample 2). Results confirmed the three-dimensional structure of subjective well-being in both samples. The three sub-scales of the MHCSF yielded high internal consistency and results from the HTMT85 indicated discriminant validity. Measurement invariance testing across three different age groups (7–8, 9–10 and 11–14 years) confirmed the full metric and approximate scalar invariance of the MHC-SF. Full scalar invariance was achieved across gender. The study also compared the latent means for mental well-being in the three age groups, and found that the younger groups showed significantly higher levels of wellbeing. The present research study strongly suggests that the MHC-SF (adolescents) is an appropriate instrument to measure the positive mental health and well-being of children and pre-adolescents as multidimensional construct.     

Optimism and Mental Health in Adolescence: a Prospective Validation Study of the Dutch Life-Orientation Test-Revised (LOT-R-A) for Adolescents

The study aimed to examine the psychometric properties of the Dutch Life Orientation Test-Revised for Adolescents (LOT-R-A), a self-report questionnaire assessing dispositional optimism, and to evaluate the two-factor structure (optimism, pessimism). The LOT-R-A and the questionnaires measuring well-being (MHC-SF-A) and psychological problems (SDQ) were completed by 459 Dutch adolescents (178 boys and 281 girls) between the ages of 11 and 18 years at baseline and 281 adolescents at a four-week follow-up. The results confirmed the two-factor structure (optimism, pessimism) of the LOT-R-A. The findings provided evidence of internal consistency of scores ranging from low to good, and evidence of good test-retest reliability of scores. Further, scores of optimism were cross-sectionally positively associated with scores of positive emotions and well-being and negatively with scores of psychological problems and negative emotions, providing evidence of convergent and divergent validity of optimism scores with emotions, well-being, and psychological problems. Lastly, scores of optimism were prospectively positively associated with scores of well-being and negatively with scores of psychological problems, providing evidence of criterion validity of optimism scores with well-being and psychological problems. Based on these findings it can be concluded that the LOT-R-A is a valid instrument to examine optimism among adolescents. Future research can help to elucidate the role of optimism in mental health interventions and can gather knowledge on how these interventions can be refined to optimally cultivate optimism during the developmental period of adolescence.     

Measurement Equivalence of the Child Behavior Checklist among Parents of African American Adolescents

The Child Behavior Checklist (CBCL/6-18) is a widely used parent-report measure of youth internalizing and externalizing problems. Accumulating evidence, however, suggests that the CBCL may not adequately assess clinical problems in diverse populations. We investigated the measurement equivalence (ME) of the CBCL in an African American adolescent sample (N = 145). Confirmatory factor analysis indicated poor factor model fit; however, modification indices and an alternative two-factor model produced improved fit statistics. Internal consistency coefficients of CBCL scales ranged from α = .65 to .88 and were generally lower than those reported for the normative sample. The CBCL exhibited convergent validity with conceptually similar scales on the Parent Report Scale of the Behavior Assessment System for Children; however, the correlations were weaker than those reported for the normative sample. The CBCL Internalizing composite failed to predict clinician-rated Emotional problems, however, the Externalizing composite predicted clinician-rated behavior problems. In summary, the CBCL did not exhibit unequivocal evidence of ME, as it both possesses and lacks a number of statistical attributes that would demonstrate its equivalence with African Americans. Future empirical and theoretical work is discussed.