Child-Adolescent Suicidal Potential Index (CASPI): a screen for risk for early onset suicidal behavior

This study's purpose was to develop a reliable and valid self-report questionnaire, the Child-Adolescent Suicidal Potential Index (CASPI), to screen for risk for suicidal behavior in children and adolescents. Four hundred twenty-five child and adolescent psychiatric patients and nonpatients completed the CASPI and other research instruments to rate suicidal and assaultive behavior and symptoms of depression, anxiety, and hopelessness. The 30-item CASPI involves 3 factors (anxious-impulsive depression, suicidal ideation or acts, family distress) that contributed to a unidimensional 2nd-order factor accounting for 59% of the total variance. Internal consistency (alpha) for the total score was .90, and test-retest reliability (ICC) for the total score was .76. Total score distinguished between children and adolescents with different severity of psychopathology and different levels of suicidal and assaultive behavior. Each of the 3 factors had different contributions to discriminating between levels of suicidal status. CASPI total score of 11 distinguished suicidal ideation or acts from nonsuicidal behavior, with sensitivity 70% and specificity 65%. CASPI total score positively correlated with symptom severity of depression, anxiety, and hopelessness.     

Reliability and validity of IJR Behavior Checklist scores: Number versus pathology level of symptoms

The parent, teacher, and clinician forms of the IJR Behavior Checklist yield four summary scores (checklist total score, pathology weighted total score, mean pathology score, and highest 5 items' mean pathology score). The checklist total score is essentially a symptom count with a double-weighting for frequent/intense occurrence; the other three scores incorporate item pathology weights. All four summary scores were shown to have moderately high validity as measures of the construct child/ adolescent psychopathology: They differentiated between well-adjusted and clinical subsamples at the .001 level. The two scores based entirely on the pathology weights manifested less satisfactory reliability than the two scores reflecting primarily number of symptoms, but surpassed the latter in power to discriminate between psychotic and nonpsychotic patients.     

Measuring informant discrepancies in clinical child research

Discrepancies among informants' ratings of child psychopathology have important implications for diagnosis, assessment, and treatment. Typically, parents and children complete measures (e.g., self-report checklists, diagnostic instruments) to assess child dysfunction. Ratings gathered from these sources reveal relatively little agreement on the nature and extent of the child's social, emotional, and behavioral problems. This article reviews and illustrates the most frequently used methods of measuring informant discrepancies in the clinical child literature (i.e., raw difference, standardized difference, and residual difference scores) and outlines key considerations to influence their selection. The authors conclude that frequently used methods of measuring informant discrepancies are not interchangeable and recommend that future investigations examining informant discrepancies in clinical child research use the standardized difference score as their measure of informant discrepancies.     

Internal consistency of a diagnostic interview for children: The Child Assessment Schedule

The purpose of this study was to evaluate the internal consistency of the content scales of the Child Assessment Schedule (CAS). A total of 116 psychiatric patients with a mean age of 10 years were administered the interview, and 92 parents were administered the parent version. Coefficient alpha was calculated for each of the 11 content scales. High internal consistency was demonstrated for school, friends, worries, mood, physical complaints, and expression of anger. More moderate but acceptable alphas were observed for the family, fears, and self-image scales. The same general pattern of results was observed for both the child and parent interviews. Additional analyses revealed that the number of items in the CAS could be reduced up to 30% without sacrificing internal consistency. These results indicate that 9 of the scales yield reliable scores.     

Unique Associations between Childhood Temperament Characteristics and Subsequent Psychopathology Symptom Trajectories from Childhood to Early Adolescence

Existing research suggests that temperamental traits that emerge early in childhood may have utility for early detection and intervention for common mental disorders. The present study examined the unique relationships between the temperament characteristics of reactivity, approach-sociability, and persistence in early childhood and subsequent symptom trajectories of psychopathology (depression, anxiety, conduct disorder, and attention-deficit hyperactivity disorder; ADHD) from childhood to early adolescence. Data were from the first five waves of the older cohort from the Longitudinal Study of Australian Children (n = 4983; 51.2% male), which spanned ages 4–5 to 12–13. Multivariate ordinal and logistic regressions examined whether parent-reported child temperament characteristics at age 4–5 predicted the study child’s subsequent symptom trajectories for each domain of psychopathology (derived using latent class growth analyses), after controlling for other presenting symptoms. Temperament characteristics differentially predicted the symptom trajectories for depression, anxiety, conduct disorder, and ADHD: Higher levels of reactivity uniquely predicted higher symptom trajectories for all 4 domains; higher levels of approach-sociability predicted higher trajectories of conduct disorder and ADHD, but lower trajectories of anxiety; and higher levels of persistence were related to lower trajectories of conduct disorder and ADHD. These findings suggest that temperament is an early identifiable risk factor for the development of psychopathology, and that identification and timely interventions for children with highly reactive temperaments in particular could prevent later mental health problems.     

The Children’s Yale-Brown Obsessive Compulsive Scale: Reliability and Validity for Use Among 5 to 8 Year Olds with Obsessive-Compulsive Disorder

The Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is the instrument of choice for assessing symptom severity in older children (i.e., 8–18 years) diagnosed with obsessive-compulsive disorder (OCD). The reliability and validity of this measure for use among younger children (i.e., 5–8 years of age), however, has never been examined. The primary aim of this study was to examine this scale’s use among those presenting with early childhood OCD. Forty-two children with OCD between the ages of 4 and 8 years of age were recruited as part of a larger treatment outcome study, and the reliability and validity of the CY-BOCS was examined. Results revealed questionable reliability for the measure’s 5-item Obsessions subscale but good reliability (i.e., internal consistency, temporal stability) for the 5-item Compulsions subscale and 10-item total scale. Results also revealed that the CY-BOCS total scale demonstrated mixed discriminant validity but strong convergent validity and sensitive to change. Collectively, the 10-item, CY-BOCS total score yields a reliable and valid scale for the assessment of symptom severity in early childhood OCD. However, we urge caution in use of the Obsessions subscale in isolation for either clinical or research purposes. Limitations and future areas of research are discussed including the potential benefit of developing a measure of OCD-related symptom severity specifically for younger children with greater attention to developmental differences among children within this population.     

Construction and validation of Self-Efficacy Scale for early school-aged children

Self-efficacy beliefs play an important role in regulating a child's functioning and emotional well-being. The aims of our study were to construct the Polish Self-Efficacy Scale for Children (SESC) in early school age and to explore its factor structure and construct validity. A total of 402 children in the age range of 8 to 10 years took part in the study. An exploratory factor analysis of the SESC revealed four factors. The internal reliability of each scale score ranged from good to very good. Results show that self-efficacy beliefs for academic achievement, self-control and regulation of negative emotion are negatively correlated with inattention, hyperactivity–impulsivity, low emotional control and trait anxiety. It is concluded that the SESC is a promising measure for research concerning child development and psychopathology.     

The reliability of the ICD‐10 and the DC 0–3 in an epidemiological sample of children 1½ years of age

The aims of this study were to investigate the reliability of ICD‐10 and DC 0–3 in the diagnostic classification of mental health problems in 1½ ‐year‐old children from the general population. The reliability study was conducted as a part of an epidemiological survey of psychopathology in 1½ ‐year‐old children from the general population. In this survey, the children were assessed and diagnosed according to the ICD‐10 and the DC 0–3 after a 2‐hr session including standardized and clinical methods and videorecordings. The case records and video material of 18 children were rediagnosed by the three child psychiatrists, who had diagnosed children in the epidemiological survey. In general, the reliability in diagnostic classification of mental health problems in 1½‐year‐old children was improved with the DC 0–3 compared to the ICD‐10. In the classification of psychopathology at Axis I, the interrater reliability and test‐retest reliability kappas were 0.66 and 0.57, respectively, with the ICD‐10, and 0.72 and 0.74, respectively, with the DC 0–3. The reliability of the classification of relationship disturbances at Axis II with the DC 0–3 was high, corresponding to κ = 1. A high agreement among raters in the differentiation between psychopathology and normal variations was found. Given experienced clinicians and standardized assessment methods, it is possible to reliably identify and diagnose psychopathology in 1½‐year‐old children from the general population.     

Psychometric properties of parents and children as informants in child psychiatry epidemiology with the Spanish diagnostic interview schedule for children (DISC.2)

Parent and child reports were examined to study how epidemiological researchers can best use the information provided to describe childhood psychopathology. As part of a multisite methodologic study of mental disorders in children, a probability sample (N=248) of children aged 9 to 17 years from the San Juan metropolitan area was selected. This sample was enriched with 74 clinic cases. Both parents and children were administered the DISC.2. Results showed that prevalence estimates were influenced by the informant. The clinicians' diagnosis is more concordant with children's reports of depression and with parents' reports of disruptive disorders. Parents and children provided unique information when interviewed with a structured psychiatric interview about child psychopathology. Their unique perspectives contributed to the observed discordance that emerged when DISC parent and DISC child results are compared. Combining the two perspectives with a simple OR rule at the symptom level did not seem to capture the unique perspectives.We acknowledge the research group of the Behavioral Sciences Research Institute for their valuable contributions to this work. We also recognize José V. Martínez, Vivian E. Febo, and Zenaida González for the data analyses, and Elizabeth Pastrana and Felícita Laboy for the secretarial work.This research was supported by grants (MH46732) from the National Institute of Mental Health (NIMH) as part of a collaborative methodologic epidemiologic study of children and adolescents (MECA) between the Universities of Columbia, Emory, Puerto Rico, Yale, and the NIMH.     

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.     

HPA-Axis Activation as a Key Moderator of Childhood Trauma Exposure and Adolescent Mental Health

Individual differences in a child’s sensitivity to stress may influence whether youth exposed to trauma develop symptoms of psychopathology. We examined the interaction between HPA-axis reactivity to an acute stressor and exposure to different types of childhood trauma as predictors of mental health symptoms in a sample of youth. Youth (n?=?121, ages 9–16; 47% female) completed a standardized stress task, including 5 post-stress salivary cortisol samples. Parents also completed the Child Behavior Checklist as a measure of child internalizing and externalizing symptoms in the past month, and completed the Early Trauma Inventory (ETI) as a measure of their child’s trauma exposure. More emotional abuse and non-intentional trauma were associated with greater internalizing symptoms. Youth exposed to physical abuse who demonstrated slower HPA-axis reactivity had elevated internalizing and externalizing symptoms. Youth exposed to emotional abuse or non-intentional traumatic events who demonstrated faster HPA-axis reactivity had elevated internalizing and externalizing symptoms. Profiles of exaggerated or attenuated HPA-axis reactivity to acute stress may be risk factors for psychopathology in children facing different stressful social environments.     

Reliability and Validity of a Brief Clinician-Report Scale for Screening Behavioral Inhibition

Given the implications of behavioral inhibition (BI) on social anxiety and depression, several cost-effective methods have been developed to detect this trait. However, there is no instrument for obtaining a systematic measurement of BI that uses the reports of mental health professionals. The present study aims to explore the psychometric properties of the Behavioral Inhibition Observation System (BIOS), a brief tool enabling clinicians to provide a quick measure of BI. Parents and teachers of 361 preschool children provided measures of BI and psychopathology. Clinicians completed the BIOS after an individual meeting with every child. Seventy-four randomly selected children were exposed to standardized observation. Two researchers completed the BIOS after standardized observation. The results show that the BIOS is structured in one dimension that explains 60 % of the total variance. It shows good internal consistency (Cronbach’s Alpha?=?.88) and good test-retest reliability. The BIOS scores moderately converge with observational measures of BI and adequately distinguish constructs not related to BI (such as aggressiveness, disruptive behavior, or peer conflict). The results support that the BIOS, an 8-item scale that takes 3 min to complete, is valid and reliable for capturing a clinician’s measure of BI. The BIOS may help to detect temperamental disposition to social anxiety.     

The Importance of Assessing Impairment Associated With Limited Prosocial Emotions

Limited prosocial emotions (LPE) are characterized by a lack of remorse or guilt, callousness/lack of empathy, being unconcerned about performance, and shallow/deficient affect. While previous research has largely focused on the presence or absence of LPE in youth, there is considerable evidence that symptom presence/absence and symptom impairment are separable dimensions, where impairment often is found to play a significant, unique role in assessing child psychopathology. The current study utilized a newly developed questionnaire with the purpose of exploring its psychometric properties and better understand the dual and potentially differential role LPE symptom presence and LPE-related impairment have in youth. Mothers (n = 265) of children (M_age = 8.04, SD = 2.07) completed questionnaires assessing LPE impairment, LPE symptoms, externalizing disorder symptoms, and functional impairment. Results demonstrated strong support for the psychometric properties of the newly developed measure of LPE impairment. Importantly, LPE-related impairment uniquely predicted all impairment domains above-and-beyond the effects of LPE symptoms, oppositional defiant disorder, and CD symptoms (as well as child age and sex covariates). Moreover, youth in the top 25th percentile on both LPE symptoms and LPE-related impairment (compared to youth only in the top 25th percentile in LPE symptoms) had greater mean externalizing symptoms and functional impairment. The preliminary evidence provided suggests researchers and clinicians may benefit from assessing both LPE symptoms and LPE-related impairment when attempting to identify youth with high levels of conduct problem symptoms and/or psychosocial impairment. Future research should aim to replicate and expand our findings to other clinical populations.     

Testing Informant Discrepancies as Predictors of Early Adolescent Psychopathology: Why Difference Scores Cannot Tell You What You Want to Know and How Polynomial Regression May

Multiple informants commonly disagree when reporting child and family behavior. In many studies of informant discrepancies, researchers take the difference between two informants’ reports and seek to examine the link between this difference score and external constructs (e.g., child maladjustment). In this paper, we review two reasons why difference scores cannot serve as unambiguous predictors of outcomes. Further, we use polynomial regression analyses to both test the validity of difference scores and provide a more direct test of the hypothesis that discrepancies in parent and child reports predict child psychopathology. Data from 218 parent-adolescent dyads (M adolescent age?=?11.5 years, 51 % female; 49 % European American, 47 % African American) were used to predict adolescent-reported antisocial behavior and depression from parent and adolescent reports of parent-adolescent conflict, parental knowledge, parental acceptance, adolescent rule-breaking behavior, and adolescent pubertal development. Results demonstrate that analyses using difference scores do not provide valid tests of the utility of informant discrepancies in predicting adolescent psychosocial maladjustment. However, interaction terms in polynomial regression analyses provide evidence that informant discrepancies predict child psychopathology. Parent-adolescent informant discrepancies predict adolescent psychopathology but researchers should avoid using difference scores to measure informant discrepancies. Polynomial regression analyses provide more comprehensive and accurate tests of whether informant discrepancies predict child and adolescent psychopathology.     

Das-Naglieri认知评估系统（中文版）在学前儿童样本中的结构验证

本研究以246名5-6岁幼儿园儿童（男101名,女145名）为研究对象,考察基于智力PASS理论开发的Das-Naglieri 认知评估系统（5-7岁版）在中国学前儿童中的适用性,对评估系统中的12个任务进行了内在一致性信度评估,以幼儿早期数学能力测试作为参考评估其校标效度,并采用验证性因素分析对评估系统的结构效度进行评估。结果发现,该版本评估系统具有较好的信度和校标效度,并且很好地拟合了PASS模型。     

青少年“无聊症候群”问题探讨

为了探讨我国学校青少年“无聊症候群”问题的有关现状及成因,选取浙江省4个地区7所中学的613名中学生为研究对象,采用自编量表进行调查。研究发现：(1)“无聊症候群”问题在青少年群体中具有较高比例;(2)男生总体平均得分显著地高于女生;(3)城区中学学生总体平均得分显著地高于乡镇中学学生;(4)独生子女与非独生子女总体上无显著性差异;(5)六个年级间总体上无显著性差异。     

Family Coordination in Families who have a Child with Autism Spectrum Disorder

Little is known about the interactions of families where there is a child with autism spectrum disorder (ASD). The present study applies the Lausanne Trilogue Play (LTP) to explore both its applicability to this population as well as to assess resources and areas of deficit in these families. The sample consisted of 68 families with a child with ASD, and 43 families with a typically developing (TD) child. With respect to the global score for family coordination there were several negative correlations: the more severe the symptoms (based on the child’s ADOS score), the more family coordination was dysfunctional. This correlation was particularly high when parents had to play together with the child. In the parts in which only one of the parents played actively with the child, while the other was simply present, some families did achieve scores in the functional range, despite the child’s symptom severity. The outcomes are discussed in terms of their clinical implications both for assessment and for intervention.     

Using Motion Tracking to Measure Avoidance in Children and Adults: Psychometric Properties,Associations With Clinical Characteristics,and Treatment-Related Change

Avoidance is implicated in many areas of psychopathology, particularly anxiety and its disorders. Accurate, reliable, valid, and objective measurement of avoidance behavior poses methodological challenges. Two key technological advances, increased computing power and the advent of motion-tracking technology, offer novel solutions to these challenges. We describe a series of three studies using a novel motion-tracking system to measure avoidance in children and adults. The first study examined behavioral avoidance of spider stimuli in large samples of children and adults (N = 200 each; the adults were the mothers of the children). Behavioral avoidance was associated with self-rated fear of spiders and increased state anxiety from before to after the task. The second study examined avoidance of threat faces in children and adults (N = 35 each; the adults were the mothers of the children) and test-retest reliability in the adults. Avoidance of threat faces was associated with broadband anxiety symptom severity. Test-retest correlations in behavioral avoidance measured 6 weeks apart was high and significant. The third study examined behavioral avoidance of spiders in clinically anxious children (N = 25) before and after cognitive-behavioral therapy for childhood anxiety disorders. Behavioral avoidance was significantly reduced following cognitive-behavioral therapy and reduction in behavioral avoidance correlated significantly with improvement in child-rated anxiety symptoms. Taken together, these studies provide strong support for the promise of motion-tracking technology to enable a new phase of behavioral avoidance research with sensitive, valid, reliable, and cost- and time-effective measurement of behavioral avoidance across the lifespan.     

Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability

Recent work has drawn attention to the previously underrecognized role that irritability plays in childhood psychopathology. Despite increased recognition of the clinical importance of pediatric irritability as a transdiagnostic symptom dimension, there is a lack of evidence-based treatments for this population that simultaneously and equitably addresses both child and contextual (e.g., parental) factors implicated in the development and maintenance of associated emotional and behavioral difficulties. In the current pilot study, we adapted the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) for the treatment of pediatric irritability in a sample of 19 children (ages 8 to 12) with primary presenting concerns of irritability and/or disruptive behaviors. Results supported the feasibility and acceptability of this treatment and provided preliminary evidence that such an approach may yield improved outcomes for symptoms of pediatric irritability and disruptive behaviors. Implications of these findings for future research and clinical interventions for pediatric irritability are discussed.     

Assessing Recall in Mothers’ Retrospective Reports: Concerns Over Children’s Speech and Language Development

Retrospective recall about children’s symptoms is used to establish early developmental patterns in clinical practice and is also utilised in child psychopathology research. Some studies have indicated that the accuracy of retrospective recall is influenced by life events. Our hypothesis was that an intervention: speech and language therapy, would adversely affect the accuracy of parent recall of early concerns about their child’s speech and language development. Mothers (n?=?5,390) reported on their child’s speech development (child male to female ratio = 50:50) when their children were aged 18 or 30 months, and also reported on these early concerns retrospectively, 10 years later, when their children were 13 years old. Overall reliability of retrospective recall was good, 86 % of respondents accurately recalling their earlier concerns. As hypothesised, however, the speech and language intervention was strongly associated with inaccurate retrospective recall about concerns in the early years (Relative Risk Ratio = 19.03; 95 % CI:14.78–24.48). Attendance at speech therapy was associated with increased recall of concerns that were not reported at the time. The study suggests caution is required when interpreting retrospective reports of abnormal child development as recall may be influenced by intervening events.