Methodological considerations in the evaluation of the convergence of psychiatric diagnoses and parent-informant checklists

Psychiatric diagnoses and objective parent checklists are alternative ways to describe child adjustment problems. There has recently been interest in evaluating the degree of agreement or convergence between these sources of information. This paper addresses three issues neglected by researchers in this area. The appropriateness of the use of indices of sensitivity and specificity to describe the correspondence of diagnoses and checklist scores is questioned. Implications of failure to consider the reliability of diagnoses in interpreting diagnosis-checklist agreement are discussed. Also, possible parameters of diagnosis-checklist agreement that should be identified by researchers are reviewed. Suggestions for improving research in this area are offered.     

Age differences in target identification as a function of retinal location and noise level: examination of the useful field of view

Foveal and peripheral target detection were compared in young adults (M age = 22 years) and older adults (M age = 66 years) who were optically corrected for the viewing distance. In a two-alternative, forced-choice task, target letters were presented at 0 degree to 10.5 degrees from fixation. Targets were presented alone, flanked on each side by one noise element (i.e., nontarget letter), or embedded in a horizontal row of 19 noise elements. An Age X Noise Level X Location interaction was obtained, wherein age differences were largest for peripheral targets presented in noise. Slope analyses of latency data showed that the performance of young adults in the high-noise condition was most similar to that of older adults in the low-noise condition. At the functional level, results indicated that aging is associated with a restricted useful field of view. In addition, the data suggest that age differences in search can be described by a model in which older adults take smaller perceptual samples from the visual scene and scan these samples more slowly than do the young adults.     

The development of a child assessment interview for research and clinical use

The Child Assessment Schedule (CAS) was developed to address the need for a standardized child interview that could be used for research and clinical purposes. The CAS has several distinguishing characteristics: (1) Questions and responses are standardized, (2) the format was designed to enhance rapport with the child, and (3) information necessary for DSM III childhood diagnoses is explicitly solicited. The CAS was administered to 32 child outpatients, 18 inpatients, and 37 normal controls. Derived scores were obtained for total psychopathology, 11 content areas, and 9 symptom complexes. Interrater reliability for the total CAS score was quite high. The CAS was able to discriminate among the three groups in total score indicating degree of psychopathology, on 9 of the 11 content areas, and on 8 of the 9 symptom complexes. Significant correlations were found between the CAS and maternal report of child behavior and between the CAS and child selfreport of internal affects. It was concluded that the CAS has adequate reliability and validity, although further research is indicated.     

When Is a Parent Out of the Picture? Different Custody,Different Perceptions

This study investigated how 200 children from mother-, father-, or joint-custody arrangements perceived their divorced families. The authors argue that it is not the type of custody that shapes the child's view of whether one parent is peripheral but, rather, the nature of relationships within the various custody arrangements.     

The Effect of Concurrent Depression on PTSD Outcomes in Trauma-Focused Psychotherapy: A Meta-Analysis of Randomized Controlled Trials

The co-occurrence of depression with posttraumatic stress disorder (PTSD) is common and associated with greater severity and impairment than PTSD alone, but the effects on PTSD treatment outcomes are unclear. This study investigated the impact of baseline depression on PTSD symptom change and dropout in a meta-analysis of 44 randomized controlled trials (N = 4,866) of trauma-focused psychotherapies for PTSD. Analyses included 107 active (k = 71) and control (k = 36) conditions. Baseline depression was indexed within samples as (a) continuous symptom severity (e.g., Beck Depression Inventory), standardized across depression measures and (b) proportion of patients with comorbid depressive disorder diagnosis. Among active conditions reporting continuous depression scores (k = 62), greater depression severity predicted smaller PTSD treatment effect sizes (ß = -.36, p = .002), but not dropout (ß = .25, p = .18). Categorical depressive diagnosis rates (k = 29)—reported less frequently—were not associated with treatment effects or dropout in active conditions. Greater depression severity may reflect a risk factor for attenuated response in PTSD psychotherapies, potentially demanding complementary strategies within trauma-focused interventions. Variability between trials in baseline depression symptoms may suggest the need to consider this sample characteristic when comparing treatment outcomes across studies.