A Confirmatory Approach to Examining the Factor Structure of the Strengths and Difficulties Questionnaire (SDQ): A Large Scale Cohort Study

The aim of this study was to examine the factor structure of the Strengths and Difficulties Questionnaire (SDQ) using a Structural Confirmatory Factor Analytic approach. The Danish translation of the SDQ was distributed to 71,840 parents and teachers of 5–7 and 10–12-year-old boys and girls from four large scale cohorts. Three theoretical models were examined: 1. a model with five first order factors (i.e., hyperactivity/inattention, conduct, emotional, peer problems and prosocial), 2. a model adding two internalising and externalising second order factors to model 1, and 3. a model adding a total difficulties second order factor to model 1. Model fits were evaluated, multi-group analyses were carried out and average variance extracted (AVE) and composite reliability (CR) estimates were examined. In this general population sample, low risk sample models 1 and 2 showed similar good overall fits. Best model fits were found when two positively worded items were allowed to cross load with the prosocial scale, and cross loadings were allowed for among three sets of indicators. The analyses also revealed that model fits were slightly better for teachers than for parents and better for older children than for younger children. No convincing differences were found between boys and girls. Factor loadings were acceptable for all groups, especially for older children rated by teachers. Some emotional, peer, conduct and prosocial subscale problems were revealed for younger children rated by parents. The analyses revealed more internal consistency for older children rated by teachers than for younger children rated by parents. It is recommended that model 1 comprising five first order factors, or alternatively model 2 with additionally two internalising/externalising second order factors, should be used when employing the SDQ in low risk epidemiological samples.     

ON THE ACTIVITIES OF THE SCANDINAVIAN PSYCHOANALYTIC SOCIETIES

This article discusses some basic problems of the theory of science connected with understanding the psychoanalytic process. The epistemology of psychoanalysis is seen in relation to the specific status of time, space and causality. It is argued that in psychic life, time and space cannot be a priori categories in the Kantian sense because they are constituted in psychic development and in the dynamics of the psyche and can be abolished in psychopathological conditions as well as in the unconscious. Psychic causality is discussed in relation to Freud's concepts of Nachträglichkeit and overdetermination and remarks are made on the necessity to consider the complex nature of psychic causality when doing research.     

Five‐year outcomes of ADHD diagnosed in adulthood

There is a dearth of long‐term follow‐up studies of adults diagnosed with ADHD. Here, the aim was to evaluate long‐term outcomes in a group of ADHD patients diagnosed in adulthood and receiving routine psychiatric health care. Adults diagnosed with any type of ADHD (n = 52) and healthy controls (n = 73) were assessed at baseline and at a 5‐year follow‐up, using Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), Brown ADD Scale (BADDS) and Adult ADHD Self‐Report Scale (ASRS). A multivariate regression method was used to identify factors predicting 5‐year outcomes, including baseline ratings, medication intensity, comorbidity, intelligence quotient (IQ), age, and sex. After 5 years, ADHD patients reported fewer and/or less severe symptoms compared to baseline, but remained at clinically significant symptom levels and with functional deficits. Baseline self‐reports of ADHD symptoms predicted their own 5‐year outcome and low baseline functioning level predicted improved global functioning at follow‐up. Factors previously reported to predict short‐term outcomes (i.e., medication, comorbidity, IQ, age, and sex) did not anticipate long‐term outcomes in present study.     

Effectiveness of an Individualized Case Formulation-Based CBT for Non-responding Youths with Anxiety Disorders

The study examined the effectiveness of an individualized case formulation-based cognitive behavior therapy (CBT) for youths (9–17 years) with anxiety disorders and their parents after unsuccessful treatment with a manualized group CBT program (the Cool Kids). Out of 106 participant youths assessed at a 3-month follow-up after manualized CBT, 24 were classified as non-responders on the Clinical Global Impression-Improvement scale (CGI-I), and 14 of 16 non-responders with anxiety as their primary complaint accepted an offer for additional individual family CBT. The treatment was short-term (M sessions = 11.14) and based on a revised case formulation that was presented to and agreed upon by the families. At post-treatment, nine youths (64.3 %) were classified as responders on the CGI-I and six (42.9 %) were free of all anxiety diagnoses, while at the 3-month follow-up 11 (78.6 %) had responded to treatment and nine (64.3 %) had remitted from all anxiety diagnoses. Large effect sizes from pre- to post-individualized treatment were found on youths’ anxiety symptoms, self-reported (d = 1.05) as well as mother-reported (d = .81). There was further progress at the 3-month follow-up, while treatment gains remained stable from post-treatment to the 1-year follow-up. Results indicate that non-responders to manualized group CBT for youth anxiety disorders can be helped by additional CBT targeting each family’s specific needs.     

Reliability, validity and normative data for the Danish Beck Youth Inventories

This study examines reliability and validity and establish Danish norms for the Danish version of the Beck Youth Inventories (BYI) ( Beck, Beck & Jolly, 2001 ), which consists of five self-report scales; Self-Concept (BSCI), Anxiety (BAI), Depression (BDI), Anger (BANI) and Disruptive Behavior (BDBI). A total of 1,116 school children and 128 clinical children, aged 7–14, completed BYI. Internal consistency coefficients were high. Most test-retest correlations were >0.70. A test-retest difference was found for BAI. Exploratory and confirmatory factor analysis indicated that the five factor structure of the instrument was justified. The BSCI, BAI and BDI discriminated moderately between the norming sample and the clinical group, and the latter group included more children who exceeded the 90th percentile of the norming sample. Diagnostic groups scored higher on relevant scales than norms. Only BSCI and BDI differentiated between diagnostic groups. The BYI showed acceptable internal consistency and test-retest stability, except for BAI. The BYI did not adequately differentiate between internalizing disorders.     

THE PROBLEM OF NATURAL DIVINE CAUSATION AND THE BENEFITS OF PARTIAL CAUSATION: A RESPONSE TO SKOGHOLT

In this article, I defend my previous argument that natural divine causation suffers under the problem of causal overdetermination and that it cannot serve as a line of demarcation between theistic evolution (TE) and intelligent design (ID). I do this in light of Christoffer Skogholt's critique of my article. I argue that Skogholt underestimates the naturalistic ambitions of some current thinkers in TE and fails, therefore, to adequately respond to my main argument. I also outline how partial causation better serves as a model for the relationship between God's providence and evolution.     

Social proximity in early mother–infant interactions: implications for gender differences?

In an exploratory study, we investigated degrees of social proximity between mothers and their 9-month-old children. Twenty-four Swedish mother–infant dyads (12 boys and 12 girls) were observed during a brief free play episode. Social proximity was measured through nine items focusing on both communication and social interaction. Overall, we found that mother–daughter dyads displayed significantly higher degrees of social proximity than mother–son dyads. More specifically, mothers with daughters displayed more physical and visual contact, and were also rated as more sensitive than mothers with sons. It was also found that girls were judged as being more compliant than boys. ©1997 John Wiley & Sons, Ltd.     

Alliance rupture and repair processes in borderline personality disorder: A case study using dialogical sequence analysis

Objective: This study examined alliance rupture and repair processes in borderline personality disorder (BPD) and how the content of sessions interacts with the quality of the alliance.

Design: A mixed methods single case study design was employed incorporating quantitative and qualitative measures of process and outcome.

Methods: This case study examined a 22-year-old female with BPD who received 16 sessions of Cognitive Analytic Therapy. Measures of alliance, symptoms and global functioning were taken across multiple time-points. Selected sessions were analysed using dialogical sequence analysis (DSA), a theory-driven method of psychotherapy research that analyses utterances according to their author, addressee and referential object.

Results: Quantitative data indicated symptom reduction without functional improvement. DSA demonstrated that the first exchanges in therapy were reflective of key relational themes. The case suggests that, rather than simply negotiating tasks and goals, repairing ruptures involves systematically linking the manifest topic to the client’s core problems.

Conclusions: This case study points to the mediating role that the content of sessions has on alliance quality. Results underline the importance of the therapist stance, the need for a shared formulation to make sense of relational processes and the use of responsively timed interventions to decrease desperation and improve self-reflection.