Gagnon-Oosterwaal, N., et al., (2012) Pre-adoption adversity, maternal stress, and behavior problems at school-age in international adoptees, Journal of Applied Developmental Psychology, doi:10.1016/j.appdev.2012.04.002
Internationally adopted children present more behavior problems than non-adopted children and are overrepresented in mental health services. These problems are related to children's pre-adoption environment, but adoptive families’ functioning and characteristics may also affect the development of behavior problems in adopted children. The aim of this longitudinal study was to examine the effect of pre-adoption adversity and parenting stress on children's behavior problems at school-age. Our sample consisted of 95 children adopted during infancy. Children's health and developmental status was evaluated soon after arrival in their adoptive country. Their behavior problems were assessed at age 7 using a self-report measure, the Dominic Interactive, and the CBCL completed by the mothers. Parenting stress was measured using the PSI. Children's characteristics at time of adoption were significantly related to their behavior problems at school-age, and maternal stress was found to have a mediating effect on this relationship.
Gagnon-Oosterwaal, N., et al., (2012). Pre-Adoption Adversity and Self-Reported Behavior Problems in 7 Year-Old International Adoptees. Child Psychiatry Hum Dev. DOI 10.1007/s10578-011-0279-5
To further investigate the long-term impact of pre-adoption adversity on international adoptees, externalizing and internalizing symptoms were assessed using a self-report measure at school-age in addition to mothers’ reports. The sample consisted of 95 adopted children and their mothers. Children’s health and developmental status were assessed soon after arrival in their adoptive family. At age 7, the Dominic Interactive, a self-report measure, was used to evaluate externalizing and internalizing symptoms while mothers completed the CBCL. Children’s self-reports were compared to their non-adopted peers’. Adopted children reported more symptoms of specific phobia than their peers. A significant correlation was found between mothers’ and children’s reports but only for externalizing symptoms. Self-reported symptoms were related to indices of nutritional and psychosocial deprivation at arrival, such as low height/age and weight/height ratios. Our results emphasize the importance of considering international adoptees’ perception of their psychological adjustment and the long-term impact of early risk factors. Keywords: International adoption; Behavior problem; Self-report; Pre-adoption adversity; Longitudinal study.
Fahim, C., He, Y., Yoon, U., Chen, J., Evans, A., Pérusse, D. (2011) Neuroanatomy of childhood disruptive behavior disorders. Aggr. Behav. 37:326–337.
Our aims were to (1) examine possible neuroanatomical abnormalities associated with the Disruptive Behavior Disorders (DBDs) as a group and (2) assess neuroanatomical anomalies specific to each DBD (i.e., conduct disorder [CD] and oppositional defiant disorder). Cortical thickness analysis and voxel-based morphometry were analyzed in 47 8-year-old boys (22 DBDs with and without CD and/or ODD and 25 healthy controls) from Magnetic Resonance Imaging brain scans. DBD symptoms were assessed using the Dominic-R. In DBD subjects relative to controls, we found (1) a decreased overall mean cortical thickness; (2) thinning of the cingulate, prefrontal and insular cortices; and (3) decreased gray matter density (GMd) in the same brain regions. We also found that scores on the Dominic-R were negatively correlated with GMd in the prefrontal and precuneus/superior temporal regions. There was a subdiagnostic main effect for CD, related to thinning of the middle/medial frontal, and for ODD in the left rectal/orbitofrontal. Findings suggest that thinning and decreased GMd of the insula disorganizes prefrontal circuits, diminishing the inhibitory influence of the prefrontal cortex on anger, aggression, cruelty, and impulsivity, and increasing a person's likelihood of aggressive behavior. These findings have implications for pathophysiologic models of the DBDs, their diagnostic classification system, and for designing more effective intervention programs. Keywords: disruptive behavior disorder; oppositional defiance disorder; conduct disorder; cortical thickness; voxel-based morphometry
McLaughlin AA, Minnes S, Singer LT, Min M, Short EJ, Scott TL, Satayathum S. (2011) Caregiver and self-report of mental health symptoms in 9-year old children with prenatal cocaine exposure. Neurotoxicol Teratol. 33(5):582-91.
Objective: To assess the effect of prenatal cocaine exposure on mental health symptoms in 9-year old children controlling for potential confounders. Methods: 332 children (170 prenatally cocaine-exposed (PCE), 162 non cocaine-exposed (NCE) were assessed using self (Dominic Interactive; DI) and caregiver report (Child Behavior Checklist; CBCL). Results: Higher levels of PCE were associated with caregiver report of clinically elevated aggressive and delinquent behavior. With each increased unit of PCE, children were 1.3 times more likely to be rated as aggressive (OR=1.30, 95% CI: 1.02-1.67, p<0.04). For each increased unit of PCE, girls were 2 times more likely to be rated as having delinquent behavior (OR=2.08, 95% CI: 1.46-2.96, p<0.0001). PCE status was also associated with increased odds of delinquent behavior (OR=2.41; 95% CI: 1.16-4.97, p=0.02), primarily due to the increased risk among girls with PCE. While girls with PCE status were 7 times more likely than NCE girls to have delinquent behaviors (OR=7.42; 95% CI: 2.03-27.11, p<0.002) boys with PCE did not demonstrate increased risk (OR=0.98; 95% CI: 0.36-2.65, p>0.97). Foster or adoptive parents were more likely to rate their PCE children as having more thought problems, inattention, delinquent behavior, aggression, externalizing and overall problems (p<0.05) than biologic mothers or relative caregivers. Higher 2nd trimester tobacco exposure was associated with increased odds of caregiver reported anxiety (OR=1.73; 95% CI 1.06-2.81, p<0.03) and marijuana exposure increased the odds of thought problems (OR=1.68; 95% CI 1.01-2.79, p<0.05). Children with PCE self-reported fewer symptoms of oppositional defiant disorder (ODD) compared to NCE children (OR=0.44, 95% CI: 0.21-0.92, p<0.03). Greater tobacco exposure was associated with increased odds of child reported ODD (OR=1.24; 95% CI 1.03-1.78, p<0.03). Conclusions: Higher PCE was associated with disruptive behaviors including aggression and delinquent behavior among girls by caregiver report, but not child report. These findings highlight the need for early behavioral assessment using multiple informants in multi-risk children.
Beatriz Olaya, Lourdes Ezpeleta, Nuria de la Osa, Roser Granero and Josep Maria Doménech (2010) Mental health needs of children exposed to intimate partner violence seeking help from mental health services. Child Youth Serv Rev. 32 (7):1004-1011.
The aim of this study is to examine whether children and adolescents exposed to inter-parental physical and environmental violence have specific needs when seeking public mental health services compared to non-exposed outpatients. The witnessing of intimate partner violence (IPV), psychopathology, functional impairment, and several individual and family variables were assessed in 520 children aged 8 to 17years. Results showed that living with violent parents at home increased the child's risk of posttraumatic stress disorder, dysthymia, self-harming behavior, and functional impairment. Exposed children's mothers were more likely to overprotect their sons, punish their daughters and report greater psychopathology, whereas fathers who engaged in marital violence displayed greater emotional distress and were more likely to punish and reject their children. The child's sex moderated the IPV effects on parenting, parental discipline, child's life events and health appraisal. Given the specific clinical profile of exposed children, mental health services should develop schedules to detect, assess, and treat these cases.
Lapalme, M., Déry, M. (2010). Évolution du trouble d’opposition et du trouble des conduites au cours de l’enfance. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement. 42(1): 14-23.
This study aimed at describing the evolution of the symptoms of the oppositional disorder and conducts disorder on a 4-year period (3 times of measurement), depending on whether both disorders appear simultaneously or separately. The sample was composed of 336 children (6–13 years-old), separated in three groups according to the nature of the disorder they presented at the beginning of the study: oppositional disorder only, conducts disorder only, both oppositional and conducts disorders. Structured diagnostic interviews based on the diagnostic criterions of the Diagnostic and Statistical Manual of Mental Disorders (4 éd. rev. vers., American Psychiatric Association, 2000) were used in order to evaluate the average number of symptoms associated to each disorder at each time of measurement. Multilevel regression analysis suggest that the initial co-occurrence of the disorders is neither associated to the evolution of the symptoms of the conducts disorder nor to those of the oppositional disorder. However, this co-occurrence, that can also include the attention-deficit/hyperactivity disorder, can increase the number of symptoms in children, which likely contributes to maintain the diagnostics in some cases.
Wyman, P.A., Gaudieri, P.A., Schmeelk-Cone, K., Cross, W., Hendricks Brown, C., Sworts, L. West, J., Burke, K.C., Nathan, J. (2009). Emotional Triggers and Psychopathology Associated with Suicidal Ideation in Young Urban Children with Elevated Aggressive-Disruptive Behavior. J Abnorm Child Psychol. 2009 October; 37(7): 917–928.
8.6% suicidal ideation (SI) was found among 349 urban 6 – 9 year olds in the top tercile of aggressive-disruptive behavior. SI was associated with more self-reported depression, ODD, conduct problems, and ADHD symptoms (ES 0.70 – 0.97) and 3.5 – 5 times more clinically significant symptoms. Parents rated more symptoms in older children associated with SI compared to parents of similar age children without SI, including greater somatic and behavior problems in 8 – 9 year olds with SI. Parent ratings did not differentiate SI and non-SI in 6 – 7 year olds. SI frequently co-occurred with thoughts about death. Children described anger, dysphoria and interpersonal conflict as motivators/triggers for SI and worries about safety/health as motivator/triggers for thoughts about death, suggesting that problems managing emotionally challenging situations are a specific factor in initiating SI. Universal and indicated interventions for children to strengthen emotional self-regulation and behavioral control are recommended to complement the current emphasis on suicide prevention among adolescents. Keywords: suicidal ideation, urban children, emotional triggers, externalizing problems
CLARK, C., SINCLAIR, L., CORREIA, S., ISAACS, B. (2008). Monitoring Outcomes in Children and Youth Receiving Psychotherapy at Surrey Place Centre. Journal on Developmental Disabilities, 14: 95-98.
The limited amount of literature available suggests the utility of psychotherapy for people with developmental disabilities. The present study assessed the effects of an individual psychotherapy program with 10 children and teens, as measured by the Developmental Behavior Checklist and the Nisonger Child Behavior Rating Form (Parent Version). Results, using parent report, indicated that there was overall improvement from the beginning of the program to the six month point. Two suggestions are provided for evaluation improvement: 1) because the measures did not always capture the concerns of the clients, the General Change Questionnaires were developed to supplement data gathered; and 2) because the perspective of the client is missing from the evaluation, the Dominic Interactive is being pilot tested.
CHISOLM, D.J., GARDNER, W., JULIAN, T., KELLEHER, K.J. (2007). Adolescent Satisfaction with Computer-Assisted Behavioural Risk Screening in Primary Care. http://www3.interscience.wiley.com/journal/118545981/home. Child and Adolescent Mental Health, 13: 163-168
Background: This study measures patient satisfaction with a computerised mental health and risk-behaviour screening tool and predictors of satisfaction.
Method: Youth, aged 11–20, were recruited to use a laptop-based screening system in nine primary care clinics. The study assessed correlations between satisfaction with the system and selected predictors.
Results: Most users were satisfied with their experience. Multivariate logistic regression found perceived ease of use, perceived usefulness, and trust to be significantly associated with high satisfaction. Satisfaction was not related to computer experience or risk behaviour status.
Conclusions: Adolescent patients, even those at risk, accept computer-assisted screening in primary care.
Primary care • adolescents • screening • clinical informatics • behavioural health
DUGRE, S., TRUDEL, M. (Accepté) Suivi longitudinal de profils d'adaptation en santé mentale chez des élèves de niveau primaire. Revue Canadienne des Sciences du Comportement
Dans le contexte de l'étude de la stabilité des problèmes de comportement, l'objectif de cette étude consiste à dégager une typologie longitudinale, à court et long termes, des trajectoires d'adaptation en santé mentale à partir de l'auto-évaluation de 183 enfants de niveau primaire. La méthodologie retenue est basée sur une conception multidimensionnelle des composantes de la santé mentale et utilise l'analyse hiérarchique pour identifier des sous-groupes d'enfants à partir d'une population générale. Une trajectoire décrit une continuité développementale et est considérée comme un patron commun de développement partagé par un groupe d'individus. Peu d'études empiriques ont été menées pour développer et appliquer les méthodes statistiques centrées sur la personne, en complémentarité avec les approches traditionnelles, dans le but de mieux comprendre les processus développementaux en termes de patrons d'adaptation (Magnusson, 1998). Les résultats obtenus diffèrent en fonction du type de stabilité observée mais ils confirment l'importance de la continuité comportementale en dépit des variations individuelles. La vision que l'enfant a de sa propre souffrance a permis d'identifier certains profils qui semblent être précurseurs de troubles ultérieurs tout en éclairant la notion de continuité/discontinuité.
MOSS, E., SMOLLA, N., CYR, C., DUBOIS-COMTOIS, K., MAZZARELLO, T., BERTHIAUME, C. (2006). Attachment and Behavior Problems in Middle Childhood as Reported by Adult and Child Informants. Development and Psychopathology, 18, (2), 425-444.
The predictive relation between attachment and mother, teacher, and self-reported psychopathology was examined for a diverse socioeconomic status French Canadian sample of 96 children. Attachment classifications were assigned on the basis of reunion behavior with mother when the children were approximately 6 years old, and child problem behavior was assessed 2 years later using the Child Behavior Checklist (mother report), the Social Behavior Questionnaire (teacher report), and the Dominic Questionnaire (child self-report). Results indicated that both insecure / ambivalent and insecure / controlling children were rated higher than secure children on a composite measure of externalizing problems. Concerning internalizing problems, only the controlling group was significantly higher on both a composite adult (teacher and mother) and self-report measure of internalizing problems. Analyses of clinical cutoff scores showed that only the controlling group had a significantly greater likelihood of overall problem behavior than other children.
MOSS, E., SMOLLA, N., GUERRA, I., MAZZARELLO, T., CHAYER, D., BERTHIAUME, C. (2006). Attachement et problèmes de comportement intériorisés et extériorisés auto-rapportés à la période scolaire. Canadian Journal of Behavioral Sciences, 38, (2), 142-157
L'association entre l'attachement et les problèmes de comportements intériorisés et extériorisés auto-rapportés a été examinée chez un échantillon de 108 enfants canadiens-français de divers statuts socio-économiques. La classification d'attachement de l'enfant a été évaluée à l'âge de 6 ans à partir de comportements exprimés par celui-ci lors de la réunion avec sa mère suite à une courte séparation. Deux ans et demi plus tard, les problèmes de comportements de l'enfant, alors âgé de 8 ans et demi, sont évalués par l'enfant lui-même au moyen du test Dominique. Les résultats indiquent que les garçons qui présentent un attachement désorganisé et les enfants ambivalents rapportent davantage de problèmes de comportements extériorisés que les enfants ayant un attachement sécurisant. De plus, les enfants désorganisés, tant filles que garçons, rapportent plus de problèmes de comportements intériorisés. Les résultats au test Dominique, conjointement à l'identification d'un patron d'attachement désorganisé / contrôlant à 5-7 ans, pourraient bien jouer un rôle important dans le dépistage des enfants de 6 à 11 ans à risque de présenter des difficultés d'adaptation en raison de problèmes de comportements perturbateurs ou de type anxio-dépressif.
Mots-clés: Attachement, problèmes de comportements intériorisés et extériorisés, auto-évaluation, âge scolaire.
LINARES, T, J., SINGER, L.T., KIRCHNER, H.L., SHORT, E.J., MIN. M.O., HUSSEY, P., MINNES. S. (2006). Mental Health Outcomes of Cocaine-exposed Children at 6 Years of Age. Journal of Paediatric Psychology, 31, (1), 85-97.
OBJECTIVE: To assess 6-year-old cocaine- and noncocaine-exposed children's mental health outcomes controlling for potential confounders. METHODS: The sample consisted of 322 children [169 cocaine exposed (CE) and 153 noncocaine exposed (NCE)] enrolled in a longitudinal study since birth. At age 6, children were assessed for mental health symptoms using the Dominic Interactive (DI), a child self-report measure, and the Child Behavior Checklist (CBCL), a caregiver report of behavioral problems. RESULTS: CE children were more likely to self-report symptoms in the probable clinical range for oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). In contrast, prenatal cocaine exposure was not related to child behavior based on the CBCL. After control for exposure, CE children in adoptive or foster care were rated as having more problems with aggression, externalizing behaviors, and total behavioral problems than NCE children and CE children in maternal or relative care. Also, CE children in adoptive or foster care self-reported more externalizing symptoms than CE children in maternal or relative care and NCE children. Findings could not be attributed to caregiver intelligence or depressive symptoms, or to the quality of the home environment. CONCLUSIONS: CE children report more symptoms of ODD and ADHD than nonexposed children. Adoptive or foster caregivers rated their CE children as having more behavioral problems than did maternal or relative caregivers of CE children or parents of NCE children. Although further studies are needed to understand the basis for the more negative ratings by adoptive or foster caregivers of their CE children, the self-report of CE children indicates a need for psychological interventions.
MOORE, MELISA M.A.; RUSS, SANDRA W. Ph.D. (2006) Pretend Play as a Resource for Children: Implications for Pediatricians and Health Professionals. Journal of Developmental & Behavioral Pediatrics, 27: 237-248
COSTELLO, E.J., EGGER, H., ANGOLD, A. (2005). 10-Year research Update Review: The Epidemiology of Child and Adolescent Psychiatric Disorders: I. Methods and Public Health Burden. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 972-986.
DUGRÉ, S., TRUDEL, M. (2005). Suivi longitudinal de profils d'adaptation en santé mentale chez des élèves de niveau primaire. Canadian Journal of Education, 28, 24-51.
ARSENEAULT, L., KIM-COHEN, J., TAYLOR, A., CASPI, A., MOFFITT, T.E. (2005). Psychometric Evaluation of 5- and 7-Year-Old Children Self-Report of Conduct Problems. Journal of Abnormal Child Psychology, 33, 537-550.
DÉRY, M., TOUPIN, J., PAUZÉ, R., VERLAAN, P. (2004) Frequency of mental health disorders in a sample of elementary school students receiving special education services for behavioural difficulties, Canadian Journal of Psychiatry, 49, 769-775
Objective: Despite being essential for defining and planning special educational services, very few data are available in Quebec regarding the nature and extent of behavioural difficulties presented by children who receive special educational services at school. This study provides a picture of the frequency of disruptive behaviour disorders (that is, attention deficit hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], and conduct disorder [CD]) and internalized disorders (including generalized anxiety disorder [GAD] and major depressive episode [MDE]) in a sample of elementary school students receiving special educational services for behavioural difficulties (n = 324).
Method: In this descriptive study, we established the presence of mental health disorders according to teacher-, parent-, and child-reported data that were obtained using structured diagnostic interviews based on DSM-IV criteria. We also examined prevalence rates by sex and age group.
Results: Three-quarters of the students met the criteria for ADHD, one-half for ODD, and one-third for CD. About 14% of the students presented with a GAD or met the criteria for an MDE in the past year. Only 2% of the students presented with an internalized disorder without a comorbid disruptive behaviour disorder.
Conclusions: Our results suggest that among students receiving special educational services for behavioural difficulties, a large proportion may have difficulties severe enough to meet the criteria for at least one DSM-IV disruptive behaviour disorder. Such findings may underscore the need to develop more collaboration between the mental health and education.
EDERER, E.M., (2004) Mental health problems in young children: self-reports and significant others as informants. Psychology Science, 46, supp.1, 123-140
Although children may be the best source of information regarding their feelings and self-perceptions, there are severe limitations to self-report measures especially for young children. Therefore, it is advisable to complement the self-reports by information by parents and teachers. This research aims at the connection between the self-reports of children on different mental health measures including aspects of social integration and the reports of parents and teachers on mental health symptoms of children using the same or similar measures. In this context it is also investigated whether the use of recently developed pictorial self-report questionnaires effects the correspondence between the self-reports of children and the reports of parents and teachers. The following measures were administered to a sample of young school children and a sample of preschool children, their parents and/or their teachers: Pre-school Symptom Self-Report (PRESS) (Martini), TONI (Valla), Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (Harter & Pike) in its German version by Asendorpf & van Aken, all three cartoon-like questionnaires of mental health aspects; Depression Test for Children (DTK) (Rossmann); and the Children’s Depression Scale for Classrooms (CDRSC) (Morris) for teachers. Although children as well as adults score consistently on different measures, there are almost no connections between the ratings of children and those of adults with regard to mental health. The results will be attributed to “informantvariability”. Implications for therapeutic approaches will be discussed.
KEY WORDS: Mental health in young children, self-, parent- and teacher-reports, pictorial tests
CALINOIU, I., MCCLELLAN, J., (2004). Diagnostic interviews. "http://www.springerlink.com/content/120650/?p=3adce44dee514189b40a8ac512c95390&pi=0" Current Psychiatry Reports, 6, 2.
This review addresses issues related to the use of structured psychiatric diagnostic interviews in children and adolescents. Structured diagnostic interviews improve the diagnostic process by better organizing the collection of clinical data and eliminating biases when applying diagnostic criteria. Available interviews generally fall into two categories. Highly structured (or respondent-based) measures use a set script and record subject’s responses without interpretation. Thus, they are useful for epidemiologic surveys or other settings in which nonclinical interviewers are used. Semistructured (or interviewer-based) tools allow clinical interpretation of responses as well as the incorporation of other sources of information, thereby making them more relevant for clinicians. Structured diagnostic instruments are currently most often used in research settings, but potentially are useful for clinical settings as well. This review also addresses challenges in psychiatric diagnosis, a brief history of diagnostic standards, and the potential limitations/advantages of using structured dignostic interviews.
EDERER, E. M. (2003). Mental health problems in young children: Self-reports and significant others as informants. Psychology Science, 45, Supplement 5, 123-140.
EDERER, E. (2003). Children's behavioral and emotional problems from the perspective of children and adults. Psychologie in Österreich, 2003 (2-3), 21.
IALONGO, NS, EDELSOHN, G, KELLAN, SG (2001). A further look at the prognostic power of young children's reports of depressed mood and feelings, Child Development, 72, 736-747.
A primary objective of the present study was to determine the validity of first graders' self-reports of depressed mood and feelings. To that end, the prognostic power of first grade self-reports of depressed mood and feelings was examined with respect to later psychopathology and adaptive functioning in a population of urban school children (N = 946). First grade self-reports of depressed mood predicted later child academic functioning, the need for and use of mental health services, suicidal ideation, and a diagnosis of major depressive disorder by age 14. The prognostic power of these early self-reports suggests that children as young as 5 or 6 years of age are capable of providing valid reports of depressed mood and feelings.
REBOK, G, RILEY, A, FORREST, C, STARFIELD, B, GREEN, B, ROBERTSON, J, TAMBOR, E (2001). Elementary school-aged children's reports of their health: A cognitive interviewing study, Quality of Life Research, 10, 59-70.
There are no standard methods for assessing the quality of young children's perceptions of their health and well-being and their ability to comprehend the tasks involved in reporting their health. This research involved three cross-sectional studies using cognitive interviews of 5-11-year-old children (N = 114) to determine their ability to respond to various presentations of pictorially illustrated questions about their health. The samples had a predominance of children in the 5-7-year-old range and families of lower and middle socio-economic status. The research questions in Study 1 involved children's ability to convert their health experiences into scaled responses and relate them to illustrated items (n = 35); Study 2 focused on the type of response format most effectively used by children (n = 19); and Study 3 involved testing children's understanding of health-related terms and use of a specific recall period (n = 60). The results of Study 1 showed that children identified with the cartoon drawing of a child depicted in the illustrated items, typically responding that the child was at or near their own age and of the same gender, with no differences related to race. Study 2 results indicated that children responded effectively to circles of graduated sizes to indicate their response and preferred them to same- size circles or a visual analogue scale. Tests of three-, four-, and five-point response formats demonstrated that children could use them all without confusion. In Study 3, expected age-related differences in understanding were obtained. In fact, the 5-year-old children were unable to understand a sufficient number of items to adequately describe their health. Virtually all children 8 years of age and older were able to fully understand the key terms and presentation of items, used the full five- point range of response options, and accurately used a 4-week recall period. Six- and seven-year-olds were more likely than older children to use only the extreme and middle responses on a five-point scale. No pattern of gender differences in understanding or in use of response options was found. We conclude that children as young as eight are able to report on all aspects of their health experiences and can use a five-point response format. Children aged 6-7 had difficulty with some health-related terms and tended to use extreme responses, but they understood the basic task requirements and were able to report on their health experiences. These results provide the guidance needed to develop and test a pediatric health status questionnaire for children 6-11 years old.
STEIN, BD, ZIMA, BT, ELLIOTT, MN, BURNAM, MA, SHAHINFAR, A, FOX, NA, LEAVITT, LA (2001). Violence exposure among school-age children in foster care: Relationship to distress symptoms, Journal of the American Academy of Child and Adolescent Psychiatry, 40, 588-594.
To describe the amount and nature of violence exposure and examine the relationship between violence exposure and distress symptoms among children in foster care. Method: Violence exposure and distress symptoms were evaluated in interviews, conducted between July 1996 and March 1998, of 300 children from Los Angeles County living in out-of-home placement. Results: Interviews were successfully completed in 91% of eligible children. The majority of children (85%) reported having been a witness to violence, and 51% had been a victim of violence during their lifetime. Of these youths, 54% and 41%, respectively, reported having been exposed to such violence in the past 6 months. Girls, victims of assaultive violence and weapon related violence, and those reporting exposure to mild violence were more likely (p <.05) to have higher levels of distress symptoms than those without such characteristics, after age was controlled for. Conclusions: Children in foster care continue to have high levels of violence exposure, even after removal from their biological parents' home. The relationship between violence exposure and distress symptoms underscores the need for clinicians to inquire about multiple forms of violence exposure among children living in out-of-home placement.
WARREN, SL, DADSON, N (2001). Assessment of anxiety in young children, Current Opinion in Pediatrics, 13, 580-585.
Anxiety disorders are highly prevalent and disabling conditions that can be identified in young children. Observations of infant temperament and attachment relationships have shown that certain early infant behaviors can be linked to later anxiety disorders. Research involving play narrative stories, pictures, cartoons, and puppets has demonstrated preliminary validity for new assessment methods of young children. Preliminary studies also have been conducted with new questionnaires and diagnostic interviews, Additional research is needed to refine these methods and to develop new comprehensive measures that focus specifically on different aspects of anxiety in young children.
EDERER, E. M. (2001). CCC: Computer Comics for Children: Seelische Gesundheit von Schulkindern am Computer? Austria Innovativ. Das Magazin für Forschung - Technologie - Wirtschaft, 2001(2), 36.
VALLA, J.P., BERGERON, L. (2001). Population-based at-school strategies to improve child and adolescent mental health. Canadian Child Psychiatry Review,10(2), 24-26.
BERGERON, L, VALLA, JP, BRETON, JJ, GAUDET, N, BERTHIAUME, C, LAMBERT, J, ST GEORGES, M, SMOLLA, N (2000). Correlates of mental disorders in the Quebec general population of 6 to 14-year olds, Journal of Abnormal Child Psychology, 28, 47-62.
Previous epidemiological studies of correlates of child and adolescent mental disorders in the general population have focused more on child/adolescent and socioeconomic/sociodemographic characteristics than on family characteristics. Moreover, there are no generally accepted methods to analyze and interpret correlates. The purpose of the Quebec Child Mental Health Survey in this regard was twofold: (1) to identify correlates of DSM-III-R internalizing and externalizing disorders according to informant (youth, parent, teacher), for three age groups (6-8, 9-11, and 12-14 years), including relevant family characteristics not considered in previous studies; and (2) to interpret the relative importance of risk indicators by ranking correlates according to strength and consistency of association across age groups. Logistic regression models suggest the inconsistency of correlates across informants. The ranking of correlates reveals that individual and family characteristics make a more important contribution than do socioeconomic characteristics, thereby supporting the relevance of proximal variables in the development of psychopathology.
ERNST, M, COOKUS, BA, MORAVEC, BC (2000). Pictorial Instrument for Children and Adolescents (PICA-III-R), Journal of the American Academy of Child and Adolescent Psychiatry, 39, 94-99.
Objective: The Pictorial Instrument for Children and adolescents (PICA-III-R) is presented as part of a comprehensive review of the tools used to diagnose psychiatric disorders in children and adolescents. Method: The PICA-III-R's development, content, initial psychometric properties, and directions for use are described. Results: The PICA-III-R assesses all DSM-III-R Axis I psychiatric d disorders in children aged 6 to 16 years, categorically (diagnosis present or absent) and dimensionally (range of severity). It comprises 137 pictures organized in modules that cover 5 diagnostic categories, including disorders of anxiety, mood, psychosis, disruptive behavior, and substance abuse. Its initial psychometric properties are promising, with good internal consistency, significant discriminative power for diagnoses, and sensitivity to changes. Conclusions: Despite great interest expressed by child and adolescent psychiatrists, further testing has not been possible for practical reasons unrelated to the scientific Importance of such work. Although it needs to be modified to follow DSM-IV criteria, the PICA-III-R can be of significant help to child and adolescent psychiatrists, far clinical as well as research diagnostic purposes. In addition, it can be used for the assessment of non-English-speaking or hearing/speech-impaired children.
LEPINE, S, SMOLLA, N (2000). Ethical issues concerning participants in community surveys of child and adolescent mental disorders, Canadian Journal of Psychiatry-Revue Canadienne de Psychiatrie, 45, 48-54.
Objective: Considering that a literature review yielded limited information on ethical issues concerning participants in child and adolescent mental health community surveys, the authors identify and discuss some of these issues. Method: First, the authors present the ethical principles set forth by the National Council on Bioethics in Human Research (NCBHR) and evoked by the 1998 Tri-Council Policy Statement, underscoring their importance as guidelines for establishing ethical standards for research with children. Second, they describe the general objectives and currently preferred methods of child psychiatric surveys. Third, they discuss issues pertaining to the validity, and innocuousness of structured interview guides, the limitations of parental authorization and children's assent, and the complexity of clinical interventions based on ethical grounds. Conclusions: The authors emphasize the importance of developing empirical knowledge regarding the questions raised and bringing the social stakeholders concerned into the debate.
MCCLELLAN, JM, WERRY, JS (2000). Research psychiatric diagnostic interviews for children and adolescents Introduction, Journal of the American Academy of Child and Adolescent Psychiatry, 39, 19-27.
MURPHY, DA, MARELICH, WD, HOFFMAN, D (2000). Assessment of anxiety and depression in young children: Support for two separate constructs, Journal of Clinical Child Psychology, 29, 383-391
Validated the interrelatedness of depression and anxiety in young children by testing four latent factor models: dual construct, unrelated; dual construct, correlated; single construct; and second-order or higher order analysis to test that depression and anxiety are primary constructs under the higher order factor of general affective distress. Children (N = 86) were ages 6 to 11, with mothers who were HIV-symptomatic or diagnosed with AIDS. Depression and anxiety measures included the Children's Depression Inventory (Kovacs, 1992), selected items from the Dominic-R (Valla, Bergeron, Berube, Gaudet, & St-Georges, 1994), and the Revised Children's Manifest Anxiety, Scale (Reynolds & Richmond, 1985). Structural equation modeling was used to test the models. Model 2 (dual construct, correlated) fit the data better than did Models 1 and 3; results for the higher order model were identical to Model 2, suggesting the higher order model is equivalent to the dual-construct model.
REICH, W (2000). Diagnostic Interview for Children and Adolescents (DICA), Journal of the American Academy of Child and Adolescent Psychiatry, 39, 59-66,
Objective: To describe the evolution of the Diagnostic Interview for Children and Adolescents (DICA) as well as the goals of the instrument and the issues surrounding its use. Method: Administration procedures, psychometric properties, and comparisons with other measures are reviewed. Results: The DICA, once considered a structured interview, can now be used in a semistructured format. It displays good reliability and works well with younger children. Conclusion: The DICA is a useful measure for both research and clinical settings, and it provides a reliable tool for assessing psychiatric information in children and adolescents.
TOUPIN, J, DERY, M, PAUZE, R, MERCIER, H, FORTIN, L (2000). Cognitive and familial contributions to conduct disorder in children, Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 333-344.
Although young children with conduct disorder (CD) are suspected of having verbal and executive function deficits, most studies that investigated this hypothesis did not control for attention deficit hyperactivity disorder (ADHD). Furthermore, relatively little is known about the interaction between cognitive deficits and familial factors in explaining the onset and persistence of CD in children. The participants in this study were 57 children with CD and 35 controls aged 7 to 12 pears. At 1-year follow-up, 41 of the participants with CD were reassessed. Children with CD were found to be significantly impaired in four of five executive function measures after ADHD symptoms and socioeconomic status (SES) were controlled. Executive function test performance, number of ADHD symptoms. and familial characteristics (SES, parental punishment) together correctly classified 90 % of the participants. Only the number of ADHD symptoms was found to significantly improve prediction of CD I year later beyond that afforded by number of CD symptoms a year earlier. Findings indicate that children with CD and ADHD symptoms are especially at risk for persistent antisocial behaviour. Results also highlight the importance of treatment programs that cover both cognitive and familial aspects associated with CD.
ABLOW, JC, MEASELLE, JR, KRAEMER, HC, HARRINGTON, R, LUBY, J, SMIDER, N, DIERKER, L, CLARK, V, DUBICKA, B, HEFFELFINGER, A, ESSEX, MJ, KUPFER, DJ. (1999). The MacArthur three-city outcome study: Evaluating multi-informant measures of young children's symptomatology, Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1580-1590.
Objective: Three sites collaborated to evaluate the reliability and validity of 2 measures, developed in tandem to assess symptomatology and impairment in 4 to 8-year-old children: the Berkeley Puppet Interview Symptomatology Scales (BPI-S) and the Health and Behavior Questionnaire (HBQ). Method: In this case-control study, mothers, teachers, and children reported on multiple dimensions of children's mental health for 120 children (67 community and 53 clinic-referred children). Results: The BPI-S and the parent and teacher versions of the HBQ demonstrated strong test-retest reliability and discriminant validity on a majority of symptom scales. Medium to strong effect sizes (Cohen d) indicated that children in the clinic-referred group were viewed by all 3 informants as experiencing significantly higher levels of symptomatology than nonreferred, community children. Conclusion: The availability of a set of multi-informant instruments that are psychometrically sound, developed in tandem, and developmentally appropriate for young children will enhance researchers' ability to investigate and understand symptomatology or the emergence of symptomatology in middle childhood.
BRETON, JJ, BERGERON, L, VALLA, JP, BERTHIAUME, C, GAUDET, N, LAMBERT, J, ST-GEORGES, M, HOUDE, L, LEPINE, S (1999). Quebec Child Mental Health Survey: Prevalence of DSM-III-R mental health disorders, Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 375-384.
The Quebec Child Mental Health Survey (QCMHS) was conducted in 1992 on a representative sample of 2400 children and adolescents aged 6 to 14 years from throughout Quebec. Prevalences of nine Axis-I DSM-III-R (American Psychiatric Association, 1987) mental health disorders were calculated based on each informant (for 6-11-year-olds: child, parent, and teacher; for 12-14-year-olds: child and parent). Informant parallelism allows the classification of results of the demographic variables associated with disorders in the logistic regression models. This strategy applies to group variables (correlates of disorders) whereas informant agreement applies to individual diagnoses. Informant parallelism implies that results for two informants or more an in the same direction and significant. In the QCMHS, informant parallelism exists for disruptive disorders, i.e. in two ADHD regression models (child and parent) higher rates among boys and young children, and in three oppositional/conduct disorders regression models (child, parent, and teacher) higher rates among boys. No informant parallelism is observed in the logistic regression models for internalizing disorders, i.e. the patterns of association of demographic variables with anxiety and depressive disorders vary across informants. Urban-rural residence does not emerge as a significant variable in any of the logistic regression models. The overall 6-month prevalences reach 19.9 % according to the parent and 15.8 % according to the child. The implications of the results for policy makers and clinicians are discussed.
PAARDEKOOPER, B, DE JONG, JTVM, HERMANNS, JMA (1999). The psychological impact of war and the refugee situation on South Sudanese children in refugee camps in northern Uganda: An exploratory study, Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 529-536.
This paper presents the results of an exploratory study on the psychosocial effects of the war situation and subsequent flight on South Sudanese children who were compared to a group of Ugandan children who did not have these experiences of war and flight. In addition to the independent variables such as sociodemographic variables and traumatic events and daily life stress, the dependent variable psychological consequences- according to parents and children themselves-as well as the influence of the mediating factors of social support and coping behaviour are presented. Results showed that Sudanese refugee children had experienced significantly more traumatic events and suffered more daily hassles than the Ugandese comparison group. They were less satisfied with the social support they received. At the same time, they used more coping modes. Compared to Ugandan children, the Sudanese reported significantly more PTSD-like complaints, behavioural problems, and depressive symptoms.
RIEKERT, KA, WIENER, L, BATTLES, H (1999). Prediction of psychological distress in school-age children with HIV, Children's Health Care, 28, 201-220.
This study examined the level of psychological distress in 61 children with HIV ages 6 to 11. Three domains of child psychological distress were measured by both caregiver and child report: separation anxiety, generalized anxiety, and depression. Information about caregiver's psychological distress was also collected. Hierarchical multiple regression analyses were conducted to test the hypothesis that caregiver psychological distress would account for significant variance in child psychological distress beyond that accounted for by demographic and disease variables. This hypothesis was confirmed only for the caregiver's report of the child's psychological distress. The child's knowledge of his or her diagnosis affected both parent and child reports of the child's psychological distress.
STEIN, B, COMER, D, GARDNER, W, KELLEHER, K (1999). Prospective study of displaced children's symptoms in wartime Bosnia, Social Psychiatry and Psychiatric Epidemiology, 34, 464-469.
Background: This study examines the psychological symptoms of Bosnian children exposed to war and trauma, and detects changes in these symptoms over time. Method: A total of 147 displaced children residing in refugee centers in Bosnia completed self-report assessments of anxiety, depressive, and posttraumatic stress symptoms at two time points. Results: Symptoms of posttraumatic stress, anxiety and depression showed a greater decrease in boys relative to girls over time. Conclusion: Gender may be an important factor in the natural course of trauma-related symptoms among war traumatized children. Further research is needed to better understand the psychological effects of war trauma on children, and the natural course of posttraumatic symptoms, so as to improve interventions targeted to this vulnerable population.
BRETON, JJ, BERGERON, L, VALLA, JP, BERTHIAUME, C, ST-GEORGES, M (1998). Diagnostic interview schedule for children (DISC-2.25) in Quebec: Reliability findings in light of the MECA study, Journal of the American Academy of Child and Adolescent Psychiatry , 37, 1167-1174.
Objective: To examine the reliability of the French Diagnostic Interview Schedule for Children DISC-2.25) in Quebec in light of other DISC-2 studies conducted in the National Institute of Mental Health's Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. Method: Reliability was assessed for DSM-III-R disorders in a community sample comprising 260 parents of youths aged 6 to 14 years and 145 adolescents aged 12 to 14 years. The DISC was completed at home. The mean test-retest interval was 13.8 days for parents and 12.8 days for adolescents. Results: Parents' reports: Internal consistency was acceptable for a majority of disorders. The kappa coefficients were in the fair or good ranges except for depressive disorders and were higher for children than for adolescents, and intraclass correlations were higher than kappa coefficients. Adolescents' reports: Internal consistency was acceptable or nearly acceptable for a majority of disorders. The kappa coefficients were in the fair range, and intraclass correlations were higher than kappa coefficients. The kappa coefficients were significantly higher for the test-retest interval of 7 to 14 days than for 14 to 21 days for adolescents' reports of anxious disorders and internalizing disorders. Conclusion: The French DISC-2.25 shows acceptable internal consistency and fair to good test-retest reliability. Across DISC-2 studies, test-retest reliability of the parents' reports improved for anxiety and depressive disorders. Among sources of variation, studies on attributes of questions would be meaningful.
EDERER, EM (1998). Depressive symptoms in young children: Self-, parent- and teacher-reports, Studia Psychologica , 40, 95-106.
Although children may be the best source of information regarding their feelings and self-perceptions, there are severe limitations of self-report measures of depressive symptoms especially for preschool children. Obviously, it is necessary to complement such data by information on the behavior of the child in various social-environmental domains, as it is reflected in the views of parents and teachers. In this study, data regarding the signs of depression in young children were compared. The following measures were administered to a sample of 90 preschool children, their parents and teachers: The Preschool Symptom Self- Report (Martini, Strayhorn, Puig-Antich, 1987), a pictorial tool including a version for children as well as a version for parents; a rating scale for parents based on the Depression Test for Children (Rossmann, 1993); and a rating scale for preschool teachers adapted from the Children's Depression Scale for Classrooms (Morris, 1992). Empirical data with regard to the psychometric criteria of the measures are reported and the results concerning the low relationship between the child's reports on depressive symptoms and the reports of parents and teachers are discussed with respect to possible sources of informant variability.
PEREZ, RG, ASCASO, LE, MASSONS, JMD, CHAPARRO, NDO (1998). Characteristics of the subject and interview influencing the test-retest reliability of the diagnostic interview for children and adolescents revised, Journal of Child Psychology and Psychiatry and Allied Disciplines, 39, 963-972.
This paper reviews some of the characteristics of the informants as well as some of the attributes of the DICA-R interview that could influence the test-retest reliability in a sample of 109 psychiatric outpatients aged 7-17 years. Different regression models using reliability coefficients constructed from the kappa statistic were obtained. Of those characteristics evaluated in the children, a high level of psychological impairment proved to be significant when it came to predicting the lowest test-retest reliability of the answers; none of the subject-related characteristics were significant in the adolescent patient model. The attributes of the questions that proved to be significant when explaining the lower reliability obtained for the individual question in the children's model were the length of the questions (longest questions), the content (internalising), the presence of time concepts, comparison with the peer group, and the need to exercise judgement; in the adolescents' model, the significant attributes were found to be the internalising content, the presence of time concepts, evaluation concerning the impairment caused by the disorder, and the need to exercise judgement. In the group of children our results are in accordance with the original paper. Similar results were found with adolescents. These findings have implications for the development and revision of new interview schedules.
ROUSSEAU, C, DRAPEAU, A (1998). Parent-child agreement on refugee children's psychiatric symptoms: A transcultural perspective, Journal of the American Academy of Child and Adolescent Psychiatry, 37, 629-636.
Objective: To compare the types and rates of psychiatric symptoms of young Central American and Cambodian refugees, as reported by both parents and children, and to examine parent-child agreement in reporting symptoms. Method: Interviews were conducted with 123 children aged 8 to 12 years and 158 adolescents aged 12 to 16 years and their parents. Parents assessed psychiatric symptoms via the Child Behavior Checklist, the 8 to 12-year-olds responded to the Dominic, and the adolescents answered the Youth Self-Report. Means of Internalizing and Externalizing scores were compared on the basis of ethnic origin, parent's sex, and child's sex, as were the Spearman correlation coefficients of parents' and children's ratings. Results: The Cambodian parents reported few symptoms in their children, and the Central Americans reported almost as many symptoms as did parents in U.S. clinical samples. The Cambodian children reported less symptoms than the Central Americans, but the interethnic difference was not significant in the adolescents' self-reports. Parent-child agreement varied considerably by sex and ethnic origin of the informant. Conclusions: The results underscore the need to involve multiple informants in assessing psychiatric symptoms of refugee children in spite of the difficulties inherent in field research with this population. They also show that data on multiple informants gathered from Western samples are not universally valid.
PFEFFERBAUM, B (1997). Posttraumatic stress disorder in children: A review of the past 10 years, Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1503-1511.
Objective: To review current knowledge about the clinical presentation, assessment, and treatment of posttraumatic stress disorder (PTSD) in children. Method: The literature on PTSD in children is examined. Results: Over the past 10 years, PTSD has been described in children exposed to a variety of traumatic experiences. Little is known about the epidemiology of the disorder in children. Partial symptomatology and comorbidity are common. A variety of factors influence response to trauma and affect recovery. They include characteristics of the stressor and exposure to it; individual factors such as gender, age and developmental level, and psychiatric history; family characteristics; and cultural factors. Since the condition is likely to occur after disaster situations, much of the literature describes the child's response to disaster and interventions tend to include efforts within schools and/or communities. A number of clinical approaches have been used to treat the condition. Conclusions: While assessment has been studied extensively, the longitudinal course of PTSD and treatment effectiveness have not been. Biological correlates of the condition also warrant greater attention.
DONOVAN, DM (1997). The play therapy controversy, Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1322-1323.
GOTHELF, D, APTER, A, VANPRAAG, HM (1997). Measurement of aggression in psychiatric patients, Psychiatry Research, 71, 83-95.
This article analyzes, describes, and characterizes the methods used for measuring aggression in studies on psychiatric patients. The authors reviewed all studies published between 1985 and 1994 in seven major psychiatric journals and found 103 studies on adult aggression and 43 on childhood and adolescent aggression. Almost half (44.7%) of the adult studies and 23.3% of the child and adolescent studies did not use any structured instrument; the remainder used a total of 52 different instruments, indicating that the methodology in this area is not well established. The methods used for measuring aggression were mainly of three types: observational measures; self-report questionnaires; and structured chart reviews. Each of these tools is described herein, with special focus on reliability and validity. Overall the reliability of the various scales is high, but the empirical validity is rather poor. In choosing a suitable method for measuring aggression; researchers should take into account the direction of investigation (e.g. state vs. trait aggression, dynamic or biological aspects of aggression) and the target population. Practical suggestions in this regard are offered.
VOSTANIS, P, HAYES, M, DUFEU, M, WARREN, J (1997). Detection of behavioral and emotional problems in deaf children and adolescents: Comparison of two rating scales, Child Care Health and Development, 23, 233-246.
The aim of this study was to establish rates of behavioural and emotional problems, and of social maladjustment, in a population of deaf children, particularly in relation to different methods of communication. The parents of 84 children who attended two schools for the deaf took part. They completed the parents' checklist (PCL), a behaviour rating scale for deaf children, and the Child Behaviour Checklist (CBCL), a measure widely used in the general population. The two instruments were significantly correlated on the severity of behavioural and emotional problems, but their previously established cut-off scores detected different rates of possible clinical cases, i.e. children with mental health disorders. According to the CBCL, 40% of children were within the clinical range, and 82% were socially dysfunctional compared with the general population. The PCL identified a much higher percentage (77%) of caseness. Behavioural and emotional problems were significantly higher in Asian children. Although all subjects used sign language, the additional use of speech, which may indicate increased hearing ability, had a protective effect for adolescents. The findings are discussed in relation to the validation of the instruments and the development of intervention programs for deaf children.
LAURENDEAU, MC, PERREAULT, R (1997). Mental health prevention programs in Quebec: Overview of policies, structures and programs in mental health care, Canadian Psychology-Psychologie Canadienne, 38,13-24.
This study represents the Quebec contribution to a Canada-wide survey that sought to determine the status of mental health prevention programs as health services undergo major restructuring. Similar to the Canada-wide survey, data on prevention policies, resources and programs were collected from provincial authorities who were responsible for mental health promotion. Data were also obtained from regional health and social services boards (Regies regionales de la sante et des services sociaux) which were in the process of being formed and from other department which offered mental health services. Although the data support the vitality of prevention programs within government departments they also suggest that those prevention programs may need greater administrative structure and that there are gaps between government promises and commitments, notably with respect to ongoing financing for prevention programs.
ANGOLD, A, COSTELLO, EJ (1996). The relative diagnostic utility of child and parent reports of Oppositional Defiant Behaviors, International Journal of Methods In Psychiatric Research, 6, 253-259.
It has been suggested that parents are better reporters of oppositional defiant behaviors than are children themselves and that this may be a reason to ignore child reports in the assessment of Oppositional Defiant Disorder (ODD). Using data from the Great Smoky Mountains Study, a community study 1,015 of nine-, eleven-, and thirteen-year-old children, we found that, indeed, children on average reported lower frequencies of all oppositional defiant behaviors than their parents reported about them. However, their reports of such behaviors and psychosocial impairment had a substantial effect on the rate of oppositional defiant disorder (ODD). Where child reports were required for the DSM-IV criteria ODD criteria to be met, rates of several 'validity' criteria and measures of outcome one year later were as high as when parent reports alone were sufficient to make the diagnosis. We conclude that child self reports of oppositional defiant symptoms are an important part of the assessment of ODD in both research applications and clinical practice.
VILLENEUVE, C, BERUBE, H, OUELLET, R, DELORME, A (1996). Prevention concerning mental health: The adolescent's perspective, Canadian Journal of Psychiatry-Revue Canadienne de Psychiatrie, 41, 392-399.
Objective: To examine several subjective components of adolescents' behaviour concerning mental illness prevention. Method: Adolescents' knowledge, their attitudes and subjective norms, as well as their thoughts about how they would concretely handle a psychological problem were measured. A self-administered questionnaire was completed by 438 male and female adolescents in grades 8 and 11. Results: Gender and age differences were revealed: girls and older adolescents were more attuned to prevention. Further, the influence on young people of peers and parents was also apparent. Conclusion: Adolescents perceive prevention concerning mental health as important.
WARNER, BS, WEIST, MD (1996). Urban youth as witnesses to violence: Beginning assessment and treatment efforts, Journal of Youth and Adolescence, 25, 361-377.
This article reviews literature on witnessing violence (''covictimization'') in children and adolescents. As violent incidents have increased dramatically in urban areas, so has exposure by inner-city youth to violence in the home, school, and community. In reaction to witnessing violence, youth may present symptoms of Post-Traumatic Stress Disorder Separation Anxiety and Depression, evince disturbed grieving and bereavement, show a number of externalizing behaviors including aggressiveness, have impaired interpersonal and family relations, and show declines in academic performance. A number of factors may mediate the impact of violence exposure including age, gender and history of prior trauma. Mental health assessment and treatment efforts for youth who have witnessed violence have been limited. Directions for future investigation are highlighted.
OFFORD, DR (1995). Child psychiatric epidemiology - current status and future- prospects, Canadian Journal of Psychiatry-Revue Canadienne de Psychiatrie, 40, 284-288.
Objective: The purpose of this paper is to present selected findings from child psychiatric epidemiology in areas of prevalence and correlates and discuss issues in interpreting these data and their relevance. Method: Selected references were used; Results: Prevalence rates of I or more child psychiatric disorders in nonclinical community samples of children and adolescents vary between 17.6% and 22%. Issues in interpreting these data include: the boundary between normal and abnormal, boundary between disorders, disagreement among informants, and problems with instrumentation. Knowledge about the correlates of child psychiatric disorders is quite extensive, but information on causal factors is relatively sparse. Conclusions: Findings in child psychiatric epidemiology are relevant to clinicians, and future emphasis in the field will be on prospective studies with multiple waves of data from different domains including the child, the family, the school, and the wider community.
BRETON, JJ, BERGERON, L, VALLA, JP, LEPINE, S, HOUDE, L, GAUDET, N (1995). Do children aged 9 through 11 years understand the disc version-2.25 questions, Journal of the American Academy of Child and Adolescent Psychiatry, 34, 946-954.
Objective: To assess the understanding of Diagnostic Interview Schedule for Children-Version 2.25 (DISC-2.25) questions by children aged 9 through 11 years. Method: Two hundred forty children were recruited from four public schools. The cognitive appraisal of 280 questions from the most prevalent DSM-III-R diagnoses was evaluated. The collaboration of four children was necessary to cover one DISC. Sixty DISCs, evenly distributed according to age and sex, were completed. Two child psychiatrists evaluated the children's answers. Nonparametric tests were used to assess understanding of questions as a whole, of time concepts (overall, categories, number), and of questions based on the number of words. Results: Children aged 9, 10, and 11 years understood 38%, 38%, and 42% of the questions as a whole, respectively, and 26%, 24%, and 30% of the overall time concepts, respectively. The understanding rates of questions as a whole were significantly higher than those of overall time concepts. Durations were significantly better understood than periods and frequencies, and questions having one time component were significantly better grasped than those with two or more. Shorter questions were significantly better understood than longer ones. Conclusion: Although the DISC has been greatly improved since the initial version, the results suggest that additional revision is needed before clinicians or researchers use the DISC with younger children.
Prior to 1995
HAVENS, J.F., WHITAKER, A.H., FELDMAN, J.F., EHRHARDT, A.A. (1994). Psychiatric Morbidity in School-Age Children with Congenital Human Immunodeficiency Virus Infection : A Pilot Study. Developmental and Behavioral Pediatrics, 15, 18-25.
RICHTERS, JE, MARTINEZ, PE, (1993). Violent communities, family choices, and children's chances An algorithm for improving the odds, Development and Psychopathology, 5, 609-627.
Data are presented concerning the early predictors of adaptational success and failure among 72 children attending their Ist years of elementary school in a violent Washington, D.C., neighborhood. Adaptational failures were defined as those children who were doing poorly or failing in school and rated by their parents as suffering clinically significant levels of behavior problems. Adaptational successes were defined as children whose performance as students was rated in the average to excellent range and whose parent-rated levels of behavior problems were within the normal range. Despite the fact that these children were being raised in violent neighborhoods, had been exposed to relatively high levels of violence in the community, and were experiencing associated distress symptoms, community violence exposure levels were not predictive of adaptational failure or success. Instead, adaptational status was systematically related to characteristics of the children's homes. More specifically, the children's chances of adaptational failure rose dramatically as a function of living in unstable and/or unsafe homes. Moreover, it was not the mere accumulation of environmental adversities that gave rise to adaptational failure in these children. Rather, it was only when such adversities contaminated or eroded the stability and/or safety levels of the children's homes that the odds of their adaptational failure increased. We argue that this erosion of the quality of the child's microsystem (i.e., family) by adversities and pressures in the exosystem (i.e., community) is not an inevitable process. Although not yet well understood, it is a process over which families have and must exercise control. The implications of these data for improving children's chances of physical, psychological, and academic survival in violent neighborhoods are considered.
MARTINEZ, P, RICHTERS, JE (1993). The NIMH community violence project .2. Children's distress symptoms associated with violence exposure, Psychiatry-Interpersonal and Biological Processes, 56, 22-35.
The rising tide of violence in American cities has placed the causes and consequences of violence squarely on the public health agenda. The U.S. Government's Year 2000 National Health Promotion and Disease Prevention Objectives includes a full chapter devoted to violence issues and delineates a number of goals and programs aimed at reducing the number of deaths and injuries associated with violence (Public Health Service 1990). Notably absent from these objectives, however, is attention to the possible adverse psychological consequences of exposure to acute or chronic violence. Nonetheless, in light of numerous media reports of children's exposure to community violence and recent reports documenting high levels of exposure even among very young children (Richters and Martinez 1993), it is reasonable to question whether the risks of exposure extend beyond death and physical injury to psychological well-being.
BRETON, JJ, VALLA, JP, LAMBERT, J (1993). Industrial disaster and mental-health of children and their parents, Journal of the American Academy of Child and Adolescent Psychiatry, 32, 438-445.
Objective: We report the findings of research conducted a year after an industrial disaster (PCB fire), which occurred on Montreal's South Shore in 1988. A total of 1,663 families were evacuated for a period of 18 days. The study evaluated 174 children between the ages of three and eleven years: 87 in the exposed group and 87 in the control sample. Method: Structured questionnaires were administered to the children and their mothers and fathers during home visits. Results: Based on the responses of the children and the mothers, children aged 6 to 11 years displayed more overall internalized and post-traumatic stress disorder (PTSD) symptoms than did those in the control group. Conclusions: The study demonstrates that the mental health of fathers as well as mothers correlates with children's symptoms and that parents are able to accurately observe their child's reaction to a disaster.
BERGERON, L, VALLA, JP, BRETON, JJ (1992). Pilot-study for the Quebec child mental-health survey .1. Measurement of prevalence estimates among 6 to 14 year olds, Canadian Journal of Psychiatry-Revue Canadienne de Psychiatrie, 37, 374-380.
ROUSSEAU, C, CORIN, E, RENAUD, C (1989). Armed-conflict and trauma - A clinical-study on Latin-American refugee children, Canadian Journal of Psychiatry-Revue Canadienne de Psychiatrie, 34, 376-385.