Adequate screening of youngsters for depressive characteristics

Introduction. In order to set up an effective early-detection of depressive symptoms in youngsters, the current study aims to investigate whether two measure moments of the Children's Depression Inventory (CDI) improve screening and whether a multi-informant procedure is superior compared to a single-informant procedure thereby controlling for comorbid. symptoms. Method. Youngsters (10-15 years) filled in the CDI and an Anxiety Scale at Time 1 and the CDI and Youth Self Report one week later. Next, a structured clinical interview was administered. The Child Behaviour CheckList was filled in by the parents. Results. Two measure moments of the CDI are not more accurate in capturing disordered mood changes. Furthermore, parent reports were no significant contributor to the variance over and above the CDI. Discussion. A second moment does not increase screening accuracy. Further research on setting up an effective multistage screening procedure for depressive symptoms for youngsters is however necessary

Comparing the Diagnostic Accuracy of Five Instruments for Detecting Posttraumatic Stress Disorder in Youth

To compare diagnostic accuracy of five posttraumatic stress disorder (PTSD) measures in a large outpatient sample of youths aged 11 to 18 years

The predictive validity of parent and teacher reports of ADHD symptoms

The objectives were to evaluate the ability of the Inattention and Hyperactivity-Impulsivity factors of the ADHD Rating Scale-IV to differentiate children with ADHD from a control group and to discriminate children with different subtypes of ADHD. Also, we sought to determine optimal cutoff scores on the teacher and parent versions of this scale for making diagnostic decisions about ADHD. In a sample of 92 boys and girls 6 to 14 years of age referred to a regional ADHD program, we assessed ADHD diagnostic status using categorical and dimensional approaches as well as parent- and teacher-report measures. Logistic regression analyses showed that the Inattention and Hyperactivity-Impulsivity factors of the ADHD Rating Scale-IV were effective in discriminating children with ADHD from a control group and differentiating children with ADHD, Combined Type from ADHD, Inattentive Type. Although both teacher and parent ratings were significantly predictive of diagnostic status, teacher ratings made a stronger contribution to the prediction of subtype membership. Using symptom utility estimates, optimal cutoff scores on the Inattention and Hyperactivity-Impulsivity scales for predicting subtypes of ADHD were determined

The predictive validity of parent and teacher reports of ADHD symptoms.

The objectives were to evaluate the ability of the Inattention and Hyperactivity-Impulsivity factors of the ADHD Rating Scale-IV to differentiate children with ADHD from a control group and to discriminate children with different subtypes of ADHD. Also, we sought to determine optimal cutoff scores on the teacher and parent versions of this scale for making diagnostic decisions about ADHD. In a sample of 92 boys and girls 6 to 14 years of age referred to a regional ADHD program, we assessed ADHD diagnostic status using categorical and dimensional approaches as well as parent- and teacher-report measures. Logistic regression analyses showed that the Inattention and Hyperactivity-Impulsivity factors of the ADHD Rating Scale-IV were effective in discriminating children with ADHD from a control group and differentiating children with ADHD, Combined Type from ADHD, Inattentive Type. Although both teacher and parent ratings were significantly predictive of diagnostic status, teacher ratings made a stronger contribution to the prediction of subtype membership. Using symptom utility estimates, optimal cutoff scores on the Inattention and Hyperactivity-Impulsivity scales for predicting subtypes of ADHD were determined

IMPROVING THE LONGITUDINAL ASSESSMENT OF ADHD IN PEDIATRICALLY AND PSYCHIATRICALLY REFERRED SAMPLES

The assessment and diagnostic process for Attention-Deficit/Hyperactivity Disorder (ADHD) is beset with complications relating to the subjectivity of symptom reporting, the nonspecific and dimensional nature of inattention, impulsivity, and hyperactivity, the high prevalence of psychiatric comorbidities, and the shifting expression of symptoms and impairment due to developmental changes from childhood to adolescence and adulthood. Actual diagnostic practices may also differ from recommended best practices. These challenges have led to the proliferation of several clinical guidelines, many of which recommend various diagnostic practices and assessment instruments. Nonetheless, relatively little is presently known about the diagnostic efficiency of these various instruments used in the diagnosis of ADHD at different developmental time points or about possible differences in ADHD presentations in pediatric versus psychiatric clinics. This study was designed to address these gaps in the ADHD knowledge base. Results of the present study suggest that clinicians should prioritize parent and clinician subjective rating scales over tests of academic achievement and neuropsychological functioning when diagnosing ADHD. Specifically, school and social functioning ratings emerged as measures with the strongest discriminatory properties. Results of this study also demonstrated that the diagnostic accuracy of the assessments were higher in pediatrically referred samples compared to psychiatrically referred samples, suggesting that there may indeed be subtle differences in the presentation of ADHD in pediatric versus psychiatric clinics, as well as differences in the comparison populations therein. The present study adds to the literature in helping clinicians in selecting the most diagnostically efficient assessment battery for ADHD across the different developmental time periods

Predictability of oppositional defiant disorder and symptom dimensions in children and adolescents with ADHD combined type

Background Oppositional defiant disorder (ODD) is frequently co-occurring with attention deficit hyperactivity disorder (ADHD) in children and adolescents. Because ODD is a precursor of later conduct disorder (CD) and affective disorders, early diagnostic identification is warranted. Furthermore, the predictability of three recently confirmed ODD dimensions (ODD-irritable, ODD-headstrong and ODD-hurtful) may assist clinical decision making. Method Receiver-operating characteristic (ROC) analysis was used in order to test the diagnostic accuracy of the Conners' Parent Rating Scale revised (CPRS-R) and the parent version of the Strength and Difficulties Questionnaire (PSDQ) in the prediction of ODD in a transnational sample of 1093 subjects aged 5-17 years from the International Multicentre ADHD Genetics study. In a second step, the prediction of three ODD dimensions by the same parent rating scales was assessed by backward linear regression analyses. Results ROC analyses showed adequate diagnostic accuracy of the CPRS-R and the PSDQ in predicting ODD in this ADHD sample. Furthermore, the three-dimensional structure of ODD was confirmed by confirmatory factor analysis and the CPRS-R emotional lability scale significantly predicted the ODD irritable dimension. Conclusions The PSDQ and the CPRS-R are both suitable screening instruments in the identification of ODD. The emotional lability scale of the CPRS-R is an adequate predictor of irritability in youth referred for ADH

Assessing ADHD symptoms in children and adults:Evaluating the role of objective measures

Background: Diagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Applying subjective measures always incorporates risks such as informant biases or large differences between ratings obtained from diverse sources. Furthermore, it has been demonstrated that ratings and tests seem to assess somewhat different constructs. The use of objective measures might thus yield valuable information for diagnosing ADHD. This study aims at evaluating the role of objective measures when trying to distinguish between individuals with ADHD and controls. Our sample consisted of children (n = 60) and adults (n = 76) diagnosed with ADHD and matched controls who completed self- and observer ratings as well as objective tasks. Diagnosis was primarily based on clinical interviews. A popular pattern recognition approach, support vector machines, was used to predict the diagnosis. Results: We observed relatively high accuracy of 79% (adults) and 78% (children) applying solely objective measures. Predicting an ADHD diagnosis using both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5%) and children (86.7%), with the subjective variables proving to be the most relevant. Conclusions: We argue that objective measures are more robust against rater bias and errors inherent in subjective measures and may be more replicable. Considering the high accuracy of objective measures only, we found in our study, we think that they should be incorporated in diagnostic procedures for assessing ADHD

Comparisons: BASC-2 Parent and Teacher Reports for Children on the DSM-5 Autism Spectrum

With the publication of the DSM-5, the diagnosis of Autism Spectrum Disorder (ASD) has been altered to follow a dimensional model that captures the essence of the autism spectrum. This new model features severity ratings of Social Communication (SC) and Restrictive/Repetitive Behaviors (RRB). Research indicates that there has also been a recent increase in the administration and adoption of broadband behavior-rating scales by clinicians, to ascertain a summary of the client’s behavior. A widely known and accepted measure is the Behavior Assessment System for Children, Second Edition (BASC-2), a multidimensional measure assessing internalizing and externalizing behaviors as well as adaptive functioning for individuals 2-25 years of age. Considerably less research has compared the Parent Rating Scale (PRS) and Teacher Rating Scale (TRS) of the BASC-2. The current study examined the PRS and TRS of the BASC-2 for children on the DSM-5 autism spectrum. Utilizing a sample of 67 children and adolescents with ASD, the PRS and TRS of the BASC-2 were compared to determine if a pattern of behavior exists for children and adolescents with ASD. Paired Sample T-tests were used to compare the BASC-2 Subscales scores on the PRS and TRS. Hierarchical linear regression analysis was conducted to determine the extent to which Parent and Teacher Ratings of logically selected BASC-2 Subscales account for the DSM-5 SC Severity Rating and RRB Severity Rating. Implications of these results for the assessment of children and adolescents with ASD are explained

Measurement quality of the Strengths and Difficulties Questionnaire for assessing psychosocial behaviour among Dutch adolescents

Approximately 15 to 25 percent of all adolescents experience psychosocial problems. The Strengths and Difficulties Questionnaire (SDQ) is widely used to screen for such problems. The studies in this dissertation provide insight into how useful the self-reported and parent-reported SDQ versions are among Dutch 12- to 17-year-olds in child and adolescent (mental) healthcare (Dutch: Jeugdgezondheidszorg, Jeugd Geestelijke Gezondheidszorg). The scales, especially of the parent-reported SDQ version, are useful for distinguishing between adolescents with psychosocial problems and those without such problems. Additionally, both SDQ versions, especially the parent-reported version, are useful for providing a preliminary indication of the type of psychosocial problems at hand (Anxiety/Mood disorder, Conduct/Oppositional Defiant Disorder, ADHD). The scales of the parent-reported version were also indicative of Autism Spectrum Disorders; the scales of the self-reported version were not. The use of the SDQ can be optimized by combining all scales of both SDQ versions into an SDQ profile. We found such profiles to be more useful for screening purposes than the so-called SDQ total difficulties scale was. In summary: The findings support the use of the SDQ among Dutch adolescents. Up until now, healthcare professional did not know if, and if so which, SDQ scales could be used for the benefit of adolescents. To inform them about the possibilities, and to help them interpret SDQ scale scores, a summary of the findings from this dissertation and new Dutch SDQ norms are presented in a manual that has been distributed among users of the SDQ (https://assets.ncj.nl/docs/a299fba5-d5e3-4c96-8d90-0605c185b0d9.pdf)

Anxiety in Children with Autism Spectrum Disorders: An Examination of Reporting Trends Among Children, Parents, and Teachers

Autism spectrum disorders (ASD) are characterized by impairments in reciprocal social skills, abnormal language development, and/or a restricted repertoire of behaviors and interests. Among individuals with ASDs, up to 84 percent are thought to have comorbid anxiety diagnoses, which can result in decreased social, emotional, behavioral, academic, and/or adaptive functioning. While differential diagnosis is necessary in order to create symptom-specific treatment protocols to address anxious symptoms, diagnostic decisions can be difficult for clinicians to make due to the common reliance on self-, parent- and teacher-report measures for collecting data. Based on theory, problems arise because deficits in the individual with ASD\u27s ability to understand and express their feelings, and deficits in the individual with ASD\u27s expressive and receptive language are sometimes thought to hinder their ability to self-report. Also, parent\u27s and teacher\u27s abilities to identify internalizing disorders through observed, externalized symptoms are sometimes questioned. In order to better understand the usefulness of self-, parent-, and teacher-reports for the purpose of improving the accuracy of symptom detection for individuals on the autism spectrum, self-, parent-, and teacher-report data was analyzed. Rrater groups were analyzed, including subjects with and without a comorbid anxiety diagnosis. Results indicated that child, parent, and teacher reports were not correlated. Scores reported by parents and teachers were significantly higher than those reported by children. Differences between raters were not influenced by whether or not the child was given an anxiety diagnosis. For children with ASD ages 6 to 16, age did not have a significant effect on the reporting trends of children, parents, and teachers. Additionally, age did not have a significant effect on scores of children with and without an anxiety diagnosis. When all three rater\u27s scores were factored into the prediction model, parent ratings were the only ratings to significantly improve the model. Parent\u27s scores most often predicted the presence of an Anxiety Disorder, NOS diagnosis, while teachers most often predicted the absence of an Anxiety Disorder, NOS diagnosis