De toekomst van het kind

Rede uitgesproken bij de aanvaarding van het ambt van gewoon hoogleraar in de Kinder-en Jeugdpsychiatrie aan de Erasmus Universiteit Rotterdam op donderdag, 5 november 198

Bullying and Victimization in Elementary Schools: A Comparison of Bullies, Victims, Bully/Victims, and Uninvolved Preadolescents

Research on bullying and victimization largely rests on univariate analyses and on reports from a single informant. Researchers may thus know too little about the simultaneous effects of various independent and dependent variables, and their research may be biased by shared method variance. The database for this Dutch study was large (N = 1,065) and rich enough to allow multivariate analysis and multisource information. In addition, the effect of familial vulnerability for internalizing and externalizing disorders was studied. Gender, aggressiveness, isolation, and dislikability were most strongly related to bullying and victimization. Among the many findings that deviated from or enhanced the univariate knowledge base were that not only victims and bully/victims but bullies as well were disliked and that parenting was unrelated to bullying and victimization once other factors were controlled.

Empirically based assessment and taxonomy of psychopathology: Cross-cultural applications. A review

This paper provides an overview of empirically based assessment and taxonomy, as illustrated by cross-cultural research on psychopathology. The empirically based approach uses standardized assessment procedures to score behavioral and emotional problems from which syndromes are derived by multivariate analyses. Items and syndromes are scored quantitatively to reflect the degree to which individuals manifest them, as reported by particular informants. Although the approach to assessing problems and to constructing taxonomic groupings differs from the ICD/DSM approach, there are no inherent contradictions between either their models for disorders nor the criterial features used to define disorders. Cross-cultural comparisons have yielded relatively small differences in problem rates and syndrome structure, plus considerable similarity in associations of problems with sex and SES, as well as similar correlations between reports by different types of informants. Research on variations in problems in relation to culture, sex, age, SES, and type of informant can contribute to improving both the ICD/DSM and empirically based approaches and to a more effective synthesis between them

Differential predictive value of parents' and teachers' reports of children's problem behaviors: A longitudinal study

This study investigated the prediction of signs of disturbance in 946 children originally aged 4 to 11 years from the general population across a 6-year period. Parents' and teachers' ratings obtained via the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) were tested as predictors of (a) academic problems, (b) school behavior problems, (c) receipt of mental health services, (d) child's need for professional help, (e) suicidal behavior, and (f) police contacts. Total problem scores in the deviant range on the CBCL or TRF were significantly associated with poor outcomes 6 years later. The combination of deviant scores on both the CBCL and TRF was a powerful predictor of poor outcomes with 56% of the girls, and 36% of the boys with total problem scores in the deviant range on both instruments maladjusted 6 years later. The CBCL syndromes Attention Problems and Delinquent Behavior, and the TRF syndromes Delinquent Behavior, Somatic Complaints, and Social Problems significantly predicted poor outcomes. Teachers' reports predicted poor outcomes equally well or even somewhat better than parents' reports. It is important to include teacher information in the diagnostic assessment of children

Pathways of self-reported problem behaviors from adolescence into adulthood

OBJECTIVE: The authors determined the impact of different pathways of psychopathological development on adult outcome in subjects followed from ages 11-18 to ages 21-28. METHOD: Problem behaviors of subjects from a general population sample were assessed through the Youth Self-Report and the Young Adult Self-Report given at four time points (1987, 1989, 1991, and 1997). In addition, DSM-IV diagnoses, information pertaining to signs of maladjustment, and measures of social functioning were obtained at the last assessment. On the basis of the self-report ratings, four contrasting developmental pathways of psychopathology were determined: persistent, decreasing, increasing, and consistently normal. RESULTS: Subjects whose overall level of psychopathology was persistent over time had a higher lifetime prevalence of DSM-IV diagnoses and a poorer general outcome in adulthood than did subjects whose level of psychopathology increased. Subjects whose level of psychopathology returned to normal after high levels of problems in adolescence were only slightly different in terms of outcome from subjects with consistently normal ratings. CONCLUSIONS: 1) People who showed high levels of problems in early adolescence but whose level of psychopathology diminished by adulthood seemed to be as healthy as people who never attained a serious level of psychopathology. 2) An ongoing devious pathway into adulthood had negative effects on many domains of functioning. These two findings are both powerful arguments for early intervention in adolescence

Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs

OBJECTIVE: The purpose of this study was to compare syndromes of parent-reported problems for children in 12 cultures. METHOD: Child Behavior Checklists were analyzed for 13,697 children and adolescents, ages 6 through 17 years, from general population samples in Australia, Belgium, China, Germany, Greece, Israel, Jamaica, the Netherlands, Puerto Rico, Sweden, Thailand, and the United States. RESULTS: Comparisons of nine cultures for subjects ages 6 through 17 gave medium effect sizes for cross-cultural variations in withdrawn and social problems and small effect sizes for somatic complaints, anxious/depressed, thought problems, attention problems, delinquent behavior, and aggressive behavior. Scores of Puerto Rican subjects were the highest, whereas Swedish subjects had the lowest scores on almost all syndromes. With great cross-cultural consistency, girls obtained higher scores than boys on somatic complaints and anxious/depressed but lower scores on attention problems, delinquent behavior, and aggressive behavior. Although remarkably consistent across cultures, the developmental trends differed according to syndrome. Comparison of the 12 cultures across ages 6 through 11 supported these results. CONCLUSIONS: Empirically based assessment in terms of Child Behavior Checklist syndromes permits comparisons of problems reported for children from diverse cultures

Childhood Internalizing and Externalizing Problems Predict the Onset of Clinical Panic Attacks over Adolescence: The TRAILS Study

Background: Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. Method: This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch longitudinal population cohort study (N = 1,584). Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR) and the parent-report Child Behavior Checklist (CBCL) at baseline (age 10-12). At age 18-20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI). We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10-20 years, using survival analysis in univariate and multivariate models. Results: There were N = 314 (19.8%) cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2%) who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, p<.05), and YSR Thought Problems (HR 1.15, p<.05) and Social Problems (HR 1.26, p<.01) predicted panic attack onset. Conclusion: Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence

Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: a 14-year follow-up during childhood, adolescence, and young adulthood

OBJECTIVE: The goal of this study was to predict the onset of mood and anxiety disorders from parent-reported emotional and behavioral problems in childhood across a 14-year period from childhood into young adulthood. METHOD: In 1983, parent reports of behavioral and emotional problems were obtained with the Child Behavior Checklist for children and adolescents 4-16 years of age from the Dutch general population. At follow-up 14 years later, lifetime mood and anxiety diagnoses were obtained by a standardized DSM-IV interview for 1,580 subjects. Cox proportional hazards models were used to predict the incidence of mood and anxiety disorders from childhood problems and demographic covariates. RESULTS: Mood disorders were significantly predicted by high scores on the anxious/depressed scale and on the internalizing composite (withdrawn, somatic complaints, and anxious/depressed). Anxiety disorders were significantly predicted by the social problems scale and the externalizing composite (delinquent behavior and aggressive behavior). Anxiety disorders predominantly started in childhood and early adolescence, whereas the incidence of mood disorders increased sharply in adolescence and young adulthood. CONCLUSIONS: These results suggest different developmental pathways for mood and anxiety disorders. The predictions based on problem behavior remained stable during the 14-year period across adolescence and young adulthood. The results therefore underline the importance of early intervention and prevention of behavioral and emotional problems in childhood