Mental health screening and assessment tools for forcibly displaced children: a systematic review

Background: An unprecedentedly large number of people worldwide are forcibly displaced, of which more than 40 percent are under 18 years of age. Forcibly displaced children and youth have often been exposed to stressful life events and are therefore at increased risk of developing mental health issues. Hence, early screening and assessment for mental health problems is of great importance, as is research addressing this topic. However, there is a lack of evidence regarding the reliability and validity of mental health assessment tools for this population. Objective: The aim of the present study was to synthesise the existing evidence on psychometric properties of patient reported outcome measures [PROMs] for assessing the mental health of asylum-seeking, refugee and internally displaced children and youth. Method: Systematic searches of the literature were conducted in four electronic databases: MEDLINE, PsycINFO, Embase and Web of Science. The methodological quality of the studies was examined using the COSMIN Risk of Bias checklist. Furthermore, the COSMIN criteria for good measurement properties were used to evaluate the quality of the outcome measures. Results: The search yielded 4842 articles, of which 27 met eligibility criteria. The reliability, internal consistency, structural validity, hypotheses testing and criterion validity of 28 PROMs were evaluated. Conclusion: Based on the results with regard to validity and reliability, as well as feasibility, we recommend the use of several instruments to measure emotional and behavioural problems, PTSD symptoms, anxiety and depression in forcibly displaced children and youth. However, despite a call for more research on the psychometric properties of mental health assessment tools for forcibly displaced children and youth, there is still a lack of studies conducted on this topic. More research is needed in order to establish cross-cultural validity of mental health assessment tools and to provide optimal cut-off scores for this population. HIGHLIGHTS Research on the psychometric properties of mental health screening and assessment tools for forcibly displaced children and youth is slowly increasing. However, based on the current evidence on the validity and reliability of screening and assessment tools for forcibly displaced children, we are not able to recommend a core set of instruments. Instead, we provide suggestions for best practice. More research of sufficient quality is important in order to establish crsoss-cultural validity and to provide optimal cut-off scores in mental health screening and assessment tools for different populations of forcibly displaced children and youth

Internal structure and reliability of the Attachment Insecurity Screening Inventory (AISI) for children age 6 to 12

Abstract Background The aim of the present study was to examine the internal structure and reliability of the Attachment Insecurity Screening Inventory (AISI) 6–12. The AISI 6–12 years is a parent-report questionnaire for assessing the parents’ perspective on the quality of the attachment relationship with their child aged between 6 and 12 years. Methods The sample consisted of 681 mothers and fathers reporting on 372 children (72.3% adoption parents, 14.9% non-biological primary care takers including foster parents, and 12.8% biological parents). The internal structure was assessed with multilevel confirmatory factor analyses (CFA) and the reliability of the scores with Cronbach’s and ordinal alphas. Results Multilevel CFA confirmed a three-factor model of avoidant, ambivalent/resistant and disorganized attachment. Multi-group CFA indicated full configural and metric measurement invariance, and partial scalar and strict measurement invariance across mothers and fathers. Reliability coefficients were found to be sufficient. Conclusions This study showed the potential of using parental reports in the initial screening of attachment related problems, especially considering the practical approach of parental reports. However, further development of the AISI 6–12 years seems important to increase the validity of the AISI 6–12 years. In addition, future studies are necessary to replicate the current findings, and to strengthen the evidence that the AISI 6–12 years is appropriate for the use in middle childhood and validly assesses the parents’ perspective on attachment insecurities in their child

Age-related characteristics of outpatients with anxiety disorders: the Leiden routine outcome monitoring study

Objective: It has been hypothesised that clinically important age-related differences between adults with anxiety disorders exist; this study aims to elucidate these differences. Methods: We analysed data from 1950 outpatients diagnosed with DSM-IV-TR anxiety disorders treated at a Dutch hospital or affiliated mental healthcare centres. Three age-groups (young- (18–25; n = 435), mid- (26–40; n = 788) and older adult (41–65; n = 727)) were compared with regard to social demographic characteristics, diagnostic characteristics, anxiety symptom profile, general psychiatric symptom profile and generic health status, in addition, linear analyses were carried out with age as a continuous variable. Results: Average age was 36.48 years (SD 11.71), 62.8% were female. Significant associations with age emerged for gender, employment, education level, living situation, observed depression, agoraphobia (AP), social phobia, aches and pains, inner tension, sleep, interpersonal sensitivity, observed hostility, physical functioning, role limitations due to physical problems, vitality and bodily pain in categorical and continuous analyses. Self reported hostility was only significant in group-wise comparisons; role limitations due to emotional problems were only significant in linear analyses (all at p < .001). Conclusions: This study identified clinically relevant differences between younger and older adult outpatients with anxiety disorders. Clinicians should take these findings into account, as they may support treatment

Routine outcome monitoring en benchmarking: Hoe kunnen we behandelresultaten op een zorgvuldige manier vergelijken?

BACKGROUND: The structural measurement of the results of treatment under the Dutch mental health services and a comparison of these results between mental health centres help to provide insight into the effectiveness of treatment in general practice. AIM: To provide an overview of the issues that require attention when the results of mental health centres are being compared. METHOD: Documentation, policy information and practical experience with routine outcome monitoring were analysed. RESULTS: We describe the problems that can arise when results obtained by mental health centres are compared and we suggest some solutions for these problems. Important/actors that have emerged from our study are as follows: working with routine outcome monitoring is a process of naturalgrowth and involves experiences with several solutions and the making of definitive choices on the basis of experience. CONCLUSION: It is instructive to compare mental health centres with each other and with regards to so-called 'best practices' (benchmarking). However, mental health centres draw on a differing wide mix of patients and use different measurement procedures and instruments. In this article we express the view that in the near future it should be possible to draw meaningful comparisons

Self-efficacy and emotional adjustment as precursors of smoking in early adolescence

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