Måleegenskaper ved den norske versjonen av Vineland Adaptive Behavior Scales - Second Edition (Vineland-II)

Beskrivelse. Vineland Adaptive Behavior Scales (Vineland ABS) er et meget brukt kartleggingsinstrument for vurdering av adaptiv atferd (daglige aktiviteter som kreves for å klare seg på egen hånd, personlig og sosialt). Instrumentet ble først publisert i 1984 i USA. Vineland-II er en omfattende revisjon, publisert 2005; skandinavisk tilpasning og normering 2011. NCS Pearson Inc. er rettighetshaver. Den skandinaviske Vineland-II er gitt ut i tre versjoner: et intervjuskjema og et spørreskjema for foreldre (foreldreskjema) med skandinaviske normer, og et lærerskjema. Adaptiv atferd vurderes innenfor fire brede domener (indekser) for aldersgruppen 2 - 21 år: kommunikasjon, dagliglivets ferdigheter, sosiale ferdigheter og motorikk (< 7 år). Funnene summeres til Generelle adaptive ferdigheter. Litteratursøk. Vårt systematiske søk etter dokumentasjon for måleegenskapene ved den norske versjonen av Vineland-II førte til 33 treff. Tre artikler ble hentet inn i fulltekst, bare en hadde benyttet Vineland-II, og relevante data ble ikke rapportert i artikkelen. Det er gjort en skandinavisk (svensk-dansk- norsk) normering av foreldreskjema, som rapporteres i manualen for Vineland-II. Psykometri. Vår vurdering av testens psykometriske egenskaper baserer seg på data fra manualen (en skandinavisk representativ tverrsnittsundersøkelse; N = 1673). Normdata rapporteres omfattende. Begrepsvaliditet støttes ved godt samsvar med etablerte diagnostiske systemer. Konfirmatoriske faktoranalyser viste en rimelig god tilpasning. Data fra en liten studie barn med autisme viste avvik som forventet. Intern konsistens og split-half reliabilitet var meget tilfredsstillende både for Generelle adaptive ferdigheter og indeksene (> 0,90, med unntak av motorikk for noen aldersgrupper). Konklusjon. Vineland-II er nylig publisert, og det foreligger ikke ennå relevante norske eller skandinaviske publikasjoner utover studien som er rapportert i manualen. Den skandinaviske utgaven har et godt normeringsgrunnlag, som brukes til en omfattende og systematisk resultatfremstilling for det enkelte barn som vurderes. Psykometriske analyser indikerer gode psykometriske egenskaper for foreldreskjema. Intervjuskjemaet som fylles ut av utreder tilsvarer foreldreskjema, men det er ikke dokumentert at normer og de psykometriske egenskapene for dette skjemaet er de samme som for foreldreskjemaet

Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study

Vitenskapelig, fagfellevurdert artikkelBackground: School drop-out is a problem all over the world with adverse life-course consequences. The aim of this paper is to study how internalising and externalising problems in the 10th grade are associated with non-completion of upper secondary school, and to examine the mediating role of grade points in the 10th grade across general academic and vocational tracks in upper secondary school. We also study the impact of health behaviour. Methods: Population-based health surveys were linked with Norwegian registries on education and sociodemographic factors (n = 10 931). Mental health was assessed by the self-report Strengths and Difficulties Questionnaire. Logistic regression was used to analyse the relations between mental health and health behaviour in 10th grade and non-completion of upper secondary school. The mediating effect of grade points was studied by causal mediation analysis. Results: Adolescents not completing upper secondary school reported more externalising problems and girls more internalising problems in the 10th grade, after adjustments. Smoking and physical inactivity increased the odds of non-completion of upper secondary school. Causal mediation analyses showed that a reduction in externalising problems of 10 percentage points led to lower rates of non-completion of 4–5 percentage points, and about three-quarters of this total effect was mediated by grades. For internalising problems the total effect was significant only for girls (1 percentage point), and the mediated effect of grades was about 30%. The effect of mental health problems on school dropout was mainly the same in both vocational and general tracks. Conclusions: Assuming a causal relationship from mental health problems to school performance, this study suggests that externalising problems impair educational attainment. A reduction of such problems may improve school performance, reduce school drop-out and reduce the adverse life-course consequences

Medical benefits in young adulthood: a population-based longitudinal study of health behaviour and mental health in adolescence and later receipt of medical benefits

Objectives To examine the extent to which smoking, alcohol, physical activity and mental health problems in 15–16-year-olds are associated with receipt of medical benefits in young adulthood, after adjustment for confounders. Design Prospective population-based cohort survey linked to national registers. Participants In the ‘Youth studies’ from the Norwegian Institute of Public Health, 15 966 10th graders in 6 Norwegian counties answered a health behaviour and mental health questionnaire; 88% were linked to National Insurance Administration Registers (FD-Trygd). Outcome measure Time to receipt of medical benefits, based on FD-Trygd. Follow-up was from age 18 years until participants were aged 22–26 years. Method We performed Cox regression analyses to examine the extent to which variations in health behaviour and mental health problems during 10th grade were associated with receipt of medical benefits during follow-up. Results Daily smoking at age 15–16 years was associated with a significant increase in hazard of receiving health benefits at follow-up compared with not smoking for boys, HR (95% CI) 1.56 (1.23 to 1.98), and for girls 1.47 (1.12 to 1.93). Physical activity was associated with a decrease in hazard compared with inactivity from 23% to 53% in boys and from 21% to 59% in girls, while use of alcohol showed a mixed pattern. The hazard for benefits use rose with increasing levels of emotional symptoms, peer problems, conduct problems and hyperactivity–inattention problems (Strengths and Difficulties Questionnaire) at 15–16 years among both genders. Conclusions Health behaviour and mental health problems in adolescence are independent risk factors for receipt of medical benefits in young adulthood

Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

<p>Abstract</p> <p>Background</p> <p>Several countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units.</p> <p>Methods</p> <p>We used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), which measures mental health problems and their severity. We collected also data about the diagnoses, suicidal problems, family situations, and the involvement of the Child Protection Service. Predictions of outcome (change in HoNOSCA <it>total score</it>) were analysed with a regression model.</p> <p>Results</p> <p>The sample comprised 192 adolescents admitted during one year (response rate 87%). Mean age was 15.7 years (range 10-18) and 70% were girls. Fifty-eight per cent had suicidal problems at intake and the mean <it>intake </it>HoNOSCA <it>total score </it>was 18.5 (SD 6.4). The largest groups of main diagnostic conditions were <it>affective </it>(28%) and <it>externalizing </it>(26%) <it>disorders</it>. Diagnoses and other patient characteristics at intake did not differ between units. Clinical psychiatric disorders and developmental disorders were associated with severity (on HoNOSCA) at intake but not with outcome. Of adolescents ≥ 16 years, 33% were compulsorily admitted. Median length of stay was 8.5 days and 75% of patients stayed less than a month. Compulsory admissions and length of stay varied between units. Mean change (improvement) in the HoNOSCA <it>total score </it>was 5.1 (SD 6.2), with considerable variation between units. Mean discharge score was close to the often-reported outpatient level, and <it>self-injury </it>and <it>emotional symptoms </it>were the most reduced symptoms during the stay. In a regression model, unit, high HoNOSCA <it>total score </it>at intake, or involvement of the Child Protection Service predicted improvement during admission.</p> <p>Conclusions</p> <p>Acute psychiatric in-patient units for adolescents effectively meet important needs for young people with suicidal risks or other severe mental health problems. These units may act in suicide prevention, stabilizing symptom severity at a lower level within a short stay. It is important to explore the differences in outcome, compulsory admissions, and length of stay between units.</p

Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors

<p>Abstract</p> <p>Background</p> <p>Discrepancies between parents and children in their assessment of children's mental health affect the evaluation of need for services and must be taken seriously. This article presents the differences between parents' and children's reports of the children's symptoms and social impairment, based on the results of the Strengths and Difficulties Questionnaire (SDQ). The interrelationship between relational aspects and socio-demographic factors with patterns of disagreement are explored.</p> <p>Methods</p> <p>Differences in the prevalence and means of SDQ symptom and impact scores were obtained from 8,154 primary school children, aged between 10 and 13 years, and their parents. Agreement between matched pairs was measured using Pearson's and Spearman's rho correlations. Socio-demographic variables, communication patterns and parental engagement were analysed as possible correlates of informant discrepancies using bivariate and multivariate logistic regression models.</p> <p>Results</p> <p>In general, although children reported more symptoms, they reported less impact of perceived difficulties than parents. The parents were more consistent in their evaluation of symptoms and impact than were the children. Exploration of highly discrepant subgroups showed that, when children reported the most symptoms and impact, qualitative aspects of the parent-child relationship and family structure seemed to be more powerful predictors of disagreement than were gender of the child and socio-demographic variables. When parents reported the most symptoms and impact, low parental educational level, low income and male gender of the child played an additional role.</p> <p>Conclusions</p> <p>Our findings underline the importance of paying attention to child reports of emotional-behavioural difficulties, particularly when parents do not identify these problems. Considerations on what meaning parent-child discrepancy might have in the context of the parent-child relationship or the family's psychosocial status should be integrated in the overall understanding of the child's situation and subsequent recommendations.</p

Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway

BACKGROUND: Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year. METHODS: This population-based cross-sectional study included all 10(th)-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity. RESULTS: The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p < 0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p < 0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p < 0.05). CONCLUSION: In adolescents from a multicultural city in Norway, relative age within a school year significantly influenced academic performance. In contrast to data from Great Britain, relative age within a school year was not an important risk factor for mental health problems in adolescents in Oslo

Clinician-rated mental health in outpatient child and adolescent mental health services: associations with parent, teacher and adolescent ratings

<p>Abstract</p> <p>Background</p> <p>Clinician-rated measures are used extensively in child and adolescent mental health services (CAMHS). The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) is a short clinician-rated measure developed for ordinary clinical practice, with increasing use internationally. Several studies have investigated its psychometric properties, but there are few data on its correspondence with other methods, rated by other informants. We compared the HoNOSCA with the well-established Achenbach System of Empirically Based Assessment (ASEBA) questionnaires: the Child Behavior Checklist (CBCL), the Teacher's Report Form (TRF), and the Youth Self-Report (YSR).</p> <p>Methods</p> <p>Data on 153 patients aged 6-17 years at seven outpatient CAMHS clinics in Norway were analysed. Clinicians completed the HoNOSCA, whereas parents, teachers, and adolescents filled in the ASEBA forms. HoNOSCA <it>total score </it>and nine of its scales were compared with similar ASEBA scales. With a multiple regression model, we investigated how the ASEBA ratings predicted the clinician-rated HoNOSCA and whether the different informants' scores made any unique contribution to the prediction of the HoNOSCA scales.</p> <p>Results</p> <p>We found moderate correlations between the total problems rated by the clinicians (HoNOSCA) and by the other informants (ASEBA) and good correspondence between eight of the nine HoNOSCA scales and the similar ASEBA scales. The exception was HoNOSCA scale 8 <it>psychosomatic symptoms </it>compared with the ASEBA s<it>omatic problems </it>scale. In the regression analyses, the CBCL and TRF <it>total problems </it>scores together explained 27% of the variance in the HoNOSCA <it>total scores </it>(23% for the age group 11-17 years, also including the YSR). The CBCL provided unique information for the prediction of the HoNOSCA <it>total score</it>, HoNOSCA scale 1 <it>aggressive behaviour</it>, HoNOSCA scale 2 <it>overactivity or attention problems</it>, HoNOSCA scale 9 <it>emotional symptoms</it>, and HoNOSCA scale 10 <it>peer problems; </it>the TRF for all these except HoNOSCA scale 9 <it>emotional symptoms; </it>and the YSR for HoNOSCA scale 9 <it>emotional symptoms </it>only.</p> <p>Conclusion</p> <p>This study supports the concurrent validity of the HoNOSCA. It also demonstrates that parents, teachers and adolescents all contribute unique information in relation to the clinician-rated HoNOSCA, indicating that the HoNOSCA ratings reflect unique perspectives from multiple informants.</p

The association between weekly hours of physical activity and mental health: A three-year follow-up study of 15–16-year-old students in the city of Oslo, Norway

<p>Abstract</p> <p>Background</p> <p>Mental health problems are a worldwide public health burden. The literature concerning the mental health benefits from physical activity among adults has grown. Adolescents are less studied, and especially longitudinal studies are lacking. This paper investigates the associations between weekly hours of physical activity at age 15–16 and mental health three years later.</p> <p>Methods</p> <p>Longitudinal self-reported health survey. The baseline study consisted of participants from the youth section of the Oslo Health Study, carried out in schools in 2000–2001 (<it>n </it>= 3811). The follow-up in 2003–2004 was conducted partly at school and partly through mail. A total of 2489 (1112 boys and 1377 girls) participated in the follow-up. Mental health was measured by the Strengths and Difficulties Questionnaire with an impact supplement. Physical activity was measured by a question on weekly hours of physical activity outside of school, defined as exertion 'to an extent that made you sweat and/or out of breath'. Adjustments were made for well-documented confounders and mental health at baseline.</p> <p>Results</p> <p>In boys, the number of hours spent on physical activity per week at age 15–16 was negatively associated with emotional symptoms [B (95%CI) = -0.09 (-0.15, -0.03)] and peer problems [B (95%CI) = -0.08 (-0.14, -0.03)] at age 18–19 after adjustments. In girls, there were no significant differences in SDQ subscales at age 18–19 according to weekly hours of physical activity at age 15–16 after adjustments. Boys and girls with five to seven hours of physical activity per week at age 15–16 had the lowest mean scores for total difficulties and the lowest percentage with high impact score at age 18–19, but the differences were not statistically significant after adjustments.</p> <p>Conclusion</p> <p>Weekly hours of physical activity at age 15–16 years was weakly associated with mental health at three-year follow-up in boys. Results encourage a search for further knowledge about physical activity as a possible protective factor in relation to mental health problems in adolescence.</p

Måleegenskaper ved den norske versjonen av Strengths and Difficulties Questionnaire, foreldrerapport (SDQ-P)

Strengths and Difficulties Questionnaire (SDQ) er et sett spørreskjema for utfylling av foreldre, lærere og barn ≥ 11 år. SDQ ble opprinnelig utgitt på engelsk av Robert Goodman i 1997. I 1999 kom de norske versjonene, basert på en oversettelse og tilbakeoversettelse ved Einar Heiervang og kolleger. Robert Goodman eier rettighetene til testen. Foreldreversjonen (SDQ-P) har 25 ledd fordelt på fem delskalaer. Det er et skjema som skal fylles ut av foreldre for å kartlegge psykiske helse, vennerelasjoner og prososial atferd hos barn i alderen 4-17 år. Det tar noen få minutter å fylle ut. Forskere, klinikere og pedagoger kan administrere og tolke SDQ-P. Våre systematiske søk etter dokumentasjon for måleegenskapene ved den norske versjonen av SDQ-P førte til 408 unike treff, hvorav 66 publikasjoner fra 34 studier ble inkludert. I alt 35 av publikasjonene rapporterte fra store befolkningsstudier i Akershus, Bergen, Trondheim, Bodø, Østfold, Romsdal, Oslo og andre deler av landet. De store befolkningsstudiene bidro med regionale normdata for barn og ungdom i alderen 4-19 år. I tre av studiene undersøkte forskerne faktorstrukturen til SDQ-P, og fire studier og to delstudier rapporterte verdier for diagnostisk nøyaktighet. Gruppesammenlikninger mellom selekterte utvalg og referansegrupper belyste også validiteten ved instrumentet, spesielt resultater for ulike diagnostiske grupper. Tre studier undersøkte også samsvaret mellom SDQ-P-skårer og skårer på andre, tilsvarende instrumenter. Vi fant mål på indre konsistens (Cronbachs alfa) i 21 av de inkluderte artiklene. SDQ-P har regionale normdata, men nasjonale data mangler. Forventede gruppeforskjeller og konfirmatoriske faktoranalyser støtter opp under instrumentets begrepsvaliditet. Tre av skalaene hadde utilfredsstillende indre konsistens. Evnen til å fange opp barn med en psykiatrisk diagnose synes å være ganske god. Likevel er ikke den diagnostiske nøyaktighet så god at SDQ-P kan anbefales som universelt screening-instrument. Den norske versjonen av SDQ-P kan være egnet til å screene for psykiatriske diagnoser i selekterte utvalg med risiko for psykiske helseproblemer