Behavioral and emotional problems of Algerian children and adolescents as reported by parents

Objective To determine the level of behavioral and emotional problems among a sample of Algerian children and adolescents aged 6–18 years living in Algiers. Methods A school-based sample of 1,405 children and adolescents was recruited; problems were assessed with the Child Behavior Checklist filled out by parents or surrogates. Results The scores varied with age, gender, and socioeconomic status (SES). Contrary to findings in other samples, most Problem scores increased with age. As found in many other cultures, girls scored higher than boys on the Internalizing scales, but lower on Externalizing scales. Youths from lower socioeconomic families tended to score higher on some Problem scales. But, above all, Algerian children and adolescents had raw scores on all Problem scales much higher than those yielded by most previous cross-cultural studies. Conclusions The high level of problems may be attributable to traumatic environmental factors (terrorism and natural catastrophes), but the lack of data from countries that have similar geographic and cultural environments makes it hard to exclude explanations based on cultural factors.     

Comparison of self-reported emotional and behavioral problems in Turkish immigrant,Dutch and Turkish adolescents

Abstract.Objective: The aim of this study was to compare self-reported emotional and behavioral problems for Turkish immigrant, native Dutch and native Turkish adolescents.Method: A total of 379 Turkish immigrant adolescents living in the Netherlands, and 1,039 Dutch adolescents from the general population completed the Dutch translation of the Youth Self-Report (YSR); 2,151 Turkish adolescents from the general population completed the Turkish translation of the YSR; parents of Turkish immigrant adolescents filled in the Turkish translation of the Child Behavior Checklist (CBCL/4–18).Results: Turkish immigrant adolescents scored themselves significantly higher than Dutch adolescents on five of the 11 YSR syndromes, most markedly on the Anxious/Depressed, Withdrawn and Internalizing scales. Dutch adolescents scored themselves higher than immigrant adolescents on the Somatic Complaints and Delinquent Behavior scales. Turkish immigrant adolescents scored themselves higher than Turkish adolescents on five of the 11 scales, most markedly on the Delinquent Behavior scale. Total problems scores for Turkish immigrant adolescents were higher than for Dutch and Turkish adolescents. Turkish immigrant adolescents scored themselves higher than their parents assessed them on seven of the 11 scales.Conclusion: Turkish immigrant adolescents reported more problems in comparison to their Dutch and native Turkish peers. Different patterns of parent-child interaction, family values and delay of Dutch language skills are considered to be responsible for these differences in scores.     

Ten-year time trends of psychopathology in Dutch children and adolescents: no evidence for strong trends

The 10-year time trends in competencies and problem scores in children and adolescents were assessed. Children and adolescents randomly selected from the Dutch general population in 1983 were assessed with the Child Behavior Checklist and the Teacher's Report Form. Their problem scores and competence scores were compared with those obtained by the same method 10 years later. No significant differences were found between the 1983 and 1993 total problem scores obtained from parents or teachers. On the level of problem items and scales, a few differences indicating an increase in problems were found. However, the magnitude of these differences was very small. Our results did not provide evidence for a clear secular increase in malfunctioning of Dutch children and adolescents.     

Adolescent depression and the Child Behavior Checklist

Using receiver operating characteristic methods, the authors planned to assess the diagnostic accuracy of a measure of depression extracted from the Child Behavior Checklist in a group of 667 referred adolescents with DSM-III diagnoses. This depression scale was based on a depression factor found by Nurcombe et al. in Child Behavior Checklists from adolescent inpatients. Receiver operating characteristic analysis showed that Child Behavior Checklist-Nurcombe scores were able to discriminate between subjects with and without major depression with an accuracy comparable to that reported for the Dexamethasone Suppression Test (area under the receiver operating characteristic curve = 0.78).     

Parent-reported competence and emotional and behavioral problems in Finnish adolescents

This study was part of an 8-year follow-up study of the Epidemiological Multicenter Child Psychiatric Study in Finland. The Child Behavior Checklists (CBCLs) were analyzed for 598 15- to 16-year-old adolescents living in the southwestern area of Finland in 1997. The internal consistency of the CBCL syndrome scales was adequate (the alpha coefficient ranged from 0.66 to 0.89). The CBCL scores differentiated between non-referred adolescents and adolescents who had been referred to the mental health service or had severe problems according to the parents. Boys had more externalizing problems than girls in the maladjustment group. Girls had more somatic symptoms in the maladjustment group than boys.     

Daily behavior ratings among child and adolescent inpatients: the abbreviated Child Behavior Rating Form

OBJECTIVE: Child and adolescent psychiatric inpatient facilities are in need of standardized behavior rating scales to assess continuous change in patient behaviors. This study used daily staff ratings to examine the factor structure and psychometric properties of an abbreviated version of the Child Behavior Rating Form (CBRF-A). METHOD: Three hundred eighty-seven inpatients, aged 3 to 17 years, were rated daily by unit staff. Subsamples of patients and/or their parents completed additional measures of behavior problems (Child Behavior Checklist, Functional Impairment Scale for Children and Adolescents) to assess the instrument's validity. RESULTS: Confirmatory factor analyses identified 5 behavior problem dimensions (Oppositionalism, Attention Problems, Overactivity, Withdrawal/Depression, and Anxiety), a second-order Externalizing dimension, and 2 positive behavior dimensions (Positive/Adaptive Social and Compliance/Self-Control). The scales were found to be internally consistent and showed expected age differences, and the scale factor structures were relatively stable over 1- and 2-week intervals. The scales correlated meaningfully with parent ratings of child behavior problems and functional impairment and were predictive of total hospital days. CONCLUSIONS: The psychometric properties of the CBRF-A appear adequate for daily inpatient rating; additional research is needed to determine the usefulness of the CBRF-A in assessing treatment and medication effects over the hospital stay.     

Parent-reported competence and emotional and behavioral problems in Finnish adolescents

This study was part of an 8-year follow-up study of the Epidemiological Multicenter Child Psychiatric Study in Finland. The Child Behavior Checklists (CBCLs) were analyzed for 598 15- to 16-year-old adolescents living in the southwestern area of Finland in 1997. The internal consistency of the CBCL syndrome scales was adequate (the alpha coefficient ranged from 0.66 to 0.89). The CBCL scores differentiated between non-referred adolescents and adolescents who had been referred to the mental health service or had severe problems according to the parents. Boys had more externalizing problems than girls in the maladjustment group. Girls had more somatic symptoms in the maladjustment group than boys.     

Treatment for Children with Reactive Attachment Disorder: Dyadic Developmental Psychotherapy

Dyadic Developmental Psychotherapy (DDP) is an approach to treating disorders of attachment based on attachment theory and research. Previously it was found that, one year after treatment ended, children who received DDP had clinically and statistically significant improvements while those in the control group did not. This study extends those results out to 4 years. The treatment group's scores on the Child Behavior Checklist (CBCL) remained in the normal range. The control group's scores on several scales worsened to a statistically significant degree, despite the fact that they received treatment from other providers during the intervening period, averaging 50 sessions.     

Exploring ADHD age-of-onset criterion in Brazilian adolescents

 Objective: To explore age-of-onset criterion for the diagnosis of attention–deficit hyperactivity disorder (ADHD) in a school sample of young Brazilian adolescents. Methods: 191 students aged 12 to 14 years were evaluated using DSM-IV ADHD criteria, measures of ADHD symptoms and global impairment. Results: Both adolescents with ADHD (n=30) and adolescents who fulfilled all DSM-IV ADHD criteria, except age of onset of impairment criterion (ADHD w/o age-of-onset, n=27) had significantly higher scores on Attention Problems, Delinquent and Aggressive Behavior scales of the Child Behavior Checklist (CBCL) and lower scores on the Child Global Assessment scale (CGAS) than non-ADHD adolescents (n=134). Adolescents with ADHD and youths with ADHD w/o age-of-onset did not differ significantly in any measure assessed. Conclusion: These results concur with recent literature proposing revision of the age-of-onset criterion for the diagnosis of ADHD. Accepted: 22 February 2000     

Competence, emotional and behavioural problems in Russian adolescents

Competence, emotional and behavioural problems were examined in 256 school-children, aged 13–17 years, in Novosibirsk, Russia, using the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and the Teacher's Report Form (TRF). The internal consistency of syndrome scales for all three instruments was generally adequate. Interrater agreements for the problem scales were higher for girls than for boys in all combinations of informants. These findings are discussed in terms of gender role development. Gender effects on the scales' scores were more numerous and stronger than age. No SES differences were found. Russian children reported more problems than children of other nationalities did. Compared with American children, Russians were lower on competencies and higher on Somatic complaints and self-reported behavioural problems. On competence scales, Russian children in an unselected sample scored themselves lower than American children in a clinical sample. It is supposed that low self-esteem may be the first effect of the unfavourable development in Russian adolescents. Accepted: 7 May 1999     

Agreement Between Chart Diagnoses and Standardized Instrument Ratings of Youth Psychopathology

Rating scales are useful for evidence-based assessment of youth psychopathology. However, it is not known whether these scales contribute information beyond that which clinicians gather without them. This study examined agreement between chart diagnoses and the Child Behavior Checklist (CBCL) for 82 community mental health clinic clients. Agreement was low, suggesting that the CBCL was not redundant with clinicians’ clinical impressions. These findings suggest that use of an instrument like the CBCL could potentially improve clinician diagnostic accuracy; future research should examine how best to utilize these scales in the diagnostic process and how to train clinicians in their use.     

Self-reports on mental health problems of youth with moderate to borderline intellectual disabilities

OBJECTIVE: To determine the extent to which the Youth Self-Report (YSR) can be used to assess emotional and behavioral problems in adolescents with intellectual disabilities (IDs). METHOD: In 2003, 281 11- to 18-year-olds with IDs (IQ > or =48) completed the YSR in an interview, and in 1993, 1,047 non-ID adolescents completed the YSR themselves. Parents completed the Child Behavior Checklist (CBCL). The ID sample was split into lower (IQ 48-69) and higher (IQ > or =70) IQ groups. Cronbach's alpha values of the YSR scales and (intraclass) correlation coefficients between and within YSR and CBCL scale scores were calculated to determine parent-adolescent agreement and YSR construct validity, which were compared between samples. Mean YSR scale scores were compared between adolescents with ID with and without psychiatric symptoms. RESULTS: Cronbach's alpha, parent-adolescent agreement, and indications of construct validity were about similar in all samples, although discriminant validity was somewhat weaker in the lower IQ group. Mean scale scores were 1.5 to 2.0 times higher for ID adolescents with psychiatric symptoms. CONCLUSIONS: The YSR seems applicable in youth with an IQ > or =48. Further research is needed to refine and confirm these findings and the factor structure of the YSR in adolescents with ID and to differentiate between adolescents with moderate and mild IDs.     

Effectiveness of autogenic relaxation training on children and adolescents with behavioral and emotional problems

OBJECTIVE: To investigate the effectiveness of autogenic relaxation training in a mildly disturbed outpatient population of children and adolescents with mostly internalizing symptoms, and/or some aggressive, impulsive, or attention deficit symptoms. METHOD: Fifty children and adolescents from southern Germany (mean age 10.2 years; range 6-15 years; mostly intact middle class family background) participated in a group intervention program. Fifteen patients were randomly assigned to a waiting-list control group. Behavior symptoms (Child Behavior Checklist), psychosomatic complaints (Giessen Complaint List), and level of stress were assessed before and after the intervention or after the waiting phase. Individual goal attainment was evaluated at the end of the intervention and in a 3-month follow-up. RESULTS: The parent report on CBCL reflected reduced symptoms compared with control. The child report indicated reduced stress and psychosomatic complaints both in the intervention and control group, and no significant group x time interaction effects occurred on these scales. Effect sizes of 0.49 in the CBCL and 0.36 in the complaint list indicated clinically relevant effects of the intervention compared with the control group. At the end of the intervention, 56% of the children and 55% of the parents reported partial goal attainment, 38% of the children and 30% of the parents reported complete goal attainment; 71% of the parents confirmed partial goal attainment 3 months postintervention. CONCLUSIONS: Autogenic relaxation training is an effective broadband method for children and adolescents.     

Social competence of children and adolescents with epilepsy.

BACKGROUND: This study compared children and adolescents with epilepsy with their healthy peers on measures of social competence. METHODS: Children and adolescents with epilepsy (70 subjects aged 11-18 years; 47.1% girls) and their healthy peers in control group (95 subjects aged 11-18 years; 50.9% girls) were compared on measures of social competence from the Child Competence Checklist (part of Child Behavior Check List). The questionnaires were completed by the parents. All participants were of normal intelligence. RESULTS: The difference of means of total T scores for subscales of sociabilitiy and activities in the epilepsy group and in the control group were statistically significant (p<0.05). The results showed that 5.7% of children and adolescents with epilepsy were in the clinical range compared to 2.1% of subjects in control group. The girls with epilepsy demonstrated greater problems with social competence (45.8+/-8.27) than boys with epilepsy (48.1+/-8.27) and this difference was statistically significant (p<0.05). Multiple analysis of variance of T scores for social competence subscales related to neurobiological variables in the group of participants with epilepsy demonstrated a statistically significant association of reduced sociability with multiple generalized seizure types (F=4,405; d.f.=2; p<0.05). CONCLUSIONS: The study clearly shows that epilepsy is a limiting factor for social competence of children and adolescents.     

Rates and patterns of comorbidity of adolescent behavioral syndromes as reported by parents and teachers in a Taiwanese nonreferred sample

OBJECTIVE: To evaluate the rates and patterns of comorbidity between behavioral syndromes in adolescents as reported by parents and teachers. Whether the patterns of comorbidity were "epiphenomenal" was also assessed. METHOD: Parents of 854 randomly selected students (response rate = 88%) in Taipei in 1996 completed the Child Behavior Checklist; among them, 240 also were randomly selected to have the Teacher's Report Form completed by their teachers. In addition to bidirectional comorbidity rates, odds ratios with and without other comorbid pairs controlled for were estimated via multiple logistic regressions. RESULTS: High comorbidity rates between behavioral syndromes were found in adolescents as reported both by parents and teachers except for that of Somatic Complaints with other syndromes. When other comorbidity pairs were controlled for, the comorbidity rates between Anxious/Depressed with externalizing syndromes turned out to be epiphenomenal, whereas those between externalizing syndromes remained high for both informants' reports. Attention Problems also remained significantly comorbid with other syndromes in the multiple logistic regressions except for that of Aggressive Behavior in the Teacher's Report Form sample. CONCLUSION: High comorbidity rates between adolescent behavioral syndromes exist in both parents' and teachers' reports, and it is important to control for the epiphenomenal condition when assessing such comorbidity rates.     

Personality in adolescents with chronic fatigue syndrome

Our aim was to study the presence of personality traits and disorder in adolescents with Chronic Fatigue Syndrome (CFS). Personality was then compared to other measures of functioning such as presence of psychiatric disorder and rating on the Child Behavior Checklist 4–18 (CBCL) and in relation to CFS outcome. Twenty-five adolescents with CFS followed-up after contacts with tertiary paediatric/psychiatric clinics were compared with 15 matched healthy controls. Interviews and questionnaires from parents and youngsters included Personality Assessment Schedule (PAS), Kiddie-SADS Psychiatric Interview, Child Behavior Checklist. CFS subjects were significantly more likely than controls to have personality difficulty or disorder. Personality features significantly more common amongst them were conscientiousness, vulnerability, worthlessness and emotional lability. There was a nonsignificant association between personality disorder and worse CFS outcome. Personality difficulty or disorder was significantly associated with psychological symptoms and decreased social competence on the CBCL but it was distinguishable from episodic psychiatric disorder. Personality difficulty and disorder are increased in adolescents with a history of CFS. Personality disorder may be linked to poor CFS outcome. Accepted: 23 August 1999     

The Children's Social Behavior Questionnaire for Milder Variants of PDD Problems: Evaluation of the Psychometric Characteristics

The Children's Social Behavior Questionnaire (CSBQ) contains items referring to behavior problems seen in children with milder variants of PDD. Data of large samples of children diagnosed as having high-functioning autism, PDDNOS, ADHD, and other child-psychiatric disorders were gathered. Besides the CSBQ, parents completed the Autism Behavior Checklist (ABC) and the Child Behavior Checklist (CBCL). The data provided the basis for scale construction of the CSBQ, a comparison of the CSBQ scales with other instruments and a comparison of groups on scores on the CSBQ. The 5 scales obtained referred to Acting-out behaviors, Social Contact problems, Social Insight problems, Anxious/Rigid behaviors and Stereotypical behaviors. Results show that the CSBQ has good psychometric qualities with respect to both reliability and validity. A comparison of the different groups showed that significant group differences were found on all scales. In general, the autism group received the highest scores, followed by the PDDNOS group and the ADHD group. Exceptions were on the Acting-out scale, where the ADHD group scored highest and on the Social Insight scale, where no significant difference was found between the PDDNOS group and the ADHD group. Implications of the results and suggestions for further research are dicussed.     

Identifying Social Withdrawal (Hikikomori) Factors in Adolescents: Understanding the Hikikomori Spectrum

Hikikomori is a Japanese term for social withdrawal, ranging from complete inability to venture outdoors to preferring to stay inside. The prevalence of hikikomori is high, up to 1.2% of the Japanese population, but only few studies have examined its emergence in adolescents. Therefore, we sought to identify environmental and psycho-behavioral characteristics related to hikikomori during adolescence. Parents of middle school students who underwent psychiatric outpatient treatment for hikikomori (n?=?20) and control group parents (n?=?88) completed the Child Behavior Checklist to evaluate their child’s psycho-behavioral characteristics and novel scales to evaluate environmental characteristics and hikikomori severity. Scores for all eight Child Behavior Checklist subscales were significantly higher in the experimental group. Multiple regression analysis revealed that “anxious/depressed,” “somatic complaints,” “lack of communication between parents” and “overuse of the Internet” were significant predictors of hikikomori severity. These findings can help identify individuals who are at risk of developing hikikomori.

     

Cross-gender behavior and psychopathology in boy psychiatric outpatients

One hundred 5- to 12-year-old boys referred for outpatient psychiatric evaluation were assessed for cross-gender behavior using the Child Behavior and Attitude Questionnaire (CBAQ) and the Child Game Participation Questionnaire (CGPQ), and for possible associated psychopathology using the Child Behavior Checklist (CBCL) and clinical psychiatric (DSM-III) diagnoses. On the two feminine scales of the CBAQ and CGPQ, 30 to 50% scored within defined clinical ranges. High feminine scale scorers did not have higher Total CBCL scores than lower feminine scale scorers, and scores on the feminine scales correlated minimally with scores on the CBCL broad and narrow-band behavior problem scales, except for a significant positive correlation with the Delinquent subscale. No particular clinical psychiatric diagnoses were significantly associated with high feminine scorers: however, high feminine behavior scorers tended to have more conduct problems and mixed adjustment disorders and less anxious and depressive psychopathology. Clinicians were not alert to the degree of cross-gender behavior found, perhaps due to the concomitant externalizing psychopathology and masculine behavior in these same patients.