Abstract
Accumulating research document the needs of intervention towards mental health problems in early childhood. The general child health surveillance offers opportunities for early detection of mental health vulnerability, conditioned the availability of feasible and validated measures. The Copenhagen Infant Mental Health Questionnaire, CIMHQ, was developed to be feasible for community health nurses and comprehensive regarding the range of mental health problems seen in infancy. Previous testing of the CIMHQ has documented feasibility and face validity. The aim was to investigate the construct validity of the general population measure by using the Rasch measurement models, and to explore the differential functioning of the CIMHQ relative to a number of characteristics of the infants, local independence of items, and possible latent classes of infants. CIMHQ was tested in 2,973 infants from the general population, aged 9–10 months. The infants were assessed by community health nurses at home visits, in the period from March 2011 to December 2013. Rasch measurement models were used to investigate the construct validity of the CIMHQ. Analyses showed an overall construct valid scale of mental health problems, consisting of seven valid subscales of specific problems concerning eating, sleep, emotional reactions, attention, motor activity, communication, and language, respectively. The CIMHQ fitted a graphical loglinear Rasch model without differential item function. Analyses of local homogeneity identified two latent classes of infants. A simple model with almost no local dependency between items is proposed for infants with few problems, whereas a more complicated model characterizes infants with more problems. The measure CIMHQ differentiates between infants from the general population with few and more mental health problems, and between subgroups of problems that potentially can be targets of preventive intervention.
Highlights
Children’s mental health problems are major challenges to public health [1], being the most frequent causes of learning disabilities and social and emotional impairment in childhood [1, 2].Extensive research documents a population prevalence of mental disorders in school-aged children around 15% [1], and available studies of preschool children show similar figures [3,4,5]
Initial descriptive analyses showed that only one child scored problems at the item of curiosity and interest (L) and only two on the item of eye contact (S)
The analyses showed that of the seven subscales analyzed only the expression of emotions and language scales fit Rasch measurement model (RM), while the remaining five subscales each fitted graphical loglinear Rasch model (GLLRM), which were all adjusted for local dependence (LD) between two or more items
Summary
Children’s mental health problems are major challenges to public health [1], being the most frequent causes of learning disabilities and social and emotional impairment in childhood [1, 2].Extensive research documents a population prevalence of mental disorders in school-aged children around 15% [1], and available studies of preschool children show similar figures [3,4,5]. Children’s mental health problems are major challenges to public health [1], being the most frequent causes of learning disabilities and social and emotional impairment in childhood [1, 2]. A high risk of continuity of mental health problems across developmental stages has been found, and developmental disorders with onset in early childhood tend to persist in older ages [2, 6,7,8,9]. Populationbased studies from recent decades have documented the existence of mental health problems and relational problems that impair young children’s development, emotional functioning and social relations [3, 4, 12, 14]; and that these problems can be reliably identified down to the age of 11⁄2 years [15]. ICD-10 disorders of psychological development have been shown to affect 3% of the child population, whereas disorders of feeding, eating and sleep, and DC:0 disorders of emotional expression and regulation affect a total of 14% of 11⁄2 years old children from the general population [16, 17]
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