Determining Risk Factors for Internalizing Problem Behavior: The Screening Instrument for Adolescents of Parents with Chronic Medical Condition

Abstract

A large body of evidence suggests that the risk for adjustment difficulties in children of parents with a chronic medical condition (CMC) depend on a number of demographic, illness-related, child adaptational, and family characteristics. In particular, internalizing problems are common in children with parental CMC. This longitudinal study describes the development and psychometric properties of the Screening Instrument for Adolescents of Parents with Chronic Medical Condition (SIAPCMC), a measure intended to assess the risk for future clinical internalizing problems. Based on a meta-analysis and empirical research, risk factors for internalizing problem behavior were identified and converted into a set of key questions. Finally, questions with high predictive value for internalizing problems were selected, yielding an 8-item measure. The SIAPCMC items cover caregiving characteristics, daily hassles affecting personal life, child report of stress, active problem solving, and quality of parent attachment. From 149 adolescents (age range = 10–20 years, mean age = 15.5, number of families = 104) who participated at Time 1, 120 adolescents also completed questionnaires 1 year later (Time 2). Adolescents filled in a test battery including the SIAPCMC and the Youth Self-Report. The SIAPCMC showed excellent reliability (Cronbach’s alpha = .88–.90) and satisfactory repeated measures correlation (r = .67) over 1 year. The indices for construct and predictive validity were good. The SIAPCMC proved to be sensitive in identifying children with future internalizing problems. Our results indicate that the SIAPCMC has sound psychometric properties. The SIAPCMC should be further tested in clinical and non-clinical settings to ground its practical use for prevention of future internalizing problems.