Abstract
The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach’s alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser–Meyer–Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported.
Highlights
Reason for the Study and Theoretical BackgroundChild and adolescent psychiatric services are increasingly confronted with demands for evidence of the effectiveness of their interventions in terms of outcome
HoNOSCA-D was practice-tested at two offices of the child and adolescent psychiatric services of the Canton of St
The revised version of HoNOSCA-D was back-translated by a native speaker of English and sent to the authors of HoNOSCA (Simon Gowers) for authorization
Summary
Reason for the Study and Theoretical BackgroundChild and adolescent psychiatric services are increasingly confronted with demands for evidence of the effectiveness of their interventions in terms of outcome. For English-speaking countries, Bickman et al (2) looked at various approaches and developed recommendations for a modular system of outcome measurement. They found the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), developed by Gowers et al (3) in England, important. Frontiers in Psychiatry | www.frontiersin.org von Wyl et al. Psychometric Properties of the HoNOSCA-D (HoNOS) (4, 5), which were developed in the United Kingdom in the early 1990s as a clinician-rated assessment instrument for routine use in adult mental health services. A major aim was the construction of a practicable instrument for differentiated assessment of the severity of mental illness that can be used as a routine clinical outcome measure
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