Internalizing Problems Scale Research Articles

Measurement bias in caregiver-report of early childhood behavior problems across demographic factors in an ECHO-wide diverse sample.

Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5-5 functions equivalently at the item level across diverse samples is unknown. Item-level data of CBCL/1.5-5 from a large sample of young children (N=9087) were drawn from 26 cohorts in the Environmental influences on Child Health Outcomes program. Factor analyses and the alignment method were applied to examine measurement invariance (MI) and differential item functioning (DIF) across child (age, sex, bilingual status, and neurodevelopmental disorders), and caregiver (sex, education level, household income level, depression, and language version administered) characteristics. Child race was examined in sensitivity analyses. Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and Total Problems. The robust item sets, excluding the high DIF items, showed good reliability and high correlation with the original Internalizing and Total Problems scales, with lower reliability for Externalizing. Language version of CBCL administration, education level and sex of the caregiver respondent showed the most significant impact on MI, followed by child age. Sensitivity analyses revealed that child race has a unique impact on DIF over and above socioeconomic status. The CBCL/1.5-5, a caregiver-report measure of early childhood behavior problems, showed bias across demographic groups. Robust item sets with less DIF can measure Internalizing and Total Problems equally as well as the full item sets, with slightly lower reliability for Externalizing, and can be crosswalked to the metric of the full item set, enabling calculation of normed T scores based on more robust item sets.

Effects of prenatal alcohol exposure on neurobehavioural development and volume of rostral cingulate cortex subregions.

Background:Maternal alcohol consumption during pregnancy can have widespread and long-lasting effects on children’s cognition, behaviour, brain function and structure. The pregenual anterior cingulate cortex (ACC) and the anterior midcingulate cortex (MCC) mediate emotional and cognitive behaviours that are affected by prenatal alcohol exposure. However, the neurobehavioural development of the pregenual ACC and anterior MCC has not been examined in people with prenatal alcohol exposure.Methods:We recruited 30 children and adolescents with prenatal alcohol exposure and 50 age- and gender-matched unexposed controls. We acquired structural MRI data sets on a 3 T scanner. We manually delineated 2 areas of the rostral cingulate cortex — the pregenual ACC and the anterior MCC — and compared them between groups. We measured behavioural and emotional problems using the Behaviour Assessment System for Children, 2nd Edition, Parent Rating Scale, and then explored their associations with rostral cingulate cortex volumes.Results:Intracranial-normalized volumes of the right pregenual ACC and the right total rostral cingulate cortex were significantly smaller in individuals with prenatal alcohol exposure than in unexposed controls. The volume of the right anterior MCC had a significant positive association with scores on the Internalizing Problems scale in individuals with prenatal alcohol exposure.Limitations:This study was cross-sectional, and detailed information about the timing and amount of exposure was not always available.Conclusion:Prenatal alcohol exposure is associated with lower volumes in the right pregenual ACC. This finding may underlie some of the emotional and behavioural problems experienced by individuals with prenatal alcohol exposure.

Association of exposure to organophosphate flame retardants and children's behavior at a median age of 18 months

Exposure to polybrominated diphenyl ether (PBDE) flame retardants (FRs) could have adverse effects on neurodevelopment in children. Some organophosphate (OPFRs) are used as alternatives for the phased-out decabromodiphenylether such as resorcinol bis(diphenyl phosphate (PBDPP) and bisphenol A bis(diphenyl phosphate (BPA-BDPP). This study aims to investigate the relationship between indoor OPFR exposure and neurodevelopmental behavior in children. OPFRs were measured in house dust and hand wipes from 42 children, aged 8-16 months, from the LInking maternal Nutrition to Child health (LINC) study. At the median age of 18 months, the children's behavior was assessed with the Child Behavior Checklist, using three composite behavior scales: externalizing problems, internalizing problems, and total problems. Linear regression analysis was performed, adjusting for maternal education and smoking by the partner. Children with higher BPA-BDPP, PBDPP, and tris(chloroethyl) phosphate (TCEP) house dust concentrations were found to have higher scores on the behavioral problems scales. A 10-fold increase in BPA-BDPP and PBDPP concentration was associated with a 4.1 and 2.6 point increase on the internalizing problems scale (respectively p=0.004 and p=0.042). Increased BPA-BDPP concentrations were associated with elevated scores on the externalizing problems scale and total behavioral problems scale (respectively 7.6 and 16 points increase per 10-fold BPA-BDPP concentration increase, p=0.015 and p=0.007). TCEP dust concentrations were associated with the externalizing problems scale (13 point increase per 10-fold TCEP concentration increase, p=0.043). This study showed the importance of investigating the health effects of exposure to organophosphate flame retardants. Further research on neurodevelopmental health effects of OPFR exposure is warranted.

Investigating impact: The effects of school-based art therapy on adolescent boys living in poverty

ObjectiveThis study assessed the effectiveness of group art therapy in improving social and emotional issues for adolescent boys of color living in poverty. MethodsThe sample consisted of 162 male ninth graders in the South Bronx; 70 % identified as Latinx and 24 % as African American. For 6 months, one pre-existing class from each of three academic tracks (Honors, Average, and At-Risk) was randomly assigned to an experimental group (n = 80) that participated in 12 weekly group art therapy sessions, and the remaining classes (n = 76) were assigned to a control condition. All participants were administered the BASC-2 Self Report Survey pre- and post-intervention. ResultsTwo-way between subjects analysis of variance was used to test for the effects of Academic Track, Group, and their interaction on the BASC-2 variables. There were no significant effects of Group and no significant interaction effects. School Problems scale and Internalizing Problems scale showed significant effects for Academic Track, with p < 0.032 and p < 0.023, respectively. For School Problems students in the At Risk group showed greater improvement than those in the Average track p < 0.01. For Internalizing Problems, students in the At Risk track showed significantly more improvement than those in the Average track, p < 0.007. ConclusionThe findings suggest that Art Therapy has promise in addressing varied needs of high school students at different academic levels who are living in poverty.

Similar names, different results: Consistency of the associations between prenatal exposure to phthalates and parent-ratings of behavior problems in preschool children

BackgroundEnvironmental health research has reported mixed findings on the associations between prenatal exposure to phthalates and parent-ratings of child behavioral problems. ObjectiveWe examined the consistency of the associations between prenatal urinary phthalate concentrations and child behavior scores across two standardized instruments – the Behavior Assessment System for Children-Second Edition (BASC-2) and the Child Behavior Checklist (CBCL) – using two analytical approaches used to correct for urine dilution. MethodA sample of 351 mother–child pairs were selected from a prospective birth cohort of pregnant women enrolled between 2009 and 2012. Women provided spot urine samples during the second trimester of pregnancy, which were analyzed for levels of nine urinary phthalate metabolites. When their typically developing children were 3–4 years of age, mothers completed the BASC-2 and CBCL on the same day. Adjusted regression analyses examined the associations between maternal prenatal phthalate concentrations and child behavior scores on the BASC-2 and CBCL. To correct for urine dilution, primary regression analyses included urinary creatinine concentration as a separate independent variable (i.e., covariate). In the secondary regression analyses, creatinine-adjusted phthalate concentrations were used. ResultsPrimary logistic regression analyses that included urinary creatinine as a covariate showed that higher prenatal phthalate concentrations were related to increased odds of scores falling into the borderline or clinical range on the Hyperactivity, Aggression, Anxiety, Depression, Withdrawal, Externalizing Problems, Internalizing Problems, and Behavioral Symptoms Index scales on the BASC-2 (ORs from 1.39 to 2.07), but only the Anxious/Depressed and Externalizing Problems scales on the CBCL (ORs from 1.80 to 3.28). Primary linear regression analyses showed that higher prenatal phthalate concentrations were related to higher scores on the Externalizing Problems (β’s = 0.16), Internalizing Problems (β’s from 0.16 to 0.20), and Behavioral Symptoms Index (β’s from 0.18 to 0.21) scales on the BASC-2, but not related to any CBCL scales. Sex-stratified analyses found that many associations were only significant for male children. Secondary analyses using creatinine-adjusted phthalate concentrations revealed that some of the associations from the primary analyses remained significant; however, a number of unique associations were observed. ConclusionPrenatal phthalate exposure was associated with preschool behavioral development; however, findings were not consistent for the BASC-2 and CBCL, especially related to the clinical/syndrome scales and Internalizing Problems scale. Further, many findings differed based on the analytical approach used to correct for urine dilution. Future work is needed to delineate the similarities and differences between similarly named child behavior constructs assessed by different neurodevelopmental assessments. Also, research is needed to better understand why and how different analytical approaches influence the reported associations between maternal prenatal phthalate concentrations and children’s behavior problems.

Mental Health Cross-Informant Agreement for Indigenous and non-Indigenous Adolescents

Cross-informant agreement between parent–youth dyads has been the focus of extensive research, but youth from diverse cultures have received less attention. Cross-information agreement between Indigenous and non-Indigenous parent–youth dyads were compared. A total of 152 parent–youth dyads, consisting of 29.6% Indigenous and 70.4% non-Indigenous, were contrasted on level of agreement using the Child Behavior Checklist and Youth Self-Report forms of the Achenbach System of Empirically Based Assessment. The overall level of agreement for the full sample (r = .41) was comparable to the extent literature. As predicted, externalizing difficulties were rated with significantly higher levels of agreement than internalizing difficulties (externalizing r = .51; internalizing r = .32). While age did not significantly moderate the levels of agreement, gender did show an effect with female youth reporting higher levels of problems than males. The most notable finding was the cultural effect on levels of agreement. The rate of cross-informant agreement for the Indigenous parent–youth dyads was significantly higher than the low to moderate agreement found for non-Indigenous pairs. Moreover, the level of cross-informant agreement between the externalizing and internalizing problem scales was similar for the Indigenous dyads (r = .59; r = .62, respectively), but was significantly different for the non-Indigenous dyads (r = .50; r = .19, respectively). This study highlights possible cultural differences in cross-informant agreement between Indigenous and non-Indigenous youth and their parents

Low levels of morning salivary α-amylase activity predict higher number of depressive symptoms in a community sample of children

&lt;p&gt;Models of the etiology of depressive disorders suggest that the onset of a depressive episode is the result of a complex phenomenon based on the interaction between genetic background, critical environmental factors such as life stressors and traumatic events, and the effects of neuroendocrine changes associated with the stress response. Numerous studies have highlighted the usefulness of morning cortisol (C) as a potential predictor of depressive episodes. The aim of this study was to compare the effectiveness of C, salivary alpha-amylase (sAA) activity/output, and the sAA/C ratio in predicting depressive symptoms in a community sample of 99 children aged 8-11 years old. Two saliva samples were obtained in the morning on two different school days. Teachers described their pupils' behavior by using the internalizing problems scales of the &lt;em&gt;Teacher’s Report Form&lt;/em&gt; (TRF) questionnaire. Our results indicate that, regardless of gender, the best predictor of depressive/withdrawal scores and overall internalizing scores on the TRF was lower mean morning levels of sAA activity. Hence, sAA could be proposed as a biological marker for the risk of developing a first episode of depressive illness in child samples. &lt;/p&gt;

Prenatal Alcohol Exposure, FASD, and Child Behavior: A Meta-analysis.

Fetal alcohol spectrum disorders (FASD) and prenatal alcohol exposure (PAE) are associated with behavioral difficulties, although there are no published systematic reviews that summarize and critique the literature. To describe the behavioral characteristics of children with PAE and/or FASD, assessed using the Achenbach System of Empirically Based Assessments (ASEBA) for school-aged children with parent, teacher, and youth (self-report) forms. Electronic literature databases, reference lists, hand-searches. peer-reviewed observational studies. Study appraisal and data extraction were undertaken by 2 independent assessors. Meta-analyses were performed for parent-rated Internalizing, Externalizing, and Total problems scales. All other ASEBA scales were summarized qualitatively. Included were 23 articles; 16 were used in meta-analyses. Pooled results showed higher Total (mean difference 12.1, 95% confidence interval [95% CI] 7.7-16.5), Internalizing (6.3, 95% CI 3.1-9.5), and Externalizing problems scores (12.5, 95% CI 7.9-17.0) in FASD than No FASD; and greater odds of scoring in the "Clinical" range in FASD. Pooled results demonstrated higher problem scores in children with PAE (P > .05). Qualitative summaries of other scales from parents, teachers, and self-report show poorer behavior ratings in children with FASD and PAE on composite Problem and Competence scores and many Syndrome subscales. Findings were restricted to behaviors assessed using the ASEBA. The published literature was limited, often with only 1 study reporting on a particular scale. Meta-analysis reveals that FASD and PAE are associated with problematic behavior in many, but not all domains. This clearly affects families, and should be considered in clinical practice by providers.

Body Image Perception and Internalization Problems Indicators in Mexican Adolescents

The aim of the study was to determine the existing differences by gender in the indicators of internalizing problems regarding the body image perception of Mexican adolescents. A descriptive and transversal study was developed. The participants were students from four public middle schools in Guadalajara Mexico. The instrument used was an online survey constituted by a sociodemographic section, an internalizing problems indicators scale (α = .85) and a body image perception scale (α = .70). Parental consent was obtained using a waiver of active consent. The survey was applied online, during school hours at the computer labs. Descriptive statistics were calculated for the sociodemographic data and the body perception scale. Z-scores were determined for the internalizing problems scale, being categorized into a three level rank. Statistical differences were estimated by gender using one-way analysis of variance (ANOVA). The sample included 2080 adolescents with a mean age of 13.6 years (SD 1), of which 51% (1059) were female and 49% (1021) male. 18.1% of the participants that describe themselves as about the right weight, followed by 13.9% that do it as slightly overweight, indicating that they are trying to lose weight. Regarding the differences by gender, 16% of the males and 17.9% of the females have high indicators of internalizing problems. Taking into consideration the body image, the males that describe themselves as very overweight and the females that do it as very underweight are the groups with higher indicators of internalizing problems. In summary, there are important differences between males and females in the internalizing problems indicators regarding the body image.

Genetic and environmental influences on the relationship between ADHD symptoms and internalizing problems: A Chinese twin study

Several twin studies have investigated the overlap between attention deficit hyperactivity disorder (ADHD) and externalizing problems; however, limited information is known regarding the genetic and environmental contribution to the overlap between ADHD and internalizing problems. This study examined the genetic and environmental influences on the variation in and covariation between ADHD symptoms and internalizing problems by using the Child Behavior Checklist (CBCL). We investigated 1,316 child and adolescent twins, including 780 monozygotic twins and 536 dizygotic twins, aged 6 years to 18 years from the Chinese Child and Adolescent Twin Registry. ADHD symptoms and internalizing problems were quantified through parent rating by using the Attention Problems Scale and other three scales, which include Anxious/Depressed, Withdrawn, and Somatic Complaints of CBCL. Genetic and environmental susceptibilities common to ADHD symptoms and internalizing problems were examined through bivariate twin modeling. Results showed that genetic factors substantially influenced the ADHD symptoms with a heritability of 72%. Modest genetic influences and substantial shared environmental influences (20-77%) were observed in the three internalizing problem scales. Common genetic and shared environmental influences were essential for the overlap between ADHD and the three internalizing problems respectively. Approximately one-fifth of the genetic variance of ADHD symptoms was shared with anxiety/depression. In conclusion, substantial genetic and shared environmental influences on ADHD symptoms and internalizing problems were observed in Chinese children and adolescents. Our finding supports a common etiology between ADHD and internalizing problems. This finding can also help explain the co-existence of these behavior problems. © 2015 Wiley Periodicals, Inc.

SUICIDAL THOUGHTS AND BEHAVIORS IN CHILDREN AND ADOLESCENTS WITH CHRONIC TIC DISORDERS.

Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N = 196, range 6-18 years old). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control. Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions. A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to 3 youths (3%) who experienced these thoughts in a community control sample (N = 100, range 6-18 years old, P = .03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale, were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity; tic-related impairment; and obsessive-compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorders' symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors. Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration.

The longitudinal association of the diurnal cortisol rhythm with internalizing and externalizing problems in pre-schoolers. The Generation R Study.

Studies investigating the association between diurnal cortisol rhythm and behavioural problems in young children have yielded inconsistent results. We tested the hypothesis that variations in diurnal cortisol rhythm in pre-schoolers are already related to problem behaviour early in life with a cross-sectional and longitudinal design. This study was embedded in Generation R, a population-based cohort from foetal life onwards. Parents collected saliva samples from their infant at 5 moments during 1 day. In 322 infants aged 12-20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Problem behaviour was assessed at ages 1.5 and 3 years with the Child Behavior Checklist/1.5-5 years. No cross-sectional associations between the cortisol composite measures and problem behaviour were found at 1.5 years. However, cortisol predicted change in internalizing problems as assessed from 1.5 to 3 years, but not change in externalizing problems. Children with higher AUC levels, flatter slopes and a more positive CAR at baseline were more likely to score higher on the Internalizing Problems scale (β per nmol/L AUC: 0.08, 95% CI: 0.00; 0.17, p=0.04; β per nmol/L/h slope: 0.57, 95% CI: 0.17; 0.98, p=0.006; β per nmol/L CAR: 0.04, 95% CI: 0.01; 0.08, p=0.02) at follow-up. Variations in diurnal cortisol rhythm are associated with change in internalizing problems in pre-schoolers. The results suggest that variations in diurnal cortisol patterns early in life precede internalizing problems.

Behavior problems in children transferred from a socioemotionally depriving institution to St. Petersburg (Russian Federation) families.

Behavior problems were studied in fifty 5- to 8-year-old children transferred from a socioemotionally depriving Russian institution to domestic families. Results indicated that the postinstitutional (PI) sample as a whole had higher clinical/borderline behavior problem rates on the parent-reported Child Behavior Checklist for Ages 6-18 (T.M. Achenbach & L.A. Rescorla, 2001) aggressive and lower rates on the withdrawn/depressed and internalizing problems scales than did non-institutionalized (non-I) children reared in Russian families. Compared with the U.S. standardization sample, PI children had significantly higher rates for aggressive, externalizing, and social problems; the non-I children had higher rates for withdrawn/depressed and internalizing problems; and both groups had higher rates for rule-breaking behavioral problems. PI children placed in domestic families at 18 months or older had higher rates of problems than did the U.S. non-I standardization sample, but children placed at younger ages did not. PI children transferred to nonbiological families had lower rates of problems compared to U.S. norms than did children transferred to biological families. Thus, prolonged early socioemotional deprivation was associated with a higher percentage of behavior problems in children placed in domestic families, especially if transferred to biological families.

The social competence and behavioral problem substrate of new- and recent-onset childhood epilepsy

This study examined patterns of syndrome-specific problems in behavior and competence in children with new- or recent-onset epilepsy compared with healthy controls. Research participants consisted of 205 children aged 8–18, including youth with recent-onset epilepsy (n=125, 64 localization-related epilepsy [LRE] and 61 idiopathic generalized epilepsy [IGE]) and healthy first-degree cousin controls (n=80). Parents completed the Child Behavior Checklist for children aged 6–18 (CBCL/6–18) from the Achenbach System of Empirically Based Assessment (ASEBA). Dependent variables included Total Competence, Total Problems, Total Internalizing, Total Externalizing, and Other Problems scales. Comparisons of children with LRE and IGE with healthy controls were examined followed by comparisons of healthy controls with those having specific epilepsy syndromes of LRE (BECTS, Frontal/Temporal Lobe, and Focal NOS) and IGE (Absence, Juvenile Myoclonic, and IGE NOS). Children with LRE and/or IGE differed significantly (p<0.05) from healthy controls, but did not differ from each other, across measures of behavior (Total Problems, Total Internalizing, Total Externalizing, and Other Problems including Thought and Attention Problems) or competence (Total Competence including School and Social). Similarly, children with specific syndromes of LRE and IGE differed significantly (p<0.05) from controls across measures of behavior (Total Problems, Total Internalizing, and Other Problems including Attention Problems) and competence (Total Competence including School). Only on the Thought Problems scale were there syndrome differences. In conclusion, children with recent-onset epilepsy present with significant behavioral problems and lower competence compared with controls, with little syndrome specificity whether defined broadly (LRE and IGE) or narrowly (specific syndromes of LRE and IGE).

Nighttime fears of preschool children: A potential disposition marker for anxiety?

ObjectiveTo examine if children who suffer from significant Nighttime Fears (NF) experience higher degree of general fears and behavioral problems and to explore whether effortful control mediates NF association with internalizing problems. MethodsOne-hundred and nine preschool children (64 boys) between the ages 4 and 6years suffering from significant NF and 30 healthy children (16 boys) were evaluated using parental reports of behavioral problems [Child Behavior Checklist (CBCL)], parental and child report of fears [Fear Survey Revised for Parents (FSS-PC), Koala Fear Questionnaire (KFQ)], and a measure of effortful control derived from the Child Behavior Questionnaire (CBQ). ResultsChildren with severe NF also suffer from an increased level of a wide variety of fears other than NF, and exhibit more behavioral problems than controls both on parental and children’s measures of general fears, and main CBCL scale scores (Internalizing, Externalizing, Total score). Additionally, children with NF had lower abilities of effortful control (as manifested in CBQ attention and inhibitory control scales). Attention control mediated NF association to internalizing problems scale. ConclusionsNF may serve as a marker for anxiety vulnerability, and this vulnerability might be mediated by abnormal attentional control. Our finding also highlights the need for a more comprehensive assessment of behavioral problems, fears and anxiety phenomena among children referred with NF.

Hippocampal volume and internalizing behavior problems in adolescence

Adolescence is characterized by dynamic changes in structural brain maturation. At the same time, adolescence is a critical time for the development of affective and anxiety-related disorders. Individual differences in typically developing children and adolescents may prove more valuable for identifying which brain regions correspond with internalizing behavior problems (i.e., anxious/depressive, withdrawal and somatic symptoms) on a continuous scale compared to clinical studies. Participants were 179 (92 males, 87 females) typically developing children and adolescents between ages 8 and 17. Hippocampal and amygdala volumes were measured automatically with FreeSurfer. Internalizing behavior was assessed with the Child Behavior Checklist (CBCL) completed by the parent, and associated with hippocampal and amygdala volumes. Hippocampal volume was inversely related with the total internalizing problems scale of the CBCL, irrespective of gender, age, or informant (mother or father). The effects were most prominent for the withdrawal and anxiety/depression subscales and the left hippocampus: more withdrawal and anxiety/depression was related to smaller left hippocampal volume. No associations were found between internalizing behavior and amygdala volume. This study shows that typically developing children and adolescents with high internalizing behavior share some of the neuroanatomical features of adult depression and anxiety-related disorders.

Assessment of problem behaviour by foster parents and their foster children

This study investigates the level of agreement between foster parents and foster children about problem behaviour and how this is associated with the breakdown of a foster care placement. The study took a sample of foster parents and their foster children (n= 60), who were aged 11–17 years, and analysed the severity of problem behaviour displayed by the foster children within 3 months of placement in the foster family and a year and a half later. The level of agreement was established with the intra-class correlation coefficient, which represents both the differences in scores and the differences in ranking. This coefficient shows that there is a statistically significant difference in the level of agreement on the Internalizing Problems scale of the Child Behaviour Checklist between the placements that broke down and those that continued. The level of agreement is associated with the severity score, which in turn is associated with the outcome of the foster care placement. To avoid placement breakdown, problem behaviour should also be assessed from the perspective of the foster child.

Parental stress affects the emotions and behaviour of children up to adolescence: A Greek prospective, longitudinal study

Systematic research about the continuity of mental health problems from childhood to adolescence is limited, but necessary to design effective prevention and intervention strategies. We used a population-based representative sample of Greek adolescents, followed-up from birth to the age of 18 years, to assess early influences on and the persistence of mental health problems in youth. We examined the role of peripartum, early development and parental characteristics in predicting mental health problems in childhood and adolescence. Results suggest a strong relationship between behavioural problems in childhood and adolescence for both genders, while emotional problems were more likely to persist in boys. Age and sex-specific models revealed significant positive associations between higher scores on the behavioural and emotional problems scales and higher frequency of accidents in preschool years, physical punishment in early childhood, lack of parental interest in child's school and activities, and perceived maternal stress in all children. Perceived paternal stress was associated with higher scores on the Total and Internalizing problems scales in the total population. Our results suggest that early interventions are necessary as mental health problems strongly persist from childhood to late adolescence. The adverse effects of parental stress and poor care-giving practices on child's psychopathology need to be recognised and improved.

Frequencies of T-Score Differences Between Achenbach Child Behavior Checklist and Teacher’s Report Form Summary Scales

A table is provided giving observed difference frequencies for caregiver versus teacher ratings of children on the Child Behavior Checklist and Teacher’s Report Form Internalizing, Externalizing, and Total Problems scales per the original normative samples. The table permits accurate evaluation of the empirical rarity of specific cross-informant rating discrepancies. This methodology provides a more direct assessment of interrater summary score differences than does the Q-correlation statistic reported in the Achenbach System of Empirically Based Assessment scoring program.

22q11.2 deletion syndrome: behaviour problems of children and adolescents and parental stress

22q11.2 deletion syndrome can be associated with a variety of somatic symptoms, developmental delays and psychiatric disorders. At present, there is little information on behaviour problems, parental stress and possible relations between these factors. Therefore, this study investigates behaviour problems of children and adolescents with 22q11.2DS, and their primary caregivers' stress. Parents of 4-17 year old subjects known to the German 22q11.2 deletion syndrome foundation were anonymously asked to fill out several questionnaires, e.g. the Child Behavior Checklist 4-18 (CBCL/4-18). The primary caregivers of 77/126 children [43 males, 34 females, mean age: 8;0 (4;0-16;11) years] sent back filled-out questionnaires. Forty-six of 76 subjects were rated as clinical on at least one of the CBCL-scales. Males had significantly higher scores on the total problems scale and the internalizing problems scale than females. The patients' age correlated with several CBCL-scales. Eleven of 49 subjects were suspicious of an autism spectrum disorder. Compared with the general population, but not with other parents of mentally and/or physically handicapped children, the primary caregivers experienced higher levels of stress, but showed normal life satisfaction. In spite of high rates of clinical behaviour problems among children and adolescents with 22q11.2DS and despite increased parental stress, most primary caregivers seem to have effective coping strategies, e.g. partnership support, to sustain normal levels of life satisfaction.