Clinician-rated mental health in outpatient child and adolescent mental health services: associations with parent, teacher and adolescent ratings

Abstract

BackgroundClinician-rated measures are used extensively in child and adolescent mental health services (CAMHS). The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) is a short clinician-rated measure developed for ordinary clinical practice, with increasing use internationally. Several studies have investigated its psychometric properties, but there are few data on its correspondence with other methods, rated by other informants. We compared the HoNOSCA with the well-established Achenbach System of Empirically Based Assessment (ASEBA) questionnaires: the Child Behavior Checklist (CBCL), the Teacher's Report Form (TRF), and the Youth Self-Report (YSR).MethodsData on 153 patients aged 6-17 years at seven outpatient CAMHS clinics in Norway were analysed. Clinicians completed the HoNOSCA, whereas parents, teachers, and adolescents filled in the ASEBA forms. HoNOSCA total score and nine of its scales were compared with similar ASEBA scales. With a multiple regression model, we investigated how the ASEBA ratings predicted the clinician-rated HoNOSCA and whether the different informants' scores made any unique contribution to the prediction of the HoNOSCA scales.ResultsWe found moderate correlations between the total problems rated by the clinicians (HoNOSCA) and by the other informants (ASEBA) and good correspondence between eight of the nine HoNOSCA scales and the similar ASEBA scales. The exception was HoNOSCA scale 8 psychosomatic symptoms compared with the ASEBA somatic problems scale. In the regression analyses, the CBCL and TRF total problems scores together explained 27% of the variance in the HoNOSCA total scores (23% for the age group 11-17 years, also including the YSR). The CBCL provided unique information for the prediction of the HoNOSCA total score, HoNOSCA scale 1 aggressive behaviour, HoNOSCA scale 2 overactivity or attention problems, HoNOSCA scale 9 emotional symptoms, and HoNOSCA scale 10 peer problems; the TRF for all these except HoNOSCA scale 9 emotional symptoms; and the YSR for HoNOSCA scale 9 emotional symptoms only.ConclusionThis study supports the concurrent validity of the HoNOSCA. It also demonstrates that parents, teachers and adolescents all contribute unique information in relation to the clinician-rated HoNOSCA, indicating that the HoNOSCA ratings reflect unique perspectives from multiple informants.

Overprotective parenting and child anxiety: The role of co-occurring child behavior problems

“…The sample was recruited for a treatment trial for anxiety disorders, based on elevated scores on Internalizing problems, or when anxiety was one of the reasons for referral. Compared to a study with a representative sample of children referred to child community clinics in Norway (Hanssen-Bauer, Langsrud, Kvernmo, & Heyerdahl, 2010), the average score on Internalizing problems was significantly higher for the children in the current study. One might consider that the variation in anxiety symptoms in the current sample was therefore limited, causing low correlations between overprotective parenting and child anxiety.…”

Translation and cross-cultural adaptation of the Motor Behavior Checklist (MBC) into Brazilian Portuguese

“…Considering the school setting, most studies show that classroom teachers play a key role in providing information about a child's behavior. [2][3][4][5] Only a few studies have assessed instruments that rely on physical education teachers as a main source of information about emotional, behavioral, and/ or developmental problems in school-age children.…”

The discrepancy between patients and informants on clinician-rated measures in major depressive disorder

“…10.4% of patients reported depression that was also identified by their informants, but 7.6% of patients reported depression that informants did not identify (McAvay et al, 2004). Special populations, such as children and adolescents (Hanssen-Bauer et al, 2010), the elderly (McAvay et al, 2004), patients with cognitive limitations (Greenop et al, 2011), individuals with comorbid personality disorders (Peselow et al, 1994), and patients with suicidal tendencies (Dejong and Overholser, 2009) among others, also seem to influence concordance between patients and informants. Finally, factors such as substance use (Baharudin et al, 2013) and the burden of caring for ill loved ones (Nik Jaafar et al, 2013), could also contribute to the underreporting of depressive symptoms.…”