Biomedical subjects

F C Verhulst

Publications and source records attributed to F C Verhulst.

At least 91 records · Page 5Linked to original sources

PubMed1995

Late psychosocial consequences for parents of children who survived cancer.

Investigated late psychosocial sequelae in 133 parents of children who survived cancer, using questionnaires developed to measure the specific impact of the disease. Childhood cancer had distinct and persistent late psychosocial effects on parents of survivors. Uncertainty and loneliness were the most reported problems. Demographic and situational characteristics such as being a mother, low SES, no religious affiliation, chronic disease in a family member other than the child surviving cancer, and concurrent stresses increased the risk of reporting late problems. Treatment itself had little or no effect on reported problems. However, when treatment led to long-term sequelae in the child, a significant and specific effect on parental problems was observed. No decline of problems over time was found, which has implications for patient care.

Adaptation, Psychological↗

PubMed1995

Developmental course of problem behaviors in adolescent adoptees.

OBJECTIVE: To determine the 3-year developmental course of problem behaviors and competencies in intercountry adoptees in adolescence and to determine the role of ethnicity and early adverse environmental influences on the development of problem behaviors. METHOD: In this prospective study, a sample of 1,538 intercountry adoptees, aged 11 to 14 years at initial assessment and 14 to 17 years at follow-up, were assessed with the Child Behavior Checklist (CBCL) at both occasions. RESULTS: Across the follow-up interval there was an increase in problem behaviors and a decrease in competencies. Increases in problem scores were greatest for the CBCL scales Withdrawn and Delinquent Behavior. These findings contrasted with the results from a longitudinal study of an epidemiological sample of children from the general population. The increase in problem scores could not be attributed to the age of the child at placement, the medical condition at placement, early neglect or abuse, or racial antagonism. CONCLUSION: In contrast with their agemates from the general population, intercountry adoptees showed an increase in maladaptive functioning in adolescence. Because early adverse influences were not responsible for the increase of problems, it was concluded that other factors pertaining to adolescent development interact negatively with adoption-specific factors that render individuals vulnerable to deviation from the normal developmental pathway.

Adolescent↗

PubMed1995

Continuity and change of self-reported problem behaviors from adolescence into young adulthood.

OBJECTIVE: To investigate the 4-year course of behavioral and emotional problems from adolescence into young adulthood in a general population sample. METHOD: The population consisted of 364 individuals, aged 15 to 18 years at the beginning of the study. Subjects filled out the Youth Self-Report at the first time of assessment. At follow-up, 2 and 4 years later, subjects aged 19 or older completed the Young Adult Self-Report, which was derived from the Youth Self-Report. RESULTS: Almost 40% of the adolescents who were classified as deviant initially were still deviant 4 years later. There was no significant difference in the continuity of internalizing problems versus externalizing problems in this sample. CONCLUSIONS: All types of problems tended to persist to a similar degree. This holds also for problems that are often regarded as typical childhood problems, such as attention problems and hyperactivity. Because adolescent problems are likely to continue, we need more knowledge on the efficacy of interventions.

Adolescent↗

PubMed1995

A twin-singleton comparison of problem behaviour in 2-3-year-olds.

Twin-singleton differences in problem behaviours in 2-3-year-olds were studied. Maternal ratings of children's problem behaviours were obtained with the CBCL/2-3. The twin sample consisted of 1363 twin pairs (456 MZ, 907 DZ), the sample of singletons consisted of 420 children from the general population. Results indicated that the general level of problem behaviours in twins was broadly comparable to that in singletons. Four of the seven syndromes showed lower scores for twins. These differences, however, were small and mainly caused by lower scores for DZ twins in comparison to MZ twins and singletons. Part of the difference could be attributed to the higher maternal age in the twin groups. Higher means for boys were found for the total problem score, and the Aggressive and Overactive syndromes.

Adult↗

PubMed1995

Self-reported and parent reported problems in adolescent international adoptees.

Self-reported and parent reported problem behaviors of 1,538 intercountry adopted adolescents aged 14-18 years were compared with those from general population samples; 22% of the adopted boys, and 18% of the adopted girls could be regarded deviant according to self-reports, compared with about 10% of the subjects from the general population. Parents' reports showed a slightly greater difference between adopted versus nonadopted boys. Childhood deprivation was weakly associated with later parent reported, but not with self-reported problems. Racial antagonism was not related to problem behaviors. Adolescence may constitute a period of increased vulnerability for adopted children.

Acculturation↗

PubMed1995

Psychopathology from adolescence into young adulthood: an 8-year follow-up study.

OBJECTIVE: This study investigated the stability of behavioral and emotional problems from adolescence into young adulthood. METHOD: Subjects from the general population (N = 459), aged 13-16 years, were evaluated initially with the Child Behavior Checklist (completed by parents) and 8 years later with the Young Adult Self-Report. The scoring format and factor structure of the two assessment instruments are similar; syndromes constructed from the two instruments are based on parents', teachers', and self-report information derived from large clinical samples. Signs of maladjustment also were assessed at follow-up through interviews. RESULTS: Of the individuals with total problem scores in the deviant range on the Child Behavior Checklist, 27.3% had total problem scores in the deviant range on the Young Adult Self-Report at follow-up. The probability of having a total problem score in the deviant range at follow-up was raised 7.4-fold by having deviant-range scores on the Child Behavior Checklist somatic complaints and anxious/depressed syndromes (simultaneously) at the initial assessment. Referral to mental health services was predicted by deviant-range scores on the anxious/depressed syndrome, while suicide attempts were predicted by deviance on the withdrawn syndrome. CONCLUSIONS: Adolescent problems tended to persist into young adulthood to a moderate degree. High rates of withdrawal from social contacts, anxiety or depression, somatic complaints without known medical origin, social problems, attention problems, delinquent behavior, and aggressive behavior during adolescence were risk factors for specific types of psychopathology and maladjustment at 8-year follow-up. The presence of psychopathology in adolescence should not be regarded as normative.

Adolescent↗

PubMed1995

Assessment of the prevalence of psychiatric disorder in young adults.

BACKGROUND: The effectiveness of different assessment procedures for determining prevalence rates of psychiatric disorder in young adults was investigated. METHOD: In a two-stage multi-method procedure, the Young Adult Self-Report, the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Structured Interview for Personality Disorders (Revised), and the Global Assessment of Functioning (GAF) Scale were used to assess prevalence rates in 706 19-24-year-olds from the general population. Furthermore, individuals' subjective perception of distress and referral to mental health services were assessed. RESULTS: The prevalence of any SCAN/DSM-III-R disorder was 19.3% (95% confidence interval: 11.2-27.4%). Most subjects who received a SCAN/DSM-III-R diagnosis were only mildly impaired. The highest prevalence rates of dysfunctioning (GAF score below 61) without referral to mental health services were for dissociative disorder (2.3%), sleep disorder (2.1%), alcohol dependence (1.3%) and affective disorder (1.8%). CONCLUSION: Instruments that assess functional impairment in addition to DSM-III-R diagnoses are indispensable in prevalence studies.

Adolescent↗

PubMed1995

The eight-year stability of problem behavior in an epidemiologic sample.

This study assessed the 8-y stability and change of parent-reported problem behaviors in 791 children from the general population assessed at 2-y intervals with the same standardized procedure, the child behavior checklist (CBCL). Problem behaviors were rather stable across even the relatively long time interval of 8 y. The 8-y stability coefficient for total problem score was 0.48, with somewhat higher stability for externalizing than internalizing problems. Despite stability, problem behaviors also changed considerably across time. These changes do not only reflect the increase in chronologic age. The present study showed that there are changes in children's problem levels that result from historical time influences. These secular trends seemed of even greater importance than aging effects, and reflect a slight increase of the norm of children's problem behaviors.

Adolescent↗

PubMed1995

Psychosexual adjustment of children and adolescents after different types of hypospadias surgery: a norm-related study.

PURPOSE: We studied the psychosexual adjustment, sexual behavior and genital appraisal of 9 to 18-year-old hypospadias patients. MATERIALS AND METHODS: We interviewed 116 hypospadias patients and 88 comparison subjects in a semi-structured manner. RESULTS: Hypospadias patients had a more negative genital appraisal and anticipated more ridicule by a partner because of penile appearance than comparison subjects but they did not have a different sexual adjustment. No significant impact of medical treatment (surgical procedures, number of operations or age at final surgery) was noted. Many hypospadias patients (38.8%) desired functional or cosmetic penile improvement. CONCLUSIONS: In addition to procedures that bring the meatus to a more terminal position, those that bring it more ventral can be performed without negatively affecting psychosexual adjustment. Hypospadias patients were reluctant to seek advice for problems and, therefore, they should be followed through adolescence.

Adaptation, Psychological↗

PubMed1995

Psychosexual adjustment of men who underwent hypospadias repair: a norm-related study.

PURPOSE: Psychosexual adjustment, sexual functioning and genital appraisal were studied in adult hypospadias patients. MATERIALS AND METHODS: A total of 73 hypospadias patients and 50 comparison subjects received a semi-structured interview. RESULTS: More hypospadias patients (32.8%) than comparison subjects (12.8%) had been inhibited in seeking sexual contacts. Hypospadias patients reported a more negative genital appraisal than comparison subjects but did not have a different sexual adjustment. The severity of hypospadias negatively affected genital appraisal. Patient age at final operation positively correlated with sociosexual development. Many patients (37%) desired functional or cosmetic penile improvement. CONCLUSIONS: The majority of hypospadias patients experienced a normal adult sex life. They were reluctant to seek advice for problems. We recommend followup of patients through adolescence.

Adaptation, Psychological↗

PubMed1994

A study of problem behaviors in 10- to 15-year-old biologically related and unrelated international adoptees.

Genetic and environmental influences on problem behaviors were studied in a sample of international adoptees. Parental ratings of childrens' problem behaviors were obtained with the Child Behavior Checklist (CBCL). The sample (mean age, 12.4 years) comprised a group of biological siblings (111 pairs), a group of nonbiological siblings (221 pairs), and a group of singletons (94). Nonshared environmental influences were most important for problem behaviors studied in this paper. Genetic influences were substantial for Externalizing behaviors but unimportant for Internalizing behaviors. For the CBCL total problem score, Attention Problems, and Externalizing behaviors, the results of the present study were in agreement with findings from twin studies. The lack of genetic influences on Internalizing behaviors contrasts with results from twin studies. For the total problem score, the Externalizing grouping, Delinquent Behavior, and Aggressive Behavior, variances for singletons were significantly smaller than for siblings. Model fit indices indicated that these differences in variances are better attributed to smaller effects of factors associated with sibship size than to active influences of siblings on each other. Significant sex differences were found for 8 of the 10 scales. The larger variances for boys on the Externalizing grouping and Aggressive Behavior could be explained by genetic influences.

Adolescent↗

PubMed1994

Differential predictive value of parents' and teachers' reports of children's problem behaviors: a longitudinal study.

This study investigated the prediction of signs of disturbance in 946 children originally aged 4 to 11 years from the general population across a 6-year period. Parents' and teachers' ratings obtained via the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) were tested as predictors of (a) academic problems, (b) school behavior problems, (c) receipt of mental health services, (d) child's need for professional help, (e) suicidal behavior, and (f) police contacts. Total problem scores in the deviant range on the CBCL or TRF were significantly associated with poor outcomes 6 years later. The combination of deviant scores on both the CBCL and TRF was a powerful predictor of poor outcomes with 56% of the girls, and 36% of the boys with total problem scores in the deviant range on both instruments maladjusted 6 years later. The CBCL syndromes Attention Problems and Delinquent Behavior, and the TRF syndromes Delinquent Behavior, Somatic Complaints, and Social Problems significantly predicted poor outcomes. Teachers' reports predicted poor outcomes equally well or even somewhat better than parents' reports. It is important to include teacher information in the diagnostic assessment of children.

Adolescent↗

PubMed1994

Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study.

To investigate the long-term psychosocial outcome of congenital heart disease, the emotional, intellectual and social functioning of 288 (young) adult patients was assessed with standardized assessment procedures 9-23 years (mean follow-up interval: 16 years) after surgical correction for congenital heart disease in childhood, and compared with that of reference groups. With respect to emotional functioning, the patients reported significantly fewer feelings of hostility, fewer neurotic complaints and a better self-esteem than reference subjects. Overall, the results concerning social functioning showed favourable outcomes on daily activities (school, employment) and leisure-time activities for (young) adults with congenital heart disease. No significant differences were found between scores of different cardiac diagnostic groups on hostility, neuroticism, self-esteem and leisure-time activities. The possibility whether the 'denial'-mechanism might have contributed to the positive outcomes is discussed.

Activities of Daily Living↗

PubMed1994

International adoption of children with siblings: behavioral outcomes.

In a study of internationally adopted children in the Netherlands 399 children placed with one or more siblings were followed up approximately ten years after placement. A comparison of problem behavior in this group with that of 1,749 children placed alone shows that the adoption of sibling groups is relatively successful.

Acculturation↗

PubMed1994

The prediction of poor outcome in young adults: comparison of the Young Adult Self-Report, the General Health Questionnaire and the Symptom Checklist.

The ability of the Young Adult Self-Report (YASR), the Symptom Checklist (SCL-90) and the General Health Questionnaire (GHQ-28) to predict maladjustment across a 2-year time-span was assessed in a general population sample of 528 18- to 22-year-olds. Referral for mental health services and need for professional help were predicted by total problem scores of the YASR, the GHQ-28 and the SCL-90 and by the internalizing scale of the YASR. Furthermore, the internalizing scale predicted suicide attempts or suicidal ideation, whereas the externalizing scale predicted police contacts. The YASR delinquent behavior syndrome was the only significant predictor of alcohol abuse. The findings supported the validity of the YASR as an instrument for the assessment of psychopathology in young adults.

Adolescent↗

PubMed1993

Behavioural and emotional problems in children and adolescents with congenital heart disease.

Behavioural/emotional problems were assessed at least nine years after surgical correction for congenital heart disease (ConHD) in childhood. Parents of 144 10-15-year-old ConHD-children completed the Child Behavior Checklist (CBCL) and 179, 11-17-year-old, ConHD-adolescents completed the Youth Self-Report (YSR). On the CBCL and YSR ConHD-children and adolescents obtained significantly higher problem scores than same-aged peers from normative reference groups. No significant differences were found between problem scores for different cardiac diagnostic groups. A negative correlation was found between CBCL total problem scores and IQ-scores of ConHD-children; for YSR total problem scores no such relationship was found.

Adaptation, Psychological↗

PubMed1993

Pathways of problem behaviors from childhood to adolescence.

OBJECTIVE: the purpose of this study was to determine the 6-year longitudinal course of psychiatric disorders in children from the general population commencing at age 4 to 11 years. METHOD: three groups of children were selected on the basis of Child Behavior Checklist ratings obtained at 2-year intervals: "persisters," "decreasers," and "increasers." Selected subjects and their parents were clinically interviewed, and DSM-III-R diagnoses were derived. RESULTS: the majority of children whose overall level of psychopathology persisted over time obtained lifetime DSM-III-R diagnoses classified as externalizing: attention-deficit hyperactivity disorder, oppositional disorder, or conduct disorder. The majority of children whose overall level of psychopathology decreased obtained lifetime DSM-III-R diagnoses classified as internalizing: anxiety disorders, major depression, or dysthymic disorder. Children with initial Child Behavior Checklist scores in the normal range whose problem scores increased received lifetime diagnoses that were neither predominantly externalizing or internalizing. CONCLUSIONS: this study showed that the majority of initially disordered children with the poorest outcome showed aggressive or antisocial behaviors, whereas disordered children whose functioning improved had problems reflecting fearful, inhibited, or depressive behavior. The findings also showed that retrospective information on the course of children's problem behaviors should be regarded with caution.

Adolescent↗

PubMed1993

Epidemiological comparisons of American and Dutch adolescents' self-reports.

OBJECTIVE: To determine the cross-cultural applicability of self-reports of adolescents' problems and competencies. METHOD: Youth Self-Reports (YSRs) were completed by 803 American and 803 Dutch nonreferred adolescents matched by gender, age, and socioeconomic status. RESULTS: Comparisons revealed that American adolescents reported many more problems than did Dutch adolescents. This finding contrasts sharply with the American/Dutch similarities in parents' and teachers' reports of children's problem behaviors. Competence scores also were much higher for the American than the Dutch sample. CONCLUSIONS: Cutpoints for discriminating the normal and the clinical range of YSR scores need to be adjusted to local norms for the Dutch sample. Cultural factors may be responsible for the cross-national differences.

Adolescent↗