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Biomedical subjects

F C Verhulst

Publications and source records attributed to F C Verhulst.

At least 109 records · Page 6Linked to original sources

"Comorbidity" in an epidemiological sample: a longitudinal perspective.

Parents' CBCL ratings of problem behaviors in 1117 4- to 11-year-olds from the general population were obtained across a 6-year interval. Data were analyzed categorically as well as quantitatively. Positive association, or overlap, was found between the majority of CBCL problem scales. Most CBCL scales were able to predict non-corresponding scales across the 6-year interval. Children who were scored in the deviant range on one particular syndrome but low on another syndrome had a better prognosis than children who were scored high on both syndromes. Studies concerning the etiology or treatment of certain conditions should control for co-occurring conditions because they may influence the results in unknown ways.

Attention Deficit Disorder with Hyperactivity↗

Two-year stability of self-reported problems in an epidemiological sample of adolescents.

This study investigated the stability and change of problems reported by adolescents during a 2-year period. An epidemiological sample of 580 adolescents aged 11-16 at the initial assessment completed the Youth Self-Report on two occasions. We found high stability in the level of Youth Self-Report total problem scores. The highest stability was found for aggressive behavior. Problem scores tended to increase across time. This increase was greater for girls than for boys, especially for the somatic complaints syndrome. Of the adolescents who could be regarded as deviant at the initial assessment, 42% could still be regarded as deviant 2 years later.

Adolescent↗

[Sexual abuse of children: the necessity of medical intervention].

Recently the Dutch Health Council published a report on the medical aspects of sexual abuse of children. The questions underlying this report reflect an attempt to arrive at hard indices of sexual abuse in children through the assessment of physical symptoms. For the medical assessment, the authors refer to the Dutch translation of an English report entitled Physical signs of sexual abuse in children, published by The Royal College of Physicians. The hazards connected with the exclusive focus on physical symptoms are recognized, and the authors stress that medical examination should be part of a much broader assessment of the child and his/her family. However, instead of confining themselves to assessment issues of physical symptoms, the authors add a rather meagre account of behavioural and emotional factors relevant to the diagnosis of sexual abuse of children. Unfortunately, this approach seems to aggravate the problems underlying misdiagnosis rather than to increase diagnostic accuracy and improve adequate care for sexually abused children.

Attitude of Health Personnel↗

Six-year stability of parent-reported problem behavior in an epidemiological sample.

An epidemiological sample of 936 Dutch children originally aged 4-11 years was assessed at 2-year intervals over a 6-year period. Parents completed the Child Behavior Checklist (CBCL) on all four occasions. Stability coefficients computed for eight CBCL syndromes, Internalizing and Externalizing dimensions, and total problems revealed considerable long-term stability. There was no significant difference in the 6-year stability of internalizing vs. externalizing scores. This finding was at odds with reports of considerably lower stability of internalizing behavior, and was consistent with findings suggesting that the stability of internalizing problems should not be underestimated. The magnitude and specificity of the long-term stability of internalizing and externalizing scores lends support to the validity of these behavioral dimensions as tapped by the CBCL. No significant sex or age differences in the stability of problem behaviors were found.

Age Factors↗

Damaging backgrounds: later adjustment of international adoptees.

In this study of 2,148 international adoptees aged 10 to 15 years, the influence of early adverse experiences on later adjustment was examined. It was found that early neglect, abuse, and the number of changes of caretaking environment increased the risk for later maladjustment. The older the age of the child at placement, the greater the probability that the child had been subjected to psychosocial adversities. This association sufficiently explained the greater likelihood of later maladjustment with increasing age of the child at placement. Age at placement, as such, did not contribute to the prediction of later maladjustment, independent of the influence of early adversities. The present study underscores the importance that parents and professionals should obtain reliable and detailed information on the child's background and functioning before adoption. This study also showed that the majority of adopted children, even those with backgrounds known to be damaging, seemed to function quite well according to their parents' reports.

Adaptation, Psychological↗

Six-year developmental course of internalizing and externalizing problem behaviors.

The 6-year developmental course of parent-reported problem behavior in an epidemiological sample of 936 children assessed with the Child Behavior Checklist at 2-year intervals was determined. Children who were scored in the deviant range of the total problem score at time 1 were nine times more likely to be scored deviant 6 years later than were children who were not deviant at time 1 (odds ratio 9.0). Of the deviant children at time 1, 33% were deviant at time 4. There was no difference in the persistence of externalizing versus internalizing problems. This underscores the notion that internalizing problems should not be disregarded. Although this study demonstrated moderate stability of problem behaviors across a 6-year interval, children's problem behaviors should not be regarded as static. Many children showed changes in their level of functioning across time. However, extreme changes were the exception rather than the rule.

Adolescent↗

Prediction of children's referral to mental health and special education services from earlier adjustment.

The 4-year stability in problem behaviors assessed with the Child Behavior Checklist (CBCL), and their predictive validity with regard to poor outcome variables was studied in 1052 4-12-year old children from a general population sample. Irrespective of sex and age, the scores on the CBCL of some 44% of the children remained above the 90th percentile over the 4-year time interval. Externalizing problem behavior tended to show somewhat greater stability than internalizing problem behavior. High initial levels of both internalizing and externalizing problems, and persistence of problems were predictive of referral to mental health services. Referral to special education was higher for younger boys with high initial attention problems and school problems. Police contacts occurred more often in older boys with high initial aggression scores.

Child↗

Agreement between parents' reports and adolescents' self-reports of problem behavior.

Parents' reports and adolescents' self-reports of problem behaviors in 883 11-19-year-olds from the general population were compared. Correlations between both informants' CBCL syndrome scores ranged from 0.27 to 0.56. Adolescents reported many more problems than their parents did about them. Discrepancies were larger for externalizing than for internalizing problems, were larger for girls than for boys and increased with age. The findings indicated that adolescents, especially as they grow older, are indispensable informants on their own problem behaviors.

Adolescent↗

Detecting psychopathology in young adults: the Young Adult Self Report, the General Health Questionnaire and the Symptom Checklist as screening instruments.

This study compares the screening capacity of an age-adjusted child-oriented questionnaire, the Young Adult Self Report (YASR) with two adult-oriented questionnaires, the General Health Questionnaire-28 (GHQ-28) and Symptom Checklist-90 (SCL-90) in a sample of young adults (18-25 years). The YASR performed just as well as the SCL-90 and both performed better than the GHQ-28. The relatively poor performance of the GHQ-28 compared with the YASR and SCL-90 could not be attributed to instrument characteristics or to the use of referral status as indicator of psychopathology. In assessing psychopathology in young adults an age-adjusted child-oriented instrument might be a good alternative to the existing adult-oriented instruments, especially when one takes into account the problem of data comparability over time in longitudinal studies in which children are followed into adulthood.

Adolescent↗

Children who cross cultures.

The subject of this study is the effects of transcultural sojourn and culture shock on the psycho-social development and school achievement of Dutch children. One hundred and three Dutch children in the age range 6-17 years who stayed abroad with their parents for at least two years and returned to Holland were compared with 81 Dutch classmates of the same age and sex. The class teacher and parent(s) were the informants. The transcultural group showed more behavioural problems on the Dutch version of the Child Behavior Checklist developed by Achenbach. Parents of the transcultural group regarded their children on a modified Graham & Rutter questionnaire as less happy than the control parents. However, no differences were found for academic achievement or problem behaviour at school as assessed by the teacher version of the CBCL, the 'Teacher's Report Form' (TRF). Organizations which send their employees abroad should direct more attention to employees' children. Attention given by parents and teachers to language problems and school performance should not pre-empt close attention to the psycho-social development of children.

Adolescent↗

Four-year follow-up of teacher-reported problem behaviours.

This study investigated the stability and change in teacher-reported problem behaviours across a four-year period. An epidemiological sample of 811 children aged 4-12 at the initial assessment was assessed twice with the Achenbach Teacher Report Form (TRF). We found medium stability in the level of TRF total problem scores. Highest stability was found for aggressive and other externalizing behaviours. Stability was higher for girls than for boys. Of the girls who could be regarded as disturbed at base line, 50% could still be so regarded four years later, whereas only 23% of the boys could be considered persistently disturbed across the study interval. Girls' scores on the Externalizing syndrome were especially stable.

Affective Symptoms↗

Longitudinal research in child and adolescent psychiatry.

An indispensable approach to the study of variations in individual development and of causal mechanisms and processes underlying the course of psychopathology is the longitudinal method. In this introductory review, the strengths and weaknesses of longitudinal research are discussed, and factors hampering progress in this field are outlined. The many advantages of this approach warrant continuing efforts to develop strategies that minimize its drawbacks.

Adolescent↗

Assessment of child psychopathology: relationships between different methods, different informants and clinical judgment of severity.

The purpose of this study was to assess the relationships between information on children's problem behavior obtained by different methods (rating scales and clinical interviews) and from different sources (adolescent, parents and teacher). From a sample of 132 14-year-old international adoptees and their parents, information was obtained via the Child Behavior Checklist (CBCL), the Youth Self-Report and the Teacher's Report Form, the Child Assessment Schedule, and the Graham and Rutter Parent Interview. Agreement between the CBCL and the clinical judgment of the severity of psychopathology was substantial. Assessment procedures providing data on the adolescents' functioning derived from different sources revealed less agreement than those derived from the same informant. Agreement was higher for externalizing than for internalizing behaviors. Data from different sources made unique contributions to clinicians' judgments of the severity of psychopathology.

Adolescent↗

Prevalence of problem behavior in Dutch children aged 2-3.

The present study provides prevalence data on behavioral and emotional problems in Dutch preschool children from the general population. The Child Behavior Checklist for ages 2-3 (3) was completed by parents of 421 children aged 2-3 living in the Dutch province of Zuid-Holland. Mean 3-week test-retest reliability of the instrument was .79 (pearson correlation) and the mean interparent agreement was .47. The CBCL/2-3 scores correlated positively and significantly (mean r of .65) with the BCL, an instrument designed to measure behavior problems, and not substantially (mean r of -.06) with the MCDI, an instrument to assess the child's level of general development. For each of the 99 problem items the prevalence rates were presented graphically for boys and girls in 6-months age-groups. The prevalence rates of individual problem items ranged from 1% to 80%. Sixteen percent of the items was scored for more than half of the sample, indicating that the behavior covered in these items may be quite common in young preschool children. In this sample 7.8% of the children were estimated to have a behavior problem, which compares well to the rates found in other studies. No age, sex, or SES differences in total problem scores were found. Almost all significant age, sex, and SES differences found for individual items were small. Age differences found for individual problem items probably reflect the growing self-other differentiation in 2-3-year-olds. Analysis of sex differences revealed that boys were rated to be more aggressive and oppositional and as having more developmental problems, and that girls were rated to have more sleep problems. SES differences were found for items which reflect hyperactive, undercontrolled, dependent, and depressed behaviors. Comparison of problem scores for referred and nonreferred preschool children indicated higher scores for referred children on 72 of the 99 problem items. The largest differences were found for the items Doesn't get along with other children, Wants a lot of attention, and Can't concentrate. Based on the total problem score 70 percent of the children could be correctly classified as referred or non-referred. A large percentage of children, however, was incorrectly classified based on the total problem score alone.

Affective Symptoms↗

Behavioral and emotional problems in youngsters with Prader-Willi syndrome.

In this study we document the behavioral/emotional problems of 27 Prader-Willi syndrome (PWS) subjects assessed with the Achenbach Child Behaviour Checklist. Compared with normal subjects of the same age and sex, PW subjects showed significantly more problem behaviour. Of the PWS subjects 87% had total problem scores in the clinical range. No significant difference was found in the proportion of Prader-Willi patients scored in the clinical range on the Internalizing over the Externalizing syndrome. The need for systematic attention towards behavioral/emotional problems when PWS patients enter adolescence is emphasized.

Adolescent↗

Problem behavior in international adoptees: I. An epidemiological study.

Behavioral/emotional problems and competencies in 2,148 international adoptees aged 10 to 15 years were compared with those in a same-aged sample of 933 children from the general population using the Achenbach Child Behavior Checklist. Parents reported more externalizing problem behavior for adopted than nonadopted children. More than twice as many 12- to 15-year-old adopted boys were scored above the cutoff criterion for problem behavior than nonadopted boys of the same age. For adopted boys in this age range especially high scores were obtained on the Delinquent and Hyperactive syndromes. Adopted children were scored less competent than nonadopted children in their social and academic functioning, whereas adopted children were found to be more active in nonsports activities and to function somewhat better than nonadopted children in sports and nonsports activities. In contrast to the effect of parental occupational level on competent scores for normative American and Dutch samples, adopted children from lower SES showed better academic performance, were less often referred to special classes, and had less other school problems than adopted children from higher SES.

Adolescent↗

Problem behavior in international adoptees: II. Age at placement.

This study of 2,148 international adoptees aged 10 to 15 indicated that the older the child at placement the greater the probability that the child will develop behavioral/emotional problems and/or will perform less well in school. For 12- to 15-year-olds, the authors found that the older the child at placement, the greater the risk for obtaining high scores on the following Child Behavior Checklist Syndromes: The delinquent and uncommunicative syndromes in boys, and the cruel, depressed, and schizoid syndromes in girls.

Adolescent↗

Problem behavior in international adoptees: III. Diagnosis of child psychiatric disorders.

This study is a clinical extension of two previous epidemiological studies on problem behavior in international adoptees. In depth pictures were obtained by clinical interviews of 132 14-year-old international adoptees and their parents. Children were selected on the basis of previously obtained Child Behavior Checklist (CBCL) scores. Clinical severity ratings and DSM-III-R diagnoses were obtained. The correlations of r = 0.63 and r = 0.45 between clinical severity ratings and CBCL problem and competence scores, respectively, indicated that the results from the authors' extensive epidemiological survey and the clinical evaluation, which took place more than 10 months later, converged. The results showed that the CBCL may be used in epidemiological studies to obtain an estimate of the prevalence of psychiatric disorders in children. The 28% prevalence rate of psychiatric disorders in this sample of 14-year-old international adoptees (22% rate for girls, 36% for boys) was somewhat higher than for general population samples reported in comparable studies. Conduct disorders were elevated in the sample. The behavior of disordered adopted children was characterized by antisocial behaviors, poor relationships, and problems of affect.

Adolescent↗