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Gary R Geffken

Publications and source records attributed to Gary R Geffken.

34 records · Page 2Linked to original sources
PubMed2005

Assessment of pediatric obsessive-compulsive disorder: a critical review of current methodology.

Obsessive-compulsive disorder (OCD) is a relatively common disorder among children and adolescents, and is associated with increased risk for concurrent and future distress and impairment. Many youth who suffer from OCD go undiagnosed or misdiagnosed, and do not attain appropriate treatment in a timely manner. As a result, researchers have focused greater attention to the assessment of pediatric OCD. This paper provides an overview of recent advances in this area, including an introduction to several new assessment instruments. Descriptions of new and commonly used instruments and their clinical/research utility are described. Psychometric properties are also reported. Finally, a critical review is offered of major trends in the assessment of pediatric OCD (e.g., diagnostic interviews, self-report and parent-report measures, and clinician-administered inventories).

Child↗
PubMed2005

Reliability and validity of the Yale Global Tic Severity Scale.

To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports of depression and anxiety. All children participated in a 2nd YGTSS administration by the same rater 48 days later. Good internal consistency and stability were found for the YGTSS scores. YGTSS scores demonstrated strong correlations with parent-rated tic severity (r = .58-.68). YGTSS scores were not significantly related to measures of clinician ratings of OCD severity (r = .01-.15), parent ratings of externalizing and internalizing behavior (r = -.07-.20), and child ratings of depression (r = .02-.26) and anxiety (r = -.06 -.28). Findings suggest that the YGTSS is a reliable and valid instrument for the assessment of pediatric TS.

Adolescent↗
PubMed2005

Parental stress and maladjustment in children with short stature.

This study examined the psychometric properties of a measure of chronic disease-related parental stress, the Pediatric Inventory for Parents (PIP), in a sample of 22 children with short stature. Additionally, we investigated relations among disease-related parental stress, parental state anxiety, and children's behavioral and psychological maladjustment. Results demonstrated acceptable internal consistency and convergent validity for the PIP. Significant and positive relations of medium to large effect sizes between parenting stress and internalizing and externalizing maladjustment were found. Recommendations for use of the PIP in clinical settings and future research directions are discussed.

Adolescent↗
PubMed2005

Factor analytic study of the Children's Yale-Brown Obsessive-Compulsive Scale.

This study examined the psychometric properties of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS; Scahill et al., 1997). Participants were 82 children and adolescents diagnosed with obsessive-compulsive disorder (OCD). Confirmatory factor analyses of 2 previously found models (Obsessions and Compulsions; Disturbance and Severity) yielded poor fit indexes. Exploratory factor analysis supported a model of severity and disturbance with slightly different item content than found by McKay et al. (2003). The internal consistency of the factors was acceptable, and the convergent and divergent validity was supported vis-a-vis correlations with clinician ratings of impairment, self-report measures of depression and anxiety, and parent ratings of Tourette's disorder (TD) symptoms. These findings suggest that the CY-BOCS Total Score may represent an inaccurate assessment of symptom severity and supports the use of the revised Severity and Disturbance factors in assessing illness severity.

Adolescent↗
PubMed2005

Online diabetes education: design and evaluation with prospective diabetes camp counsellors.

An educational Website was designed by the Florida Initiative in Telehealth and Education group, and an online diabetes education test was developed using a sample of 60 children and young adults aged 8-22 years, all of whom had diabetes. The 31 items were analysed for item difficulty. Eight test items were eliminated as being unsuitable. The test was then used in 67 prospective diabetes counsellors (23 men, 44 women) who volunteered for a summer camp. Camp counsellors ranged in age from 17 to 33 years (mean 22 years, SD 3). The counsellors' mean pre-test scores were 80% and their mean post-test scores were 92%. There was a significant improvement (P=0.001) of approximately 1.25 questions from pre- to post-test. This supports the use of the online educational Website for training individuals working with children with diabetes. The Website may prove to be useful for online education in other areas of diabetes management.

Adolescent↗
PubMed2005

Psychological adjustment of children with short stature: a comparison of clinic-referred children with short stature and type 1 diabetes mellitus.

This study compared the psychological adjustment between children with short stature and youth with type 1 diabetes mellitus (DM1). The Child Behavior Checklist, Children's Depression Inventory, Social Anxiety Scale for Children--Revised, and Asher Loneliness Scale were administered to 58 children (26 with short stature and 32 with DM1) and a parent during a regularly scheduled clinical appointment for endocrinology care. Results show that the parents of children with short stature rated their children as having more social, thought, and attention problems, and exhibiting greater delinquent behavior, as compared to parental ratings of children with DM1. No diagnostic group differences in child or parent-rated internalizing symptoms were found. Implications of these findings for personnel working with children with short stature are discussed.

Adaptation, Psychological↗
PubMed2005

Current directions in pediatric obsessive-compulsive disorder.

Pediatric OCD, a chronic and impairing condition, is not uncommon. Diagnosis is often difficult given the secrecy of many patients and co-occurring psychopathology. CBT alone or CBT with concurrent SSRI therapy are considered the first-line treatment. Nevertheless, relatively few mental health professionals are adequately trained in CBT for OCD. For example, in a national survey of 79 clinicians treating pediatric OCD in Norway, less than 33% of clinicians reported using exposure/response prevention (or similar techniques) despite rating CBT as a favorable approach to treatment. Limited access to professionals proficient in CBT may result in the prescription of pharmacotherapy alone or pharmacotherapy with other concurrent psychotherapies (that are not demonstrated as efficacious). Clearly, improving the referral network to experts trained in CBT for OCD is necessary to provide efficacious treatment, associated with reduced rates of relapse. Intensive CBT may extend resources to families without access to trained professionals in their area, given the potential for effective therapy in a succinct time period. Accordingly, in addition to the controlled trial evaluating CBT, pharmacotherapy, and combined treatment, initial investigations of intensive CBT for pediatric patients appear necessary. Additionally, intervention studies for children with significant comorbid psychopathology should be pursued.

Child↗
PubMed2004

Psychometric evaluation of the Children's Yale-Brown Obsessive-Compulsive Scale.

This study evaluated the psychometric properties of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). A total of 61 children and adolescents, aged 4-18 years, who were diagnosed with obsessive-compulsive disorder (OCD) participated. Thirty-seven of these children also participated in a second CY-BOCS administration by the same rater an average of 41 days later. Good internal consistency and test-retest reliability were found for the CY-BOCS Obsession and Compulsion Severity Scores and the Total Score. CY-BOCS scores demonstrated strong correlations with clinician-rated measures of impairment, obsessions, and compulsions. In addition, CY-BOCS scores were moderately related to measures of depression, aggressive behavior, and symptoms of attention deficit hyperactivity disorder, but were not significantly related to clinician ratings of tics or self-reports of general anxiety. Findings suggest that the CY-BOCS is a reliable and valid instrument for the assessment of childhood obsessions and compulsions.

Adolescent↗
PubMed2004

Further psychometric properties of the Tourette's Disorder Scale-Parent Rated version (TODS-PR).

This study evaluated the psychometric properties of the Tourette's Disorder Scale-Parent Rated (TODS-PR), a 15-item parent-rated instrument that assesses a range of common symptoms seen in childhood Tourette's Disorder (TD) patients including tics, obsessions, compulsions, inattention, hyperactivity, aggression, and emotional disturbances. Participants were 67 children and adolescents ages 6-17 years who were diagnosed with TD and/or OCD and seen as a part of a larger study. Confirmatory factor analyses supported the original 4-factor structure of the TODS-PR with some slight re-specification of factor content. Internal consistencies were acceptable for the TODS-PR Total Score and factors. The TODS-PR Total Score and factors showed good convergent validity with other measures of symptomatology and impairment. These findings suggest that the TODS-PR is a reliable and valid parent-rating scale for assessing TD symptoms.

Adolescent↗
PubMed2004

Social-psychological correlates of peer victimization in children with endocrine disorders.

OBJECTIVE: To examine the relation between victimization by peers and child and parent reports of social-psychological adjustment. STUDY DESIGN: The Social Experience Questionnaire, Children's Depression Inventory, Social Anxiety Scale for Children-Revised, and Asher Loneliness Scale were administered to 93 children diagnosed with various endocrine disorders. The child's parent/guardian completed the Child Behavior Checklist. RESULTS: For the entire sample, peer victimization was positively related to child-reported depression, social anxiety, loneliness, and parent-reported externalizing symptoms. Those children with endocrine disorders without observable features had a stronger relation between peer victimization and depression and internalizing and externalizing behavior problems than did those who had endocrine disorders with observable physical features. CONCLUSIONS: Recognition of the magnitude of the problem and means of evaluating for peer victimization is important for clinicians who see children with chronic diseases.

Adolescent↗
PubMed2004

Peer victimization and psychosocial adjustment in children with type 1 diabetes.

This study investigated the frequency and psychosocial correlates of peer victimization in a sample of youths with diabetes. The Social Experience Questionnaire, Children's Depression Inventory, Social Anxiety Scale for Children-Revised, and Asher Loneliness Scale were administered to 32 children diagnosed with type 1 diabetes and 32 control children without a medical diagnosis who were matched for age and gender. Results indicated that children with diabetes reported higher rates of relational victimization and lower levels of prosocial peer support than youths without diabetes. In addition, relational victimization was positively associated with depression, social anxiety, and loneliness for diabetic children. Implications of these findings for clinicians working with this population are discussed.

Adolescent↗
PubMed2004

Association between overt and relational aggression and psychosocial adjustment in undergraduate college students.

This study examined the relations between overt and relational aggression, social anxiety, loneliness, depressive symptoms, and alcohol and drug use in a sample of 287 undergraduate college students. Consistent with prior work, men reported engaging in more overt aggression than women. Contrary to our predictions, men also reported engaging in more relational aggression than women. Results also indicated that overt and relational aggression were positively associated with social anxiety, loneliness, depressive symptoms, alcohol use, and drug use for the overall sample. Hierarchical regression analyses showed positive relations between overt aggression and alcohol use for men and no relations between relational aggression and any psychosocial adjustment index. For women, overt aggression uniquely predicted social anxiety, loneliness, and depressive symptoms, whereas relational aggression uniquely predicted social anxiety, loneliness, depression, and alcohol and drug problems. Implications of these findings are discussed in terms of the role of peer aggression in students' psychosocial adjustment.

Adaptation, Psychological↗
PubMed2004

Cognitive-behavioral therapy for obsessive-compulsive disorder: review of treatment techniques.

Obsessive-compulsive disorder (OCD) is a chronic, impairing condition with an estimated lifetime prevalence in adults of 2.5%. Controlled treatment trials have demonstrated that cognitive-behavioral therapy (CBT) is an effective intervention for OCD. However, many individuals diagnosed with OCD do not receive appropriate, empirically validated interventions, perhaps due to limited knowledge of CBT among mental health practitioners. This article provides a review of CBT for OCD. Issues related to treatment delivery and assessment are presented and highlighted by an individual example.

Attitude↗