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Biomedical subjects

H M Koot

Publications and source records attributed to H M Koot.

At least 19 recordsLinked to original sources

Psychometric properties of the revised Developmental Behaviour Checklist scales in Dutch children with intellectual disability.

The present study assessed the reliability and validity of the revised scales of the Developmental Behaviour Checklist (DBC) in a Dutch sample of children with intellectual disability (ID). The psychometric properties of the parent and teacher versions of the DBC were assessed in various subsamples derived from a sample of 1057 Dutch children (age range=6-18 years) with ID or borderline intellectual functioning. Good test-retest reliability was shown both for the parent and teacher versions. Moderate inter-parent agreement and high one-year stability was found for the scale scores. Construct validity was satisfactory, although limited by high informant variance. The DBC scales showed good criterion-related validity, as indicated by significant mean differences between referred and non-referred children, and between children with and without a corresponding DSM-IV diagnosis. The reliability and validity of the revised DBC scales are satisfactory, and the checklist is recommended for clinical and research purposes.

Adolescent↗

Effect of dry bed training on behavioural problems in enuretic children.

UNLABELLED: Children with nocturnal enuresis (n = 91) selected by school doctors in The Netherlands from 1991 to 1994 were included in a study to assess the course of behavioural problems especially when the children became dry after the Dry Bed Training (DBT) programme. The Child Behaviour Checklist (CBCL) questionnaire was completed by 88 parents (96%) prior to DBT (T1) and by 83 parents (91%) 6 mo after DBT (T2). The mean CBCL total problem score at T1: 24.0 (range 2-91, SD 16) was significantly higher than that of a Dutch norm group: 20.45, (p=0.025). Compared to T1, the mean CBCL total problem score at T2 was 16.8 (range 0-73; SD 14.7; p < 0.0001). Of the children with CBCL total problem scores at T1 in the borderline or clinical range, 92% became dry and 58% improved to the normal range. At T2, the children seemed to have less internal distress, fewer problems with other people, and were less anxious and/or depressed. CONCLUSION: Children with behavioural/emotional problems who wet their beds need not first be treated for their behavioural/emotional problems. Bedwetting can be treated successfully with DBT when other treatments such as normal alarm treatment have failed, and alarm treatment/DBT can have a positive influence on behavioural/emotional problems.

Adolescent↗

Quality of life measurement in children and adolescents: issues, instruments, and applications.

There is increasing interest in measuring quality of life (QL) in children and adolescents, but this interest has developed without careful attention given numerous important issues. Consequently, there is much diversity and confusion in this measurement area. We discuss at a conceptual level herein how to construe and define QL, approach its measurement, and the implications of for whom this is done. Methodological issues pertaining to validation, proxy report, and child development are also discussed. Guidelines for selecting QL measures are provided and a set of generic QL measures is recommended for further consideration. Finally, applications of the QL concept in the policy, service and care, and science areas are delineated.

Adolescent↗

The association between physiological and behavioral pain measures in 0- to 3-year-old infants after major surgery.

To estimate the association between behavioral and physiological pain measures and to identify determinants predicting the level of association, the COMFORT 'behavior' scale, heart rate (HR), mean arterial pressure (MAP), and the variability of HR and MAP (HRV and MAPV) were assessed every 3 hours after major abdominal or thoracic surgery. Subjects were 204 infants aged 0-3 years. The within-subject correlations, using the repeated measures, were 0.37, 0.44, 0.48, and 0.49 for COMFORT 'behavior' with HRV, HR, MAP, and MAPV, respectively. Neonates had lower behavior-physiology correlations than the older infants, due to low pain scores. Pain characteristics significantly predicted the COMFORT 'behavior'-HR/MAP correlations, suggesting that the behavior-physiology correlations increase with increasing pain. The behavior-physiology correlations were not greatly affected by physical condition. These data demonstrate large interindividual differences in behavior-physiology correlations after major surgery in 0- to 3-year-old infants. These differences should be further explored in future research.

Abdomen↗

Early preschool predictors of preadolescent internalizing and externalizing DSM-IV diagnoses.

OBJECTIVE: To investigate the independent predictive value of parent-reported psychopathology and family risk factors in early preschool in relation to parent-reported internalizing and externalizing psychopathology in preadolescence. METHOD: Subjects were participants in a longitudinal study of 420 two- to three-year-olds from the general population of Zuid-Holland, the Netherlands, which started in 1989. At a second follow-up 8 years later (ages 10-11 years), 358 children participated. For this study, 332 children were included for whom DSM-IV diagnoses (derived from the Diagnostic Interview Schedule for Children-Version 4-Parent Version) were obtained at age 10 to 11 years. Preschool risk factors were obtained through the Child Behavior Checklist for ages 2 to 3 years and a parent interview. RESULTS: Early preschool internalizing and externalizing problems were predictive of their DSM-IV counterparts 8 years later, independent of the influence of early parent-reported family risk factors. Preschool child physical problems were independently predictive of both internalizing and externalizing diagnoses in preadolescence. Of the environmental risk factors, only stressful life events contributed independently to the prediction of later externalizing problems. CONCLUSION: Early adverse family circumstances and parenting characteristics do not contribute to the prediction of later psychopathology once child characteristics are accounted for.

Child↗

Body image, psychosocial functioning, and personality: how different are adolescents and young adults applying for plastic surgery?

This study addressed three questions: (1) Do adolescents undergoing plastic surgery have a realistic view of their body? (2) How urgent is the psychosocial need of adolescents to undergo plastic surgery? (3) Which relations exist between bodily attitudes and psychosocial functioning and personality? From 1995 to 1997, 184 plastic surgical patients aged 12 to 22, and a comparison group of 684 adolescents and young adults from the general population aged 12 to 22 years, and their parents, were interviewed and completed questionnaires and standardised rating scales. Adolescents accepted for plastic surgery had realistic appearance attitudes and were psychologically healthy overall. Patients were equally satisfied with their overall appearance as the comparison group, but more dissatisfied with the specific body parts concerned for operation, especially when undergoing corrective operations. Patients had measurable appearance-related psychosocial problems. Patient boys reported less self-confidence on social areas than all other groups. There were very few patient-comparison group differences in correlations between bodily and psychosocial variables, indicating that bodily attitudes and satisfaction are not differentially related to psychosocial functioning and self-perception in patients than in peers. We concluded that adolescents accepted for plastic surgery have considerable appearance-related psychosocial problems, patients in the corrective group reporting more so than in the reconstructive group. Plastic surgeons may assume that these adolescents in general have a realistic attitude towards their appearance. are psychologically healthy, and are mainly dissatisfied about the body parts concerned for operation. corrective patients more so than reconstructive patients. Introverted patients may need more attention from plastic surgeons during the psychosocial assessment.

Adaptation, Psychological↗

Preschool developmental pathways to preadolescent internalizing and externalizing problems.

The present study investigated longitudinal pathways from specific early preschool behavioral problems (ages 2-3 years) to internalizing and externalizing problems in preadolescence (ages 10-11 years), and the role of social problems at school entry (ages 4-5 years) in such pathways. Path analyses were performed using both parent and teacher reports in a sample of 251 to 346 children from the general population, depending on the availability of parent and teacher data at each time of assessment. Structural equation modeling revealed homotypic internalizing and externalizing pathways, predictions from early preschool externalizing problems to later internalizing problems, and negative predictive paths from early internalizing problems to externalizing problems in preadolescence. Cross-informant predictions spanning 8 years were found between parent-reported aggression and overactivity at ages 2-3 years and teacher-reported externalizing problems at ages 10-11 years. Further, results showed that boys' pathways were more complex and showed greater predictive validity than pathways for girls, and that social problems at school entry played a significant role in pathways to internalizing problems, but only for boys. The results are discussed from a developmental psychopathology perspective.

Child↗

The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3-year-old infants.

The aim of this study was to test the reliability and validity of the COMFORT scale as a postoperative pain instrument for children aged 0-3 years. Subjects were 158 neonates and toddlers after major abdominal or thoracic surgery. Trained nurses rated the children's pain at 3, 6 and 9 h postoperative on the Pediatric Surgical Intensive Care Unit using the COMFORT and a VAS for pain. Interrater reliability of the COMFORT items proved to be good (Kappa 0.63-0.93) for all items with the exception of the item 'Respiratory response', which was moderate (Kappa 0.54). LISREL analyses showed that the structure of the COMFORT data was best represented by three latent variables: COMFORT 'behaviour' with loadings from the behavioural items (Alertness, Calmness, Respiratory response/Crying, Physical movement, Muscle tone and Facial tension) and separate latent variables for 'Heart rate baseline' (HR) and 'Mean arterial blood pressure baseline' (MAP). Factor loadings of the items were invariant across time, indicating stability of the structure. The latent variables COMFORT 'behaviour' and VAS pain were highly interrelated indicating congruent validity. Stability of COMFORT 'behaviour' and VAS pain was moderate which might be due to varying painful episodes in this sample. HR and MAP, although stable across time, were weakly related to VAS pain and COMFORT 'behaviour'. These findings support the use of the COMFORT 'behaviour' scale to assess postoperative pain in neonates and infants.

Blood Pressure↗

Psychosocial sequelae in 29 children with giant congenital melanocytic naevi.

Giant congenital melanocytic naevus (GCMN) may be expected to affect psychosocial functioning of children and their parents due to deviant appearance and painful treatment. To obtain insight into clinical aspects and psychosocial functioning of those suffering from GCMN, 29 children diagnosed with GCMN syndrome or single GCMN received a dermatological examination, were interviewed, and their mothers and teachers completed standardized questionnaires on the child's competence and behavioural/emotional problems and their own adjustment. Social problems were reported for 30% of the patients and behavioural/emotional problems for 25.9%. There was no correlation between visibility of the naevus, treatment or child age and psychological problems. Mothers reported considerable psychosocial burden. It is concluded that children with GCMN are at increased risk of social and behavioural/emotional problems, and mothers suffer considerable psychological impact of their child's condition.

Adaptation, Psychological↗

Children with congenital diaphragmatic hernia are at risk for lower levels of cognitive functioning and increased emotional and behavioral problems.

The physical, psychological, and social functioning of 11 children aged 8 to 12 years with Congenital Diaphragmatic Hernia (CDH) was assessed with several standardized assessment procedures. Physically, most children functioned well at follow-up with half of the children showing minor physical problems such as bronchial hyperreactivity. The mean IQ of the children was 15 points (1 SD) below the norm of 100. Only 6 children were at expected school level. The children showed more emotional and behavioral problems than in the general population as reported by parents and teachers. The children themselves reported more depressive problems, but not a lower self-esteem than children in the general population. These results were confirmed by the results of interviews with parents and children concerning psychosocial functioning. It is concluded that children with CDH show more cognitive and learning problems and increased rates of emotional and behavioral problems compared to children in the general population. Since no children treated with Extra Corporeal Membrane Oxygenation (ECMO) were involved in this study, the earlier reports that lower cognitive functioning is limited to children with CDH treated with ECMO can not be confirmed by this study. Considering the results of this study, there is a need for further follow-up studies concerning the long-term psychological and social functioning of children with CDH.

Child↗

Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism.

OBJECTIVES: To test whether early treatment with a high initial dose of levothyroxine can prevent suboptimal mental development in all neonates with congenital hypothyroidism (CH). STUDY DESIGN: Sixty-one patients, 27 with severe CH and 34 with mild CH, were treated either early (<13 days) or late (> or =13 days) with either a high initial dose of levothyroxine (> or =9.5 microg/kg/d) or a low initial dose (<9.5 microg/kg/d). With these criteria, 4 treatment groups were formed. The results of the Bayley test, performed at the age of 10 to 30 months and expressed as mental developmental index (MDI) and psychomotor developmental index (PDI), were related to socioeconomic status, treatment group, initial free thyroxine (FT(4)) concentration, and mean FT(4) concentration during the first 3 months of treatment (FT(4)-A) and the ensuing 9 months (FT(4)-B). RESULTS: Mean (+/- SD) MDI was 113 +/- 14, and mean PDI was 114 +/- 12. In the severe CH group, only the patients treated early with a high initial dose had normal MDI scores (124 +/- 16), whereas the scores of the other groups ranged from 97 to 103. In contrast, all patients in the mild CH group had normal scores (range, 122-125), except those in the group treated late with a low initial dose, whose score was 110 +/- 10. Forty-three percent of the variance in MDI and PDI scores was explained by treatment factors, such as the treatment group, initial FT(4) concentration, FT(4)-A, and FT(4)-B. CONCLUSIONS: Our data suggest that optimal treatment includes achievement of euthyroidism before the third week of life by initiation of therapy before 13 days with a levothyroxine dose above 9.5 microg/kg/d and maintenance of FT(4) concentrations in the upper normal range during the first year. Thus treated, patients with CH can achieve normal psychomotor development at 10 to 30 months, irrespective of the severity of the disease.

Child Development↗

Child-reported depression and anxiety in preadolescence: I. Associations with parent- and teacher-reported problems.

OBJECTIVE: To examine a wide range of parent- and teacher-reported behaviors in relation to child-reported depression and anxiety in preadolescence. METHOD: Subjects were participants in a longitudinal study of 420 preschool children from the general population that started in 1989. At second follow-up 8 years later (ages 10-11 years), usable parent information was obtained for 358 children. For this study, 274 children for whom complete child, parent, and teacher reports were obtained at age 10 to 11 years were included. Measures included the Dimensions of Depression Profile for Children, the State-Trait Anxiety Inventory for Children, the Child Behavior Checklist/4-18, and the Teacher's Report Form. RESULTS: Of 120 parent-reported problem items, only 11 and 9 were associated with child-reported depression and anxiety, respectively. For teachers, 33 and 20 items (of 120) were significantly associated with child-reported depression and anxiety, respectively, including items referring to withdrawal, anxiety, depression, social problems, and academic problems. CONCLUSIONS: Teachers are more likely than parents to notice internalizing problems and related problems such as social and academic problems in children reporting depression or anxiety.

Anxiety↗

Child-reported depression and anxiety in preadolescence: II. Preschool predictors.

OBJECTIVE: To examine the predictive association of parent- and teacher-reported behaviors at age 2 to 3 years in relation to child-reported depression and anxiety at age 10 to 11 years. METHOD: Subjects were participants in a longitudinal study of 420 children aged 2 to 3 years from the general population first assessed in 1989 and again in 1991 (n = 397) and 1997 (n = 358). For the present study, 249 children were included for whom all relevant measures were obtained. These measures include the Child Behavior Checklist (CBCL) for 2- to 3-year-olds at time 1, the CBCL for 4- to 18-year-olds and the Teacher's Report Form at time 2, and the Dimensions of Depression Profile for Children and the State-Trait Anxiety Inventory for Children at time 3. RESULTS: Only 5 and 8 of 220 parent-reported preschool problem items were significantly related to later child-reported depression and anxiety, respectively, and only 3 of 120 teacher-reported problem items were related to later anxiety. Of 120 teacher-reported preschool problem items, 21 were significantly related to later depression, including items referring to early signs of depression and social and academic problems. CONCLUSIONS: Teachers, but not parents, can provide valuable information regarding preschool signals of preadolescent depression, but not anxiety. These signals include early social and academic problems.

Anxiety↗

Predictors of psychopathology in young adults referred to mental health services in childhood or adolescence.

BACKGROUND: For children referred to mental health services future functioning may be hampered. AIMS: To examine stability and prediction of behavioural and emotional problems from childhood into adulthood. METHOD: A referred sample (n = 789) aged 4-18 years was followed up after a mean of 10.5 years. Scores derived from the Child Behavior Checklist, Youth Self-Report and Teacher Report Form were related to equivalent scores for young adults from the Young Adult Self-Report and Young Adult Behavior Checklist. RESULTS: Correlations between first contact (T1) and follow-up (T2) scores were 0.12-0.53. Young adult psychopathology was predicted by corresponding T1 problem scores. Social problems and anxious/depressed scores were predictors of general problem behaviour. CONCLUSIONS: Problem behaviour of children and adolescents referred to outpatient mental health services is highly predictive of similar problem behaviour at young adulthood. Stability is higher for externalizing than for internalizing behaviour and for intra-informant than for inter-informant information. Stabilities are similar across gender. To obtain a comprehensive picture of the young adult's functioning, information from related adults may prove valuable.

Adolescent↗

Common and specific correlates of preadolescent internalizing and externalizing psychopathology.

The specificity of various child characteristics and environmental correlates of childhood internalizing and externalizing problems was examined using both cross-sectional and longitudinal analyses (from ages 2-3 and 4-5 years) in a general population sample of 10-11-year-olds. Specificity was defined according to a between-subjects and a within-subjects method, using parent and teacher reports of psychopathology. Temperamental withdrawal, parental internalizing psychopathology, and early single parenthood (for girls) were identified as correlates that are specific for internalizing problems, whereas temperamental high general activity level was identified as externalizing-specific. Further, parenting stress, poor school results (only for boys), and stressful life events (only for girls) were found to be common correlates of psychopathology. Research implications regarding the findings and the use of a within-subjects method are discussed.

Adolescent↗

Long-term physical, psychological, and social functioning of children with esophageal atresia.

BACKGROUND/PURPOSE: Little is known about the long-term psychosocial functioning of children with esophageal atresia (EA). The physical, psychological, and social functioning of children with EA was studied using standardized assessment procedures, and relations between medical and social background variables and outcome were investigated. METHODS: Subjects were 36 children (20 boys, 16 girls; mean age 10.2 years) with EA. Fourteen children had minor and 11 children had major associated congenital anomalies. According to the "Montreal" classification, eight children with major congenital anomalies who also had been dependent on artificial ventilation as newborns fell into the high-risk class. The children were subjected to an intelligence test. Parents completed standardized questionnaires concerning emotional and behavioral problems, psychosocial stress, and family functioning; children completed questionnaires concerning depression and self-esteem; and teachers completed questionnaires concerning emotional and behavioral problems. Results were compared with normative data from the general population, and correlations between background and outcome variables were computed. RESULTS: According to Desjardins' classification, 16 children had excellent, nine children had good, and four children had fair outcome. The mean intelligence quotient (IQ) of the children was 90.2, which is almost 10 points lower than the standardized norm of 100 (P < .01). High-risk children (n = 7) had a significantly lower IQ (mean IQ, 79.4; P < .05). Five times as many children (n = 8; 22%) as in the general population (4%) required special education (P < .001). More than twice as many children (30% to 35%) as in the general population (15%) showed elevated rates of emotional and behavioral problems as reported by parents and teachers (P < .02). The children did not report more negative self-esteem or more depressive symptoms than children in the general population. Children with a lower IQ reported lower scholastic competence (r = .38, P < .05) and showed more emotional and behavioral problems as reported by teachers (r = -.43, P < .05). Family functioning and levels of psychosocial stress were the same as in the general population. Children in worse functioning families showed more emotional and behavioral problems as reported by parents (r = .37, P < .05) and higher depression scores as reported by themselves (r = .47, P < .01). CONCLUSIONS: In a follow-up study using standardized assessment procedures, it was shown that children with EA have more learning, emotional, and behavioral problems than children in the general population. A high-risk group of children with major associated congenital anomalies who had been ventilated as a newborn, were at special risk for cognitive problems.

Affective Symptoms↗

Continuity of psychopathology in youths referred to mental health services.

OBJECTIVE: To investigate the stability and predictive strength of behavioral and emotional problems in childhood and adolescence. METHOD: A referred sample (N = 1,652), aged 4 to 18 years at initial assessment, was followed up after a mean interval of 6.2 years. Problem scores derived from Child Behavior Checklist, Youth Self-Report, and Teacher's Report Form at initial assessment (T1) were related to scores on the same instruments at follow-up (T2). RESULTS: Correlations between T1 and corresponding T2 problem scores averaged 0.41 intrainformant (range 0.22-0.61) and 0.22 interinformant (range -0.09-0.57). Stabilities were similar across gender, and larger for Externalizing versus Internalizing scores, except on youths' self-reports. Psychopathology scores at follow-up were predicted by corresponding T1 scores. Girls were predicted to have higher T2 Somatic Complaints, Anxious/Depressed, Thought Problems, and Internalizing scores than boys. Children younger at intake were predicted to have higher scores than older children on T2 Social and Attention Problems. CONCLUSIONS: Findings indicate continuity of specific behavioral and emotional problems in clinically referred children and adolescents.

Adolescent↗