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Biomedical subjects

Robert Goodman

Publications and source records attributed to Robert Goodman.

At least 19 recordsLinked to original sources
PubMed2006

The children's services interview: validity and reliability.

BACKGROUND: The Children Service Interview was designed as a brief measure of service use related to mental health problems in Great Britain. METHOD: We validated the Children's Services Interview against medical records from a sample of 87 children, and assessed test-retest reliability from 25 parents completing two interviews. We examined criterion validity by looking at the service use patterns of children attending clinics for different types of disorders. RESULTS: The Children's Services Interview showed high levels of face validity and moderate or better concordance with medical records as far as contacts were recorded in the case notes. Test-retest reliability was moderate or better apart from contacts with the voluntary sector, teachers, and the number and duration of appointments with some professionals. CONCLUSION: The study suggests the Children's Services Interview can extract moderately valid and reliable data on service use. DECLARATION OF INTEREST: Tamsin Ford was supported by a Wellcome Clinical Training Fellowship in Health Services Research while completing this work.

Adolescent↗
PubMed2006

Relationship between parental psychopathology, parenting strategies and child mental health--findings from the GB national study.

BACKGROUND: Parental and child psychiatric disorders have been found to be associated, and this association can be mediated by other psychosocial variables, including parenting attitudes and strategies. As most previous studies included clinical samples, the purpose of this study was to establish the relationship between parental psychopathology and parenting strategies with child psychiatric disorders in a national survey population. METHODS: The sample included 10,438 children of 5-15 years and their parents, from representative UK households. Families were assessed on child psychiatric diagnosis, parental psychopathology, family functioning, and socioeconomic status. Parenting strategies included using rewards, physical and non-physical punishments towards their child. FINDINGS: Parental psychopathology scores (OR 3.99, 95% CI 3.13-5.09) and non-physical punishment (OR 1.50, 95% CI 1.27-1.76) were associated with child psychiatric disorders. This association was particularly prominent among children with conduct disorders: parental psychopathology scores (OR 3.13, 95% CI 2.28-4.30) and non-physical punishment (OR 3.19, 95% CI 2.55-3.97). Absence of child psychopathology was associated with a combination of rewarding and non-punitive parenting strategies. CONCLUSIONS: Although parents in the general population may be using less physical strategies than in the past, non-physical punishment is strongly related to mental health problems in children. Enhancement of positive parenting through universal and targeted interventions is an important preventive strategy.

Adolescent↗
PubMed2006

Preadolescent conduct problems in girls and boys.

OBJECTIVE: To examine sex differences in correlates of disruptive behavior disorders (DBDs) in preadolescent children using indicators of a wide range of well-established risk factors for DBDs and outcomes 3 years after initial assessment. METHOD: Analyses were based on data for 5- to 10-year-olds (n = 5,913) from the British Child and Adolescent Mental Health Survey 1999, and a 3-year follow-up of selected subsamples (n = 1,440) at ages 8 through 13 years. DSM-IV diagnoses were assigned using the Developmental and Well-Being Assessment at both contacts. RESULTS: Boys and girls were equally exposed to most social and family risks for DBDs, with little evidence of differential sensitivity to these risks. Boys were exposed more to neurodevelopmental difficulties, attention-deficit/hyperactivity disorder, and peer problems and had lower rates of prosocial behaviors; together, these factors and physical punishment could account for 54% of the observed sex differences in DBDs. At follow-up, outcomes for girls and boys with DBDs were very similar. For children with subthreshold conduct problems at initial assessment, boys were more likely to go on to exhibit DBDs than were girls (25% versus 7%). CONCLUSIONS: Sex differences in the levels of a variety of child characteristics and interpersonal factors are likely to be important in understanding sex differences in risk for DBDs in preadolescent samples.

Adolescent↗
PubMed2006

Barriers to the identification of children with attention deficit/hyperactivity disorder.

BACKGROUND: In most countries, the majority of children with attention deficit/hyperactivity disorder (ADHD) are undiagnosed. In the United Kingdom, a major barrier to accessing specialist services is the limited recognition of disorders by general practitioners. However, it is unclear whether there are also barriers at other stages of the help-seeking process. For children with ADHD, this study aims to examine the correlates of the different stages of help-seeking. METHOD: Children with ADHD (n = 232) were identified from the 1999 British Child and Adolescent Mental Health Survey. Rates and correlates of parental recognition of child mental health problems and contact with services for these problems were examined. Children who had used particular types of services were compared with those who had not. RESULTS: Most (80%) parents of children with ADHD recognise that their child has a problem although few (35%) construe this in terms of hyperactivity. The impact of the symptoms on key adults, rather than child factors, best predicted parental recognition of problems. Most parents had been in contact with education-based professionals but few had consulted primary care for these problems or had sought help from relevant specialist health services. Parental recognition of problems and perceived burden, rather than child factors, were the main correlates of contact with services. Parental views that their child has hyperactivity were associated with greater severity of symptoms. CONCLUSIONS: The main barrier to care for ADHD is the limited presentation of these problems to primary care. The majority of parents discuss their concerns with professionals based in education services. There is a need for parental education about ADHD and for health service input to support education professionals in their contact with concerned parents.

Adolescent↗
PubMed2005

[Parental beliefs and child-rearing attitudes and mental health problems among schoolchildren].

OBJECTIVE: To verify the prevalence and identify the risk factors related to mental health problems among schoolchildren and its possible association with the beliefs and educational attitudes of parents/caretakers. METHODS: Cross-sectional study with a stratified probabilistic sample (n=454) of first to third-graders from public and private schools in Southeastern Brazil. Standardized instruments were administered to parents/caretakers by trained interviewers, including screening questionnaires for mental health problems among children and parents/caretakers; a questionnaire on beliefs and attitudes; and a questionnaire for socio-economic status. Chi-square tests and logistic regression models were used for statistical analysis. RESULTS: We found 35.2% prevalence of clinical/borderline cases among students. Parents/caretakers that believed in corporal punishment as a child-rearing method used physical aggression towards their children more frequently (64.8%). Logistic regression models showed that the act of hitting the child with a belt was associated to conduct problems and to overall mental health problems among schoolchildren in the presence of other risk factors: child gender (male), parents/caretakers with mental health problems, and adverse socioeconomic conditions. CONCLUSIONS: The high prevalence of mental health problems among schoolchildren and its association with child-rearing methods and mental health problems among parents/caretakers indicate the need for psycho-educational interventions aimed to reduce physical abuse and mental health problems in childhood.

Adolescent↗
PubMed2005

The prevalence of psychiatric disorders among 5-10 year olds in rural, urban and slum areas in Bangladesh: an exploratory study.

BACKGROUND: No previous epidemiological studies of child mental health have been conducted in Bangladesh, partly due to lack of suitable measures. METHODS: A Bangla translation of a standardised child psychiatric interview, the Development and Well-Being Assessment (DAWBA), was validated against routine clinical diagnoses on a consecutive series of 100 referrals to a child mental health service. A two-phase study of prevalence was applied to random samples of 5- to 10-year-olds (N=922) drawn from three contrasting areas: a rural area, a moderately prosperous urban area, and an urban slum. RESULTS: There was substantial agreement between the DAWBA and the independent clinic diagnosis (kappa=0.63-0.94). The estimated prevalence of any ICD-10 diagnosis was 15% (95% CI 11-21%). The rate of obsessive-compulsive disorder was higher than in previous studies. Children from the slum area were significantly more likely to have serious behavioural problems, and marginally more likely to have post-traumatic stress disorder. CONCLUSION: A conservative extrapolation is that around 5 million Bangladeshi children and adolescents have psychiatric disorders. In a country with very few child mental health professionals, there is a vast gap between need and provision that must be addressed.

Adolescent↗
PubMed2005

Brief report: young people at risk for eating disorders in Southeast Brazil.

A representative sample of 7-14-year-old young people in southeast Brazil (N=1251) was assessed using standardized parent and youth interviews, thereby identifying an 'at-risk' group of young people who met one or more DSM-IV criteria for anorexia and/or bulimia nervosa. These young people were compared with an age and gender matched comparison group for body mass index (BMI) and socio-economic status (SES). The prevalence of young people at risk for eating disorders was 1.4% (higher in females and rising with age). 'At-risk' individuals did not differ from controls in BMI but were of higher SES. In Brazil, the link between symptoms of eating disorders and higher SES is not just a referral artefact but is evident in a representative community sample. This might reflect a stronger preference for thinness among more westernized social groups.

Adolescent↗
PubMed2005

The Eating Disorders Section of the Development and Well-Being Assessment (DAWBA): development and validation.

OBJECTIVE: Development and validation of the Eating Disorders Section of the Development and Well-Being Assessment (DAWBA). It is a package of questionnaires, interviews and evaluation techniques, designed to generate DSM-IV and ICD-10 based diagnoses of anorexia, bulimia nervosa and the respective partial syndromes in epidemiological studies, in subjects who are 7 to 17 years old. The parents are interviewed in all cases, as are young people aged 11 or more. METHODS: 174 girls, divided into three groups, were assessed with the Eating Disorders Section of the Development and Well-Being Assessment: 48 with eating disorders, 55 clinical controls (with depression, obsessive-compulsive disorder or gastrointestinal disease) and 71 community controls. The sensitivity, specificity and predictive values of the assessment were investigated by comparing the Development and Well-Being Assessment diagnoses with independent psychiatric diagnoses. The test-retest reliability was investigated by reapplying the measure on 55 subjects after 2 or 3 weeks. RESULTS: For the detection of any DSM-IV and ICD-10 eating disorder, the final Development and Well-Being Assessment diagnosis had a sensitivity of 100%, specificity of 94%, positive predictive value of 88%, and a negative predictive value of 100%; there was 95% agreement between the initial and repeat diagnoses (a kappa of 0.81). CONCLUSION: The Eating Disorders Section of the Development and Well-Being Assessment has suitable psychometric properties for use in clinical and epidemiological studies.

Adolescent↗
PubMed2005

Child and adolescent psychopathology in a developing country: testing the validity of the strengths and difficulties questionnaire (Urdu version).

A study to test the validity of the Urdu version of the Strengths and Difficulties Questionnaire (SDQ) was carried out in Pakistan. The study population consisted of 212 children aged 4 to 16 years presenting to psychiatric (case group: n = 72) and paediatric outpatient clinics (comparison group: n = 140). Parents of these children were interviewed using the extended version of the SDQ. The case group was further subjected to diagnostic ICD-10 criteria by child psychiatrists, who were blind to SDQ scores. The Urdu version was able to discriminate between the study groups. The mean difficulties score was higher in the case group (mean = 21.7) than the comparison group (mean = 14.4), the difference (mean difference = 7.3) being statistically significant (p < 0.01, 95% CI = 5.3, 9.3) with an effect size of 1.1. Adequate sensitivity (> or = 61%) was obtained for each type of psychiatric disorder in the case group using the abnormal category of the SDQ symptom scores as a cutoff. A simple 'pencil-and-paper' algorithm combining symptom and impact scores further identified children in need of intervention. A ROC curve analysis showed an area under the curve > 0.70 for all scores. The choice of optimal cutoffs for the Urdu version is discussed.

Adolescent↗
PubMed2005

Russian child mental health--a cross-sectional study of prevalence and risk factors.

BACKGROUND: The fall of communism and subsequent economic crises have been followed by major social and health problems. High rates of child mental health problems are frequently cited by the Russian media, though there is little relevant evidence. AIMS: The aim of this study was to investigate the prevalence and associations of child mental health problems in Russia using internationally recognised measures and diagnostic systems. METHOD: A two-stage, two-phase cross-sectional survey of the mental health of 7- to 14-year-olds involved random sampling of schools, followed by random sampling of pupils from school lists. A sample of 448 children was obtained, representing an 83% participation rate. In the first phase, screening measures of psychopathology and risk were administered to parents, teachers and 11- to 14-year-olds. In the second phase, more detailed psychiatric assessments were carried out for subgroups of screen-positive and screen-negative children (N=172). RESULTS: The prevalence of psychiatric disorder was about 70% higher than that recently found in Britain with comparable measures, but there were few differences between Britain and Russia in type of disorder or key risk factors. CONCLUSION: There is a pressing need for evidence-based mental health treatments to be made widely available to Russian children and adolescents.

Adolescent↗
PubMed2005

Violations of exhibiting and FDA rules at an American Psychiatric Association annual meeting.

We conducted a cross-sectional study of all exhibit booths for the 24 pharmaceutical companies at the 2002 American Psychiatric Association (APA) convention. We collected and categorized one of each item distributed by the companies at each booth. A total of 268 items were collected from 24 companies (median=8). The most common categories of items were "reprints or pamphlets" (37%) and "noneducational gifts" (27%), including music CDs and invitations to dinners and museums. There were a total of 16 violations of the APA's own exhibit rules: eight companies had one violation and two companies had four violations. Four companies engaged in FDA-prohibited off-label promotion; one also violated the APA code. Over half of all companies (54%) were in violation of either APA rules or FDA regulations. The APA's voluntary code has failed to adequately reduce inappropriate promotional activity at the annual APA meeting.

Congresses as Topic↗
PubMed2005

The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties.

OBJECTIVE: To evaluate the Strengths and Difficulties Questionnaire in a U.S. national population sample of children and adolescents, develop normative scoring bands, and test the association of high-scoring groups with service contacts or use for mental health reasons. METHOD: An Americanized version of the Strengths and Difficulties Questionnaire parent report was administered to parents of 10,367 4- to 17 -year-olds in the 2001 National Health Interview Survey. Scoring bands were developed to differentiate low, medium, and high levels of emotional or behavioral difficulties. Children at high risk of serious difficulties were identified by three different scoring methods: (1) high symptom scores, (2) parental perception of definite or severe difficulties, and (3) high symptoms plus impairment. These ratings were validated against service contact or use and other well-established demographic and broader risk factors for child emotional and behavioral problems. RESULTS: Results indicated good acceptability and internal consistency. Normative scoring bands were similar, though not identical, to the original British bands. Results of each scoring method had a strong association with service contact/use. CONCLUSIONS: This study supports the usefulness of the Strengths and Difficulties Questionnaire as an effective and efficient screener for child and adolescent mental health problems in the United States.

Adolescent↗
PubMed2005

Literacy difficulties and psychiatric disorders: evidence for comorbidity.

BACKGROUND: Literacy difficulties show high levels of comorbidity with both disruptive and emotional disorders, but questions remain over the nature and specificity of these links. METHOD: Relationships between specific literacy difficulties and psychiatric disorder were investigated in a large-scale national sample of children aged 9 to 15 years. RESULTS: Specific literacy difficulties were more common in children from lower socio-economic backgrounds, and were significantly associated with increased risks of Attention-Deficit Hyperactivity Disorder (especially inattentive symptomatology), Conduct Disorder and anxiety disorders in both girls and boys, and with self-reports of depressed mood in boys. Associations between literacy difficulties and diagnoses of both Attention-Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) were mediated by inattentiveness, as were links with low mood. Links between specific literacy difficulties and anxiety were of a different nature, suggestive of a direct impact of literacy problems on risk for anxiety disorders. CONCLUSIONS: Literacy difficulties are significantly associated with externalizing disorders via inattention, but may constitute a more immediate risk factor for naturally anxious children to develop clinically significant levels of anxiety.

Adolescent↗
PubMed2004

Sex differences in developmental reading disability: new findings from 4 epidemiological studies.

CONTEXT: An influential article published in 1990 claimed that the increased rate of reading disability in boys was a consequence of referral bias. OBJECTIVES: To summarize the history of research on sex differences in reading disability and to provide new evidence from 4 independent epidemiological studies about the nature, extent, and significance of sex differences in reading disability. DESIGN, SETTING, AND PARTICIPANTS: The Dunedin Multidisciplinary Health and Development Study comprised 989 individuals (52.1% male) in a cohort born between April 1972 and March 1973 in Dunedin, New Zealand, and followed up from age 3 years; reading performance and IQ were assessed at ages 7, 9, and 11 years using the Burt Word Reading Test and the Wechsler Intelligence Scale for Children-Revised (WISC-R), respectively. The Christchurch Health and Development Study comprised 895 individuals (50% male) in a prospectively studied cohort born in the Christchurch, New Zealand, region during a 4-month period in 1977; reading performance and IQ were assessed at ages 8 to 10 years using the Burt Word Reading Test and the WISC-R. The Office for National Statistics (ONS) Study comprised a UK nationally representative sample of 5752 children (50.1% male) aged 9 to 15 years in 1999; reading was assessed on the British Ability Scales II and IQ on the British Picture Vocabulary Scales II. The Environmental Risk Longitudinal Twin Study (E-Risk) comprised 2163 twin children from England and Wales (49.1% male) identified at birth in 1994 and 1995 and included administration of the Test of Word Reading Efficiency at age 7 years and the Wechsler Preschool and Primary Scale of Intelligence-Revised as a test of IQ at age 5 years. MAIN OUTCOME MEASURE: Reading performance by sex in the lowest 15% of the distribution for all 4 studies, with and without taking IQ into account. RESULTS: In all 4 studies, the rates of reading disability were significantly higher in boys. For non-IQ-referenced reading disability: Dunedin study, 21.6% in boys vs 7.9% in girls (odds ratio [OR], 3.19; 95% confidence interval [CI], 2.15-4.17); Christchurch study, 20.6% in boys vs 9.8% in girls (OR, 2.38; 95% CI, 1.62-3.50); ONS study, 17.6% in boys vs 13.0% in girls (OR, 1.43; 95% CI, 1.23-1.65); and E-Risk, 18.0% in boys vs 13.0% in girls (OR, 1.39; 95% CI, 1.04-1.86). The rates for IQ-referenced reading disabilities were similar. CONCLUSION: Reading disabilities are clearly more frequent in boys than in girls.

Aptitude Tests↗
PubMed2004

The relative importance of child, family, school and neighbourhood correlates of childhood psychiatric disorder.

BACKGROUND: Many studies have described associations between childhood psychiatric disorder and characteristics of the child, and their family, school and neighbourhood, but few studies have studied them simultaneously. Also, most investigators have failed to allow for the extent to which different exposures are correlated, or for clustering at different levels of observation. Our objective was to establish which correlates were independently associated with psychiatric disorder. METHOD: Data on DSM-IV psychiatric diagnoses, as well as child and family characteristics, were obtained on 8772 English 5- to 15-year-olds included in a large British prevalence survey of mental health. These data were supplemented by independent measures of school and neighbourhood disadvantage. We entered child and family variables with the measures of school and neighbourhood disadvantage into a logistic regression analysis to establish which variables were independently associated with child psychiatric disorder. RESULTS: No variables were associated with all types of disorder. Poor general health and life events were related to emotional disorders, while conduct disorders were most closely associated with family variables, and ADHD was only related to child characteristics. Disadvantaged schools, deprived neighbourhoods, low socioeconomic status, parental unemployment, cohabiting, large family size, and poverty were not independently associated with disorder. CONCLUSIONS: Individually assessed child and family factors may be more influential than aggregate measures of school and neighbourhood factors. Different disorders have distinctive correlates. Many of the best known "risk factors" are not independently related to childhood psychiatric disorder, and are, therefore, acting distally in the causal pathway or irrelevant.

Adolescent↗
PubMed2004

Using the Strengths and Difficulties Questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders.

BACKGROUND: Child psychiatric disorders are common among children in foster and residential care, but often go undetected and therefore untreated. AIMS: To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community. METHOD: SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 1,028 looked-after 5-17 year olds from a nationwide English survey. RESULTS: Multi-informant SDQs (parents, teachers, older children) identified individuals with a psychiatric diagnosis with a specificity of 80 % and a sensitivity of 85%. The SDQ prediction works best when SDQs have been completed by both carers and teachers. When it is only possible to have one adult informant, carers and teachers provide information of roughly equal predictive value. By contrast, self-reports by 11-17 year olds provide little extra information when there is already an adult informant. CONCLUSION: Using multi-informant SDQs as a regular screening measure for looked-after children could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.

Adolescent↗
PubMed2004

Childhood psychiatric disorder and unintentional injury: findings from a national cohort study.

OBJECTIVE: We set out to examine the relationship between unintentional injury and common child psychiatric disorders, including both internalizing and externalizing diagnoses. METHODS: The 1999 British Child and Adolescent Mental Health Survey provided a nationally representative sample of over 10,000 children aged 5-15 years. Measures included assessment of diagnoses of psychiatric disorder from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, unintentional injury, and a range of potentially related psychosocial factors. RESULTS: Children with psychiatric disorders had higher rates of unintentional injury. After accounting for psychosocial risk factors and comorbid psychopathology, oppositional defiant disorder (ODD) was independently associated with burns and poisoning. Attention deficit hyperactivity disorder (ADHD) was related to fractures, and depression and anxiety also showed independent links to some injury types. CONCLUSIONS: ODD and ADHD, rather than conduct disorder, appear to be the externalizing disorders associated with unintentional injury. We discuss possible models of the relationships between internalizing disorders and unintentional injury.

Adolescent↗