Approaches to measurement and definition in the epidemiology of behavior disorders: ethnic background and child behavior.
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Comparison was made between Devereux Child Behavior Rating Scale (DCB) ratings of matched groups of hyperactive and emotionally-behaviorally disturbed children. The emotionally behaviorally disturbed group was chosen to represent a population with presenting symptoms similar to hyperactivity. Ratings of the two groups exceeded the normative population on all DCB factors. The hyperactive group received higher scores on 16 factors and was significantly higher than the emotionally-behaviorally disturbed group on 8 factors. The hyperactive group received the most extreme scores on behavioral dimensions generally described as characteristic of the hyperactive syndrome. The results suggested that the DCB can assist in differentiating hyperactive children from children with presenting symptoms similar to those of hyperactivity.
The relationship between parenting and child behavior was assessed with 15 mothers and 15 fathers of 2- to 3-year-old children. Higher maternal overreactivity was found to be related to more maternal and paternal attributions of child externalizing problems. Self-perception of more paternal nurturance, fewer demands for age-inappropriate responsibility and autonomy, and less laxness were related to fewer paternal attributions of child behavior problems. New constructs for the descriptive categories positive parenting and negative parenting are proposed. These constructs allow one to strongly predict attributions of child behavior. Additionally, each specific behavior forming these new categories is related to specific attributions of child behavior. These specific behaviors and constructs could refine the focus of parent-training programs.
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OBJECTIVE: This study investigated the inter-rater agreement between parents' reports and adolescents' self-reports of behavioral and emotional problems using cross-informant scales both cross-sectionally and longitudinally. MATERIAL AND METHODS: Subjects were participants in a longitudinal study of 695 school-aged children from the general population, aged 7-10 during the first assessment. They were evaluated with the Child Behavior Checklist (completed by parents) and later, from 11 year-old, with the Youth Self-Report. The scoring format and factor structure of the two assessment instruments are similar; cross-informant syndromes constructed from the two instruments are based on parents' and self-report information. Measures included anxiety/depression, withdrawal, somatic complaints, aggression, delinquency and attention problems. RESULTS: Findings indicate that there is longitudinal stability in parents' ratings of children's behavioral problems. Our findings also confirm that adolescents, especially as they grow older, are indispensable informants about their problem behavior, because many of the problems they experience remain unnoticed by their parents. Adolescents reported higher levels of anxiety/depression, withdrawal, somatic complaints, aggression and delinquency, but lower levels of attention problems than their parents. CONCLUSIONS: Our results reflect the typical level of parent-child agreement in reports of problem behaviors as it occurs in other samples. Other investigators could use these data as a background, for testing of longitudinal associations and parent-child agreements in different samples.
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PROBLEM: What is the relationship between child behaviors as perceived by the mother and father, mother-child interaction, and the home environment? SUBJECTS: A subsample of 28 families of healthy, full-term newborns recruited from a larger longitudinal study. METHODS: Mothers and fathers completed the Eyberg Child Behavior Inventory when their child was 24 months old. NCATS and HOME Inventory were administered. The Neonatal Perception Inventory was previously completed by the mother within 72 hours of birth and at 1 month postpartum. FINDINGS: Significant interparent correlations for intensity of child behaviors; however, the association for behaviors considered to be problematic was not significant. Fathers tended to report fewer behavior problems and less frequent occurrences. Several significant relationships were found between child behavior ratings, interaction, and the home environment. Gender of child and maternal employment status did not significantly influence parental perceptions of child behavior. CONCLUSIONS AND IMPLICATIONS FOR NURSING: While parents may share perceptions of child behaviors, they may differ in interpretation of whether those behaviors are problematic. Administering behavior inventories to both parents may help them identify and respect each other's differing opinions. These same inventories can be used to measure effects of interventions, and are adjuncts to direct behavioral observations of parent-child interaction.
OBJECTIVE: To study the long-term stability of Child Behavior Checklist (CBCL) profile types, which represent children's overall patterns of single and comorbid scale elevations. METHOD: Profile types were determined for 623 outpatient children at referral and then at mean follow-up 4.8 years later, and their continuity was determined. RESULTS: At baseline 37.5% of the children were classified by a profile type, and 41.9% of these originally classified children continued to be classified at follow-up. The average odds ratio for a child continuing as a specific CBCL profile type from baseline to follow-up was 8.2. When children changed from one specific profile type to another, they usually continued in the same broad externalizing or internalizing category. Children who were not classified by a profile type at baseline generally remained unclassified. CONCLUSIONS: Stability findings for CBCL profile types appeared good and were similar to past longitudinal results for CBCL scales and DSM diagnoses. These profile types may prove an important empirical method for addressing the problem of comorbid clinical pictures.
Past research on risk factors in child development has tended to focus on 1 risk factor rather than examining the effects of multiple factors simultaneously. The present research examines the main and interactive effects of parental psychopathology (schizophrenia, psychiatric control, and normal control) and maltreatment on child behavior. Child aggression, delinquency, and social withdrawal were assessed at 2 times so that the effects of risk factors on behavioral change could also be examined. The results indicate significant relations between the risk factors and child behavior. Most notably, parental psychiatric status and maltreatment interacted significantly, such that offspring of schizophrenic parents from maltreating families showed increases in externalized behavior problems over time. These results support a diathesis-stress model of psychopathology.
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Used the Eyberg Child Behavior Inventory (ECBI) to measure disruptive behavior problems in children and adolescents. A controversy exists, however, on the dimensional structure of the ECBI. To evaluate this issue, an exploratory factor analysis was first performed on a sample of 1,263 children and adolescents. This analysis identified 3 meaningful factors (i.e., Oppositional Defiant Behavior Toward Adults, Inattentive Behavior and Conduct Problem Behavior) and a fourth, poorly defined factor. A confirmatory factor analysis (CFA) evaluated the fit of the 3 meaningful factors in a second sample of 1,264 children and adolescents. The 3-factor model with 2 correlated errors provided a excellent fit. This 3-factor model also provided a significantly better fit than 2- and 1-factor models. Multiple group CFA indicated that the factor pattern, item-factor loadings, factor correlations, and correlated errors were equivalent across the samples. The CFA on sex yielded similar results. Initial normative information is presented for boys (n = 1,322) and girls (n = 1,205) within 4 age ranges (i.e., 2-5, 6-9, 10-13, 14-17) for the 3 factors. The use of these 3 factors, especially Oppositional Defiant Behavior and Conduct Problem Behavior, should make the ECBI more useful as a screening and outcome measure.
Assessed parent attributions for child behavior using open-ended questions. Sixty-one parents of children with attention deficit hyperactivity disorder (ADHD) and 49 parents of nonproblem children participated. An open-ended, thought-listing question asked following child behavior indicated that parents spontaneously offer causal attributions for their children's behavior. Responses to a second open-ended question asking specifically for attributions for the child behavior indicated that both groups of parents attributed prosocial (PRO) child behaviors more than problem behaviors to internal, controllable, and stable causes or to the external situation and attributed problem behaviors most often to uncontrollable and unstable causes within the child or to factors within the parent. Compared with parents of nonproblem children, parents of children with ADHD were less likely to see themselves as the cause of child behavior and were more likely to mention medication. Analyses indicated that, although attributions elicited by rating scales were related to attributions provided in an open-ended format, each method provided unique information.
The usefulness of the Behavioral Assessment System for Children (BASC) and Child Behavior Checklist (CBCL) Parent scales was examined with respect to (a) differentiating students with attention deficit-hyperactivity disorder (ADHD) from non-ADHD students and (b) discriminating between the predominantly inattentive-type and combined-type ADHD-afflicted students. For both the BASC and the CBCL, a different optimal discriminant classification tree analysis (CTA) model was developed for each of the 2 diagnostic predictions. For distinguishing ADHD students from non-ADHD students, the BASC model was more parsimonious and accurate than the CBCL model. Toward the goal of differentiating between primarily inattentive and combined types, the CBCL's model was superior for predicting primarily inattentive students. The results demonstrate the diagnostic utility of the BASC and CBCL and describe salient behavioral dimensions associated with subtypes of ADHD.
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66 children attending first grade at a special school for educationally subnormal children were examined medically and psychologically. Classification was done according to ICD-10. In addition, the parents were asked to rate their children's behavior with the "Child Behavior Checklist" by Achenbach and Edelbrock. The most common symptoms rated in this group of 6- to 8-year-old children were lack of concentration, speech and language problems, hyperactivity, demand for attention and arguing. The mean total score (cut-off score: 30) and the number of crucial items (cut-off score: at least two crucial items) differed significantly between the children with and those without psychiatric disorders. No significant correlation was found between the mean total score or the number of crucial items and the sex of the children or the other axes of the Multi-axial Classification of Child Psychiatric Disorders.
BACKGROUND: Television is a source from which children gain information about life and experience different types of behavior. The Child Behavior Checklist (CBCL) has not been used thoroughly to evaluate the behavioral effects of television viewing on children. OBJECTIVE: To examine the competency and problem behavior correlates of television viewing in school-aged children using the CBCL. DESIGN: Cross-sectional survey. SETTING: Two randomly selected grade schools, one from a high-income district and the other from a low-income district. PARTICIPANTS: Students in grades 2 and 3 and their parents. MAIN OUTCOME MEASURES: A questionnaire on children's time spent watching television and engaging in other daily activities and the CBCL were sent to the parents of 888 second- and third-grade students. RESULTS: Results of the questionnaire reported that the overall mean +/- SD daily television viewing time was 2.5 +/- 1.3 hours. Overall television viewing time had a negative correlation with social and school achievement (r = -0.17, P<.001 and r = 0.11, P =.03, respectively) subscale scores. Withdrawn (r = 0.11, P =.004), social problem (r = 0.14, P =.001), thought problem (r = 0.11, P =.03), attention problem (r = 0.20, P<.001), delinquent behavior (r = 0.12, P<.001), aggressive behavior (r = 0.22, P<.001), and externalization (r = 0.19, P<.001) subscales and total problem (r = 0.15, P<.001) scores were positively correlated with time spent watching television. Stepwise logistic regression analysis revealed that the only significant variables associated with a risk of watching television for more than 2 hours were age, gender, social subscale, and attention problem subscale scores of the CBCL. CONCLUSION: As evaluated by the CBCL, television viewing time is positively associated with social problems, delinquent behavior, aggressive behavior, externalization, and total problem scores. Older age, male gender, and decreasing social subscale and increasing attention problem subscale scores on the CBCL increases the risk of watching television for more than 2 hours.
OBJECTIVE: To determine the relationship between child behavior and quality of life before and after tonsillectomy and adenoidectomy by means of a standardized assessment of child behavior, the Child Behavior Checklist (CBCL), and a validated quality-of-life survey of pediatric obstructive sleep apnea, the OSA-18. DESIGN: Before-after study. SETTING: Hospital-based pediatric otolaryngology practice in a metropolitan area. PARTICIPANTS: Sixty-four children (mean [SD] age, 5.8 [3.1] years; 36 boys, 28 girls) who underwent tonsillectomy and adenoidectomy for treatment of sleep-disordered breathing or recurrent tonsillitis. INTERVENTION: Parents or caretakers completed the OSA-18 and the CBCL for ages 2 to 3 years or 4 to 18 years before surgery and 3 months postoperatively. MAIN OUTCOME MEASURES: The OSA-18 mean survey scores and change scores, and the CBCL total problem T scores and change in total problem T scores. RESULTS: The mean (SD) preoperative OSA-18 score was 3.9 (1.5) and change score was 2.3 (95% confidence interval, 1.9-2.7). The mean total problem score was 7.3 points lower after surgery (95% confidence interval, 4.9-9.7), indicating a significant decrease (P<.001, matched t test). The preoperative CBCL total problem score was consistent with abnormal behavior for 16 children (25%), but only 5 children (8%) scored in the abnormal range postoperatively (P =.03, log-likelihood ratio test). The OSA-18 preoperative mean survey score had fair to good correlation with the preoperative CBCL total problem T score (r = 0.50, P<.001, Pearson correlation), and the OSA-18 change score had fair to good correlation with the change in CBCL total problem T score (r = 0.54, P<.001, Pearson correlation). CONCLUSIONS: Behavioral and emotional difficulties are found in children with sleep-disordered breathing before treatment and improve after intervention. Scores on a standardized measure of assessment of behavior demonstrate significant correlation with scores on a validated quality-of-life instrument.