Systematic Review of Screening Instruments for Psychosocial Problems in Children and Adolescents With Long-Term Physical Conditions

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Abstract

Children and adolescents with long-term physical conditions (LTPCs) are at greater risk of developing psychosocial problems. Screening for such problems may be undertaken using validated psychometric instruments to facilitate early intervention. A systematic review was undertaken to identify clinically utilized and psychometrically validated instruments for identifying depression, anxiety, behavior problems, substance use problems, family problems, and multiple problems in children and adolescents with LTPCs. Comprehensive searches of articles published in English between 1994 and 2014 were completed via Medline, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases, and by examining reference lists of identified articles and previous related reviews. Forty-four potential screening instruments were identified, described, and evaluated against predetermined clinical and psychometric criteria. Despite limitations in the evidence regarding their clinical and psychometric validity in this population, a handful of instruments, available at varying cost, in multiple languages and formats, were identified to support targeted, but not universal, screening for psychosocial problems in children and adolescents with LTPCs.

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Most cited references 137

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The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology.

H. Meltzer, Suzanne H Richards, Jason R Goodman … (2000)

The Development and Well-Being Assessment (DAWBA) is a novel package of questionnaires, interviews, and rating techniques designed to generate ICD-10 and DSM-IV psychiatric diagnoses on 5-16-year-olds. Nonclinical interviewers administer a structured interview to parents about psychiatric symptoms and resultant impact. When definite symptoms are identified by the structured questions, interviewers use open-ended questions and supplementary prompts to get parents to describe the problems in their own words. These descriptions are transcribed verbatim by the interviewers but are not rated by them. A similar interview is administered to 11-16-year-olds. Teachers complete a brief questionnaire covering the main conduct, emotional, and hyperactivity symptoms and any resultant impairment. The different sorts of information are brought together by a computer program that also predicts likely diagnoses. These computer-generated summary sheets and diagnoses form a convenient starting point for experienced clinical raters, who decide whether to accept or overturn the computer diagnosis (or lack of diagnosis) in the light of their review of all the data, including transcripts. In the present study, the DAWBA was administered to community (N = 491) and clinic (N = 39) samples. There was excellent discrimination between community and clinic samples in rates of diagnosed disorder. Within the community sample, subjects with and without diagnosed disorders differed markedly in external characteristics and prognosis. In the clinic sample, there was substantial agreement between DAWBA and case note diagnoses, though the DAWBA diagnosed more comorbid disorders. The use of screening questions and skip rules greatly reduced interview length by allowing many sections to be omitted with very little loss of positive information. Overall, the DAWBA successfully combined the cheapness and simplicity of respondent-based measures with the clinical persuasiveness of investigator-based diagnoses. The DAWBA has considerable potential as an epidemiological measure, and may prove to be of clinical value too.

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Subthreshold depression in adolescence and mental health outcomes in adulthood.

David M. Fergusson, L John Horwood, Elizabeth M Ridder … (2005)

There is increasing interest in the extent to which individuals with subthreshold depression face increased risks of subsequent major depression and other disorders. To examine linkages between the extent of depressive symptoms (asymptomatic, subthreshold, major depression) at ages 17 to 18 years and mental health outcomes up to age 25 years in a New Zealand birth cohort. Data were gathered during the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of 1265 New Zealand children (635 males, 630 females). General community sample. The analysis was based on 1006 participants who represented 80% of the original cohort. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom criteria for major depression and anxiety disorder, treatment-seeking, suicidal ideation, and suicide attempt. There were significant associations (P<.01) between the extent of depression at ages 17 to 18 years and rates of subsequent depressive symptoms, major depression, treatment for depression, anxiety disorder, treatment for anxiety disorder, suicidal ideation, and suicide attempts. After adjustment for covariate factors, the extent of depression at ages 17 to 18 years remained associated with later depression and suicidal tendencies. Planned comparisons showed that sample members with subthreshold depression had a similar prognosis to those meeting criteria for major depression. Findings suggest that sample members with subthreshold depression are a group with elevated risks of later depression and suicidal behaviors. Current diagnostic procedures, which classify people with subthreshold depression into complex discrete groups, might obscure the fact that depressive symptoms are dimensional and range from none to severe.

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Investigations of temperament at three to seven years: the Children's Behavior Questionnaire.

M Rothbart, S Ahadi, K Hershey … (2015)

This article reviews evidence on the reliability and validity of the Children's Behavior Questionnaire (CBQ), and presents CBQ data on the structure of temperament in childhood. The CBQ is a caregiver report measure designed to provide a detailed assessment of temperament in children 3 to 7 years of age. Individual differences are assessed on 15 primary temperament characteristics: Positive Anticipation, Smiling/Laughter, High Intensity Pleasure, Activity Level, Impulsivity, Shyness, Discomfort, Fear, Anger/Frustration, Sadness, Soothability, Inhibitory Control, Attentional Focusing, Low Intensity Pleasure, and Perceptual Sensitivity. Factor analyses of CBQ scales reliably recover a three-factor solution indicating three broad dimensions of temperament: Extraversion/Surgency, Negative Affectivity, and Effortful Control. This three-factor solution also appears to be reliably recovered in ratings of children in other cultures (e.g., China and Japan). Evidence for convergent validity derives from confirmation of hypothesized relations between temperament and socialization-relevant traits. In addition, parental agreement on CBQ ratings is substantial. The CBQ scales demonstrate adequate internal consistency, and may be used in studies requiring a highly differentiated yet integrated measure of temperament for children in this age range.

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Author and article information

Journal

Journal ID (nlm-ta): Glob Pediatr Health

Journal ID (iso-abbrev): Glob Pediatr Health

Journal ID (publisher-id): GPH

Journal ID (hwp): spgph

Title: Global Pediatric Health

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Electronic): 2333-794X

Publication date (Electronic): 10 February 2017

Publication date Collection: 2017

Volume: 4

Electronic Location Identifier: 2333794X17690314

Affiliations

[1 ]University of Auckland, Auckland, New Zealand

[2 ]Auckland District Health Board, Auckland, New Zealand

Author notes

[*]Hiran Thabrew, Department of Psychological Medicine, University of Auckland, Level 12 Support Block, Auckland Hospital, Park Road, Grafton, Auckland 1142, New Zealand. Email: h.thabrew@ 123456auckland.ac.nz

Article

Publisher ID: 10.1177_2333794X17690314

DOI: 10.1177/2333794X17690314

PMC ID: 5315369

SO-VID: 7b690c27-6af8-496a-a268-43f2b6fb7f52

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This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 20 December 2016

Date accepted : 27 December 2016

Custom metadata

cover-date January-December 2017

Keywords: screening,depression,anxiety,children,adolescents,chronic illness

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Keywords: screening, depression, anxiety, children, adolescents, chronic illness

Systematic Review of Screening Instruments for Psychosocial Problems in Children and Adolescents With Long-Term Physical Conditions

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Creative methods for psychotherapy

Most cited references 137

The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology.

Subthreshold depression in adolescence and mental health outcomes in adulthood.

Investigations of temperament at three to seven years: the Children's Behavior Questionnaire.

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