Biomedical subjects

H R Bird

Publications and source records attributed to H R Bird.

At least 37 records · Page 2Linked to original sources

PubMed1996

The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study.

OBJECTIVE: To describe the NIMH Diagnostic Interview Schedule for Children (DISC) Version 2.3 and to provide data on its performance characteristics in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. METHOD: Data were collected on the DISC-2.3 at four sites on 1,285 randomly selected children, aged 9 through 17 years, and their parents. Two hundred forty-seven of these child-parent pairs were reassessed on the DISC-2.3 by a clinician interviewer, 1 to 3 weeks later. RESULTS: Administration time was approximately 1 hour and the interview was acceptable to more than 90% of subjects. The reliability of questions to parents assessing impairment and age of onset was generally good to acceptable for most diagnoses but was less satisfactory for the child interview. Using information from parent and child, the prevalence for any diagnosis ranged from 50.6 if no impairment criteria were required to 5.4 if a Global Assessment Scale score of 50 or less was necessary. The prevalence of anxiety disorders and enuresis was markedly reduced by requiring attributable impairment. CONCLUSIONS: The DISC-2 is a reliable and economical tool for assessing child psychopathology. Reliability of the DISC-P-2.3 is superior to that of the child DISC for most diagnoses but is least good for anxiety disorders. The 2.3 version of the instrument provides a significant improvement over earlier versions.

Adolescent↗

PubMed1996

Criterion validity of the NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3).

OBJECTIVE: To examine the criterion validity of the NIMH Diagnostic Interview Schedule for Children (DISC) Version 2.3 in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, using a design that permitted several comparisons of DISC-generated diagnoses with diagnoses based on clinician symptom ratings. METHOD: Two hundred forty-seven youths were selected from the 1,285 parent-youth pairs that constituted the four-site MECA sample. Subjects who screened positive for any of the five diagnostic areas under investigation in the validity study (attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, depressive disorder, and the major anxiety disorders) were recruited, as well as a comparable number of screen negatives. Clinicians reinterviewed separately both the youth and the primary caregiver using the DISC followed by a clinical-style interview, and then they rated the presence of symptoms and impairment. Computer algorithms combined this information into diagnoses using comparable rules for both DISC and clinical rating diagnoses. RESULTS: In general, the DISC showed moderate to good validity across a number of diagnoses. CONCLUSIONS: Results suggest some specific diagnostic areas in which further revision of the DISC is warranted. Three main sources of variability in DISC-clinician diagnostic agreement were evident over and above that due to the instrument itself, including (1) the informant used, (2) the algorithm applied in synthesizing symptom reports, and (3) the design of the validity comparison.

Adolescent↗

PubMed1996

Epidemiology of childhood disorders in a cross-cultural context.

The present report summarizes the epidemiologic research on childhood psychopathology that has been carried out in different cultural settings over the past 15 years from either an empirical or a diagnostic perspective. Prevalence and risk factor findings are summarized and contrasted. Some controversies surrounding cross-cultural research are discussed and methodological recommendations applicable to cross-cultural epidemiologic research are provided.

Adolescent↗

PubMed1996

The Diagnostic Interview Schedule for Children (DISC-2.1) in Spanish: reliability in a Hispanic population.

The reliability across time, informants and interviewers of the Spanish translation of the DISC-2.1 was tested on a Puerto Rican Hispanic sample using a test-retest design. Levels of reliability between clinic and community samples and between younger and older children were compared to explore the sources of low reliability for certain psychiatric disorders. Parents' reports tended to be more reliable than those of their children, although the difference was less obvious with older children. Reliability was generally higher for the externalizing disorders and when the second interviewer was a psychiatrist rather than a lay interviewer.

Adolescent↗

PubMed1993

Patterns of diagnostic comorbidity in a community sample of children aged 9 through 16 years.

Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were done to provide information on the comorbidity of four major diagnostic domains (attention deficit disorders, conduct/oppositional disorders, depression and anxiety disorders). A high level of comorbidity was found among these four domains of child and adolescent psychopathology. In general the patterns of comorbidity were not affected by whether the data was put together by a clinician or by means of a computer algorithm scoring a structured interview. The patterns were not affected in any major way by who the informants were in the diagnostic process. Minor differences were found in certain comorbidity patterns depending on the sex and age of the subjects. Comorbidity was associated with level of impairment and to service utilization.

Adolescent↗

PubMed1993

Symptoms of attention-deficit hyperactivity disorder in an Italian school sample: findings of a pilot study.

OBJECTIVE: The objective of this study was to complete a teacher questionnaire on a sample of children (N = 232) in nine fourth grade classes in schools in two regions of central Italy to assess the frequency of occurrence of symptoms of attention-deficit hyperactivity disorder (ADHD) and the rates of probable cases in the sample. METHOD: Each ADHD symptom was rated by the teacher as either absent (0), sometimes present (1) or frequently present (2). RESULTS: Of the children 3.9% had eight or more DSM-III-R Criterion A symptoms of ADHD scored at a "frequent" level (score of 2) and were considered to be "likely cases" of ADHD; an additional 6.9% did not meet this threshold but had a total score of 16 or more on the scale and were considered to be "possible cases." CONCLUSIONS: The findings suggest the need for more systematic epidemiological investigations to evaluate the true prevalence of the syndrome and its risk factors in the Italian population.

Attention Deficit Disorder with Hyperactivity↗

PubMed1992

Aggregating data from multiple informants in child psychiatry epidemiological research.

One of the issues confronting the field of child psychiatric epidemiology is devising ways to aggregate discrepant reports from multiple informants obtained in structured diagnostic assessments of children and adolescents. The present report uses data from an epidemiological community survey to attempt to address this issue. The results obtained through statistical procedures designed to identify the "optimal" informant for specific symptomatic criteria and diagnoses do not seem to offer a clear-cut advantage over a simple combinatorial rule that identifies symptomatic criteria as positive when they are acknowledged as positive by either parent or child informants.

Adolescent↗

PubMed1992

Are attentional-hyperactivity deficits unidimensional or multidimensional syndromes? Empirical findings from a community survey.

Factor analysis on teacher ratings of symptoms in a probability community sample of children aged 6 to 16 years (N = 614) yielded two factors: Inattention and Hyperactivity-Impulsivity. Subsequent cluster analyses on the scores of factorially derived scales for a subsample of 170 children with a diagnosis of attention deficit disorder with (ADDH) and without hyperactivity (ADDWO), or normals, resulted in five clusters that accounted for 88% of the variance. The existence of these clusters was confirmed using external validating criteria. The data support a bidimensional conceptualization of attention deficit disorder with hyperactivity, one dimension consisting of symptoms of inattention and another of symptoms of hyperactivity-impulsivity. The data also suggests that a condition very similar to the DSM-III-R description of undifferentiated attention-deficit disorder also exists as a distinct entity.

Adolescent↗

PubMed1992

Mental health status among Puerto Ricans, Mexican Americans, and non-Hispanic whites.

Compared mental health characteristics of island Puerto Ricans to three groups from the Los Angeles Epidemiologic Catchment Area Study: Mexican American immigrants, U.S.-born Mexican Americans, and Non-Hispanic whites. The Diagnostic Interview Schedule was used to obtain both diagnostic and symptom scale information about affective disorders, alcohol abuse/dependence, somatization, phobic disorder, and psychotic disorder. Mexican American immigrants had the fewest mental health problems of all groups. Puerto Ricans had more somatization disorder, but less affective and alcohol disorders than U.S.-born Mexican Americans or non-Hispanic whites. Results are considered in the light of selection factors, relative disadvantage of groups and methodological problems.

Adolescent↗

PubMed1991

Screening for childhood psychopathology in the community using the Child Behavior Checklist.

One of the uses of the Child Behavior Checklist is as a screening instrument for childhood psychopathology in two-phase designs. The present report involves a two-phase epidemiological survey conducted in Puerto Rico in which the CBCL was used as a screening instrument during the first stage, and children were evaluated clinically during the second stage. The data indicate that in using the CBCL for screening for psychopathology in children, parent information is most informative, particularly for children in the adolescent age group. Nevertheless, the data also reinforce the need to obtain teacher information with the Teacher Report Form to enhance screening sensitivity. In this population, the data obtained with the Youth Self-Report were found to be of limited usefulness for screening purposes.

Adolescent↗

PubMed1990

Epidemiological comparisons of Puerto Rican and U.S. mainland children: parent, teacher, and self-reports.

U.S. mainland and Puerto Rican nonreferred samples were compared via the Child Behavior Checklist (ages 4 to 16), Teacher's Report Form (ages 6 to 16), and Youth Self-Report (ages 12 to 16). Problem scores were significantly higher in parent and teacher ratings of Puerto Rican than mainland subjects, but were significantly lower in self-ratings by Puerto Rican adolescents. Adolescents in both cultures reported significantly more problems than their parents or teachers did. Most of the significant cross-cultural differences in parent, teacher, and self-ratings of competencies showed more favorable scores for the mainland subjects. High referral rates, a high prevalence of DSM diagnoses, and low scores on the Children's Global Assessment Scale are consistent with the high problem rates reported by Puerto Rican parents and teachers but not with the lower rates reported by adolescents. Different clinical cutoffs may be needed for all assessments in the mainland versus Puerto Rico.

Adolescent↗

PubMed1990

Children of parents with psychiatric disorder in the community.

The relationship between parental psychopathology and risk for maladjustment in the offspring was investigated in a community sample. The children of 130 parents who met criteria for 12 DIS/DSM-III disorders were compared to the children of 235 normal parents. Significantly more children of disturbed parents were functionally impaired and had higher scores in the parent and youth Child Behavior Checklist total behavior scores as compared to children of normal parents. These associations were maintained even after accounting for an adverse family environment, suggesting a strong relationship between parental and childhood psychopathology as well as a mediating influence of environmental adversity.

Adaptation, Psychological↗

PubMed1990

Psychopathology and developmental delay in homeless children: a pilot study.

The authors report a survey of 50 parent-child pairs from homeless families housed in New York City hotels. The purpose of the survey was to determine the extent of emotional or behavioral disturbances and of developmental delays in homeless children aged 4 through 10 years, the presence of depression or a history of depression or other psychiatric problems in the parents of these children, and to determine whether the children and adults had mental health needs. The results indicate that nearly all of the children showed some difficulties. Sixty-one percent of the children had receptive verbal functioning at or below the first percentile for age, 29% were functioning at the fifth percentile for age in psychomotor ability, and 38% exhibited emotional and behavioral problems. Twenty-eight percent of the parents exhibited evidence of mild to severe depression; a smaller percentage admitted to past psychiatric problems.

Adult↗

PubMed1990

Impairment in the epidemiological measurement of childhood psychopathology in the community.

The desirability of incorporating a measure of impairment to the categorization of childhood psychopathology in the community is examined. The use of the Children's Global Assessment Scale (CGAS) for this purpose is recommended. The choice of 61 (definite case) and 71 (probable case) as cutpoints on the Children's Global Assessment Scale is supported empirically by the data on service utilization, parental perceived need, and behavior problem scores obtained in the Puerto Rico Child Psychiatry Epidemiological Study.

Adolescent↗

PubMed1989

Risk factors for maladjustment in Puerto Rican children.

Data are presented on risk factors for childhood psychopathology derived from a study of an island-wide probability sample of children in Puerto Rico aged 4 through 16 years. Analyses estimated the effects of 12 demographic, health, and family variables on the probability of being a "case," using two different operational definitions of caseness, as well as on the probability of receiving the diagnoses of oppositional disorder, attention deficit disorder, separation anxiety, depression, functional enuresis, and adjustment disorder. When compared to other findings, the results from these analyses indicate that the relationship between maladjustment and the risk factors evaluated does not appear to be culturally specific.

Adolescent↗

PubMed1988

Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. The use of combined measures.

A two-stage epidemiologic survey was carried out on a probability sample of the population aged 4 through 16 years in Puerto Rico. The survey used the Child Behavior Checklist as a screening instrument, and prevalence rates were estimated on the basis of clinical diagnoses and other measures provided by child psychiatrists during the second stage. Maladjustment was operationally defined through the use of combined measures, including DSM-III diagnosis and a scale of functional impairment. Data were provided on the demographic correlates of maladjustment and on the comorbidity of DSM-III diagnostic domains. The prevalence rates obtained vis-à-vis the availability of mental health services on the island reflected a major public health problem.

Adjustment Disorders↗

PubMed1987

The Spanish Diagnostic Interview Schedule. Reliability and concordance with clinical diagnoses in Puerto Rico.

A Spanish translation of the Diagnostic Interview Schedule (DIS) was assessed using samples of Puerto Rican patients and community subjects from the San Juan area. Concordance between DIS results from psychiatrists' interviews and from laypersons' interviews was similar to results with the DIS in mainland samples. Comparisons of laypersons' DIS results with psychiatrists' clinical diagnoses yielded generally poorer agreement. Levels of agreement improved when diagnoses were clustered into higher-rank categories. These results raise cultural issues related to the use of the DIS in Puerto Rico.

Adolescent↗

PubMed1987

The prevalence of specific psychiatric disorders in Puerto Rico.

An epidemiologic survey of the lifetime and six-month prevalence rates of several psychiatric disorders was conducted in Puerto Rico. This study, carried out in 1984, applied selected schedules of a Spanish translation of the Diagnostic Interview Schedule to a stratified, island-wide probability sample of the population. With few exceptions, prevalence rates in this study were similar to those obtained in the US communities studied in the Epidemiologic Catchment Area program. The demographic correlates of the disorders are reviewed, and differences between the results of this study and those of previous studies suggesting a higher rate of mental disorder among Puerto Rican populations are discussed.

Adolescent↗