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Biomedical subjects

T M Achenbach

Publications and source records attributed to T M Achenbach.

At least 37 records · Page 2Linked to original sources

Six-year predictors of problems in a national sample of children and youth: I. Cross-informant syndromes.

OBJECTIVE: To illuminate the development of psychopathology by tracing 6-year predictive paths to outcomes assessed in terms of empirically based syndromes. METHOD: A national sample assessed at ages 4 through 12 years via parent reports was reassessed 3 and 6 years later via parent, teacher, and self-reports. RESULTS: For syndromes having the clearest DSM counterparts, cross-informant predictive paths revealed similar traitlike patterns for Aggressive Behavior in both sexes; Delinquent Behavior was less traitlike, with greater sex differences in predictive paths; the Attention Problems syndrome was developmentally stable, but, surprisingly, it was associated with more diverse difficulties among girls than boys; conversely, Anxious/Depressed was associated with more diverse difficulties among boys than girls. CONCLUSIONS: Quantification of problems via empirically based syndromes can detect important sex, age, and developmental variations that may be masked by uniform diagnostic cutoff points for both sexes and diverse ages. This may be especially true for diagnostic cutoff points derived mainly from clinical cases of one sex, such as depression for girls versus attention and conduct disorders for boys.

Adolescent↗

Six-year predictors of problems in a national sample: III. Transitions to young adult syndromes.

OBJECTIVE: To test developmental paths from adolescent syndromes and other candidate predictors to young adult syndromes. METHOD: A national sample assessed at ages 13 through 16 and 16 through 19 years was reassessed at 19 through 22 years in terms of six syndromes derived empirically from parent and self-reports, two syndromes derived only from parent reports, and one derived from self-reports. RESULTS: Several young adult syndromes were similar to adolescent syndromes and were strongly predicted by these syndromes. A new syndrome designated as Shows Off and an adult Aggressive Behavior syndrome were both predicted by the adolescent Aggressive Behavior syndrome. This indicates a developmental transition away from overt aggression among some aggressive youths but not others. A syndrome designated as Irresponsible was predicted by the adolescent Attention Problems syndrome and may be an adult phenotype of attention deficit disorder. Surprisingly, attention problems were associated with more diverse problems among females than males. CONCLUSIONS: There are strong predictive relations from adolescent to adult syndromes. Sex differences in predictive paths argue against basing assumptions about both sexes on findings for one sex.

Adolescent↗

Six-year predictors of problems in a national sample of children and youth: II. Signs of disturbance.

OBJECTIVE: To identify 1986 and 1989 variables that significantly predicted signs of disturbance assessed in 1992. METHOD: 1986 parent reports and 1989 parent, teacher, and self-reports of syndromes, competencies, family variables, and stressful experiences were tested as predictors of 1992 reports of academic problems, school behavior problems, receipt of mental health services, suicidal behavior, police contacts, substance abuse, and the sum of these six signs. RESULTS: The predictors accounted for large percentages of variance in most signs and predicted fairly accurately which members of case-control samples would manifest specific signs. Overall predictive accuracy was similar for both sexes, but many predictors differed for boys versus girls. The six signs were weakly associated with each other but were strongly associated with particular syndromes. CONCLUSIONS: Signs of disturbance were predictable over a 6-year period despite the diversity of a national sample. Previous manifestations of certain signs were modest predictors of the same signs. The Delinquent Behavior and Attention Problems syndromes, plus stressful experiences, predicted the most signs. Sex differences in predictors argue against generalizing findings and inferences from one sex to the other.

Adolescent↗

Epidemiology of behavioral and emotional problems among children of Jamaica and the United States: parent reports for ages 6 to 11.

Research on child behavior problems requires standardized methodology in order to identify similarities and differences between societies. The present study compared parent-reported behavior problems of 360 Jamaican and 946 U.S. children aged 6 to 11. It revealed few differences in individual, total, internalizing (e.g., depression), and externalizing (e.g., fighting) problem scores as a function of nationality, gender, or age. Findings from this and other studies indicate the feasibility of a common methodology in cross-national studies of children's problems, but also the need for further refinement.

Affective Symptoms↗

Comorbidity of empirically based syndromes in matched general population and clinical samples.

Comorbidity of deviance on eight empirically based syndromes was compared in matched general population and clinical samples of 2,705 children aged 4-18, using a bidirectional formula to avoid confounding effects of differential base rates. Syndromes were assessed via parent ratings on the CBCL, teacher ratings on the TRF, and self ratings on the YSR. Significantly higher comorbidity rates were obtained for clinical than general population samples for all 28 pairings of CBCL syndromes, 15 pairings of TRF syndromes, and 22 pairings of YSR syndromes. Bidirectional comorbidity rates for empirically based syndromes were compared to pairings of comparable DSM-III diagnoses.

Adolescent↗

Behavioral and emotional problems among Thai and American adolescents: parent reports for ages 12-16.

We studied adolescents' behavioral and emotional problems in the United States and in Thailand, a Buddhist country in which, reportedly, aggression is discouraged and self-control, emotional restraint, and social inhibition are encouraged. Standardized parent reports on 118 problems revealed 45 Thai-U.S. differences. Thai adolescents were reported to show more overcontrolled problems (e.g., shyness, compulsivity, inhibition of talking, fearfulness, and constipation) than American adolescents (p < .0001). The two groups did not differ reliably in total undercontrolled problems, but Americans showed higher levels of direct, overt, and interpersonally aggressive undercontrol (e.g., fighting and bullying), whereas Thais showed more indirect and subtle undercontrol that was not interpersonally aggressive (e.g., sulking and sullenness). The findings suggest that different cultures may be linked to different styles of adolescent problem behavior.

Adolescent↗

Three-year course of behavioral/emotional problems in a national sample of 4- to 16-year-olds: 3. Predictors of signs of disturbance.

We tested parent-reported family variables, problems, competencies, and stress as predictors of (a) academic problems, (b) school behavior problems, (c) receipt of mental health services, (d) child's need for additional help, (e) suicidal behavior, (f) police contacts, and (g) the sum of these 6 outcomes. Included in the study were 995 cases manifesting at least 1 sign of disturbance (from Outcomes a-f) and 995 matched controls from a national sample of 2,479 children assessed twice over a 3-year interval. Path analyses identified predictors that were significant across age and sex plus those specific to particular groups. The predictive models accounted for medium to large effects in Time 2 signs of disturbance. Time 2 Child Behavior Checklist scores were significantly associated with all Time 2 disturbance scores. The multiple significant risk factors associated with signs of disturbance indicated variations in pathways leading to particular signs of disturbance.

Adolescent↗

Epidemiological comparisons of American and Dutch adolescents' self-reports.

OBJECTIVE: To determine the cross-cultural applicability of self-reports of adolescents' problems and competencies. METHOD: Youth Self-Reports (YSRs) were completed by 803 American and 803 Dutch nonreferred adolescents matched by gender, age, and socioeconomic status. RESULTS: Comparisons revealed that American adolescents reported many more problems than did Dutch adolescents. This finding contrasts sharply with the American/Dutch similarities in parents' and teachers' reports of children's problem behaviors. Competence scores also were much higher for the American than the Dutch sample. CONCLUSIONS: Cutpoints for discriminating the normal and the clinical range of YSR scores need to be adjusted to local norms for the Dutch sample. Cultural factors may be responsible for the cross-national differences.

Adolescent↗

Are American children's problems getting worse? A 13-year comparison.

OBJECTIVE: To determine whether the prevalence of children's behavioral/emotional problems changed significantly over a 13-year period. METHOD: Problems and competencies reported by parents and teachers for a random sample of 7 to 16 years old assessed in 1989 were compared with those reported by parents for a 1976 sample and by teachers for a 1981 to 1982 sample. Parent reports were obtained with the Child Behavior Checklist; teacher reports were obtained with the Teacher's Report Form. RESULTS: Problem scores were higher and competence scores were lower in 1989 than in the earlier assessments. The secular changes were small but included diverse problems, syndromes, and competencies. Changes did not differ significantly by age, gender, socioeconomic status, nor black/white ethnicity. Correlations of 0.97 to 0.99 between rankings of item scores across 7.5- and 13-year intervals support the stability of the assessment procedures. Despite increases in problem scores, the 1989 U.S. scores were not higher than those in several other cultures. CONCLUSIONS: Viewed categorically in terms of caseness, more untreated children in the 1989 than the 1976 sample would be considered to need help. Multicohort longitudinal studies now in progress will test predictors of within- and between-cohort change.

Adolescent↗

Nine-year outcome of the Vermont intervention program for low birth weight infants.

Twenty-four low birth weight children who had received an experimental intervention (LBWE) during the neonatal period, 31 control children who had received no treatment (LBWC), and 36 normal birth weight children were compared. The intervention involved seven hospital sessions and four home sessions in which a nurse helped mothers adapt to their LBW babies. At age 9, LBWE children scored significantly higher than LBWC children on the Kaufman Mental Processing Composite, Sequential, Simultaneous, Achievement, Arithmetic, and Riddles scales, after statistical adjustments for socioeconomic status. The LBWE children had also advanced more rapidly in school than had LBWC children. Parent (Child Behavior Checklist) and teacher (Teacher's Report Form) ratings of school functioning were more favorable for LBWE than LBWC children, with especially strong effects on Teacher's Report Form scores for academic performance and the attention problems syndrome. At age 9, LBWE children were not significantly inferior to normal birth weight children on any measure. These results bear out a progressive divergence between the LBWE and LBWC children that first became statistically significant in cognitive scores at age 3. The findings suggest that the intervention prevented cognitive lags among LBW children and that this eventually had a favorable effect on academic achievement, behavior, and advancement in school. The progression from no significant differences between LBWE and LBWC children on early cognitive and achievement scores to significant and pervasive differences in later functioning argues for long-term follow-up periods to evaluate properly the power of behavioral interventions to compensate for biological risks.

Adaptation, Psychological↗

Three-year course of behavioral/emotional problems in a national sample of 4- to 16-year-olds: I. Agreement among informants.

Quantitative and categorical indices of psychopathology are reported for a nationally representative longitudinal sample assessed via eight empirically derived cross-informants syndromes, internalizing, externalizing, and total problems. Results showed medium to large stabilities for parents' ratings during a 3-year interval on all comparable scales. Predictive correlations between time 1 parents' ratings and time 2 teacher and self-ratings were weaker than parent-to-parent correlations. Classification of children as deviant showed weaker predictive relations than did quantitative scores. Odds ratios showed that children classified as deviant by parents' time 1 ratings were much more likely to be deviant at time 2 on corresponding parent, teacher, and self-ratings than were children initially classified as nondeviant.

Adolescent↗

Three-year course of behavioral/emotional problems in a national sample of 4- to 16-year-olds: II. Predictors of syndromes.

This study examined relations between parents' ratings of children's behavioral/emotional problems, family variables, and stressful experiences as predictors of 3-year outcomes in a nationally representative sample of American children. Outcomes were measured by time 2 parent, teacher, and self ratings on eight empirically derived cross-informant syndromes. Path analyses indicated that parent ratings of each time 1 syndrome predicted parent ratings of the same time 2 syndrome. Family variables and intervening stressful experiences predicted parent and self ratings, but not teacher ratings of syndromes. The number of family members receiving mental health services was the family variable that predicted the most time 2 syndromes. Parent reports of stress predicted parent ratings of time 2 syndromes, whereas child reports of stress predicted self-ratings of time 2 syndromes.

Adolescent↗

National survey of problems and competencies among four- to sixteen-year-olds: parents' reports for normative and clinical samples.

We compared parent-reported problems and competencies for national samples of 2,600 4-16-year-olds assessed at intake into mental health services and 2,600 demographically matched nonreferred children assessed in a home interview survey. Parents responded to the ACQ Behavior Checklist, which includes 23 competence items, three competence scales, 216 problem items, eight syndrome scales, Internalizing, Externalizing, and total competence and problem scores. Most items and scales discriminated significantly (p less than .01) between referred and nonreferred samples. There were important sex and age differences in problem patterns, but regional and ethnic differences were minimal. Somewhat more problems and fewer competencies were reported for lower- than upper-socioeconomic-status children. Referral rates were similar in the most urban and rural areas, but they were significantly higher in areas of intermediate urbanization. Correlations of problem scores with those obtained 10 years earlier in a regional survey and with surveys in other countries showed considerable consistency in the rank order of prevalence rates among specific problems. Apparently owing to its more differentiated response scales, the ACQ was susceptible to respondent characteristics that reduced its discriminative power below that of the Child Behavior Checklist. Comparisons of procedures for discriminating between the normal and the clinical range supported the value of a borderline category for children who are neither clearly normal nor clearly deviant. Interview data from the survey sample yielded significantly higher ACQ problem scores for children who had fewer related adults in their homes, those who had more unrelated adults in their homes, those whose biological parents were unmarried, separated, or divorced, those whose families received public assistance, and those whose household or family members had received mental health services. Children who scored higher on Externalizing than Internalizing problems tended to have unmarried, separated, or divorced parents and to come from families receiving public assistance. However, among children whose household or family members had received mental health services, there were greater proportions of both Externalizing and Internalizing patterns than among other children.

Adolescent↗

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↗

Problems and competencies reported by parents of Australian and American children.

We compared problems and competencies reported for 2600 randomly selected nonreferred children in Sydney and the U.S.A. Sydney children scored significantly higher on 82 problem items, with a mean total problem score of 31.6 versus 20.1 for the U.S.A. Nevertheless, item scores correlated 0.92 between countries, most differences between competence scores were small, and patterns were similar for sex, age, socioeconomic status, and internalizing versus externalizing problems. Although higher clinical cutoffs may be needed in Sydney, the similarity of patterns in scores permits calibration of the Child Behavior Checklist between Sydney and the U.S.A. Sex differences found in seven cultures were summarized.

Achievement↗

Seven-year outcome of the Vermont Intervention Program for Low-Birthweight Infants.

We compared 24 low-birthweight subjects of an experimental intervention (LBWE), 32 no-treatment controls (LBWC), and 37 normal birthweight (NBW) subjects. The intervention involved 7 hospital sessions and 4 home sessions in which a nurse helped mothers adapt to their LBW babies. At age 7, LBWE scored significantly higher than LBWC on the Kaufman Mental Processing Composite (p less than .001), Sequential (p = .02), and Simultaneous (p = .001) Scales, after statistical adjustments for socioeconomic status. LBWE did not differ from NBW (F less than 1). These results bear out a divergence between the LBWE and LBWC that first became statistically significant at age 3. The findings suggest that the intervention prevented cognitive lags among LBW children, and that long-term follow-ups are needed to evaluate the developmental effects of efforts to overcome major biological and environmental risks.

Child, Preschool↗

Replication of empirically derived syndromes as a basis for taxonomy of child/adolescent psychopathology.

To advance the empirical identification of child/adolescent syndromes, principal components analyses were performed on four sets of parents' ratings of 8,194 6- to 16-year-olds referred to American and Dutch mental health services. The following syndromes replicated well for both sexes at ages 6-16: Aggressive, Anxious/Depressed, Attention Problems, Delinquent, Somatic Complaints, and Withdrawn. For both age ranges, a syndrome designated as Socially Inept replicated well among boys, and one designated as Mean replicated well among girls. Evidence was also found for a Schizoid syndrome in all sex/age groups and a Sex Problems syndrome among girls at ages 6-11. Syndrome scores discriminated well between nationwide normative and clinical samples. The replicated syndromes contribute to the empirical basis for a taxonomy of the kinds of disorders commonly seen between the ages of 6 and 16.

Adolescent↗