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PubMed2004

Quantifying clinical judgment in the assessment of adolescent psychopathology: Reliability, validity, and factor structure of the Child Behavior Checklist for clinician report.

The aim of this study was to assess the reliability and validity of the Child Behavior Checklist (CBCL) as completed by doctoral-level clinicians in the treatment of adolescents. We asked 294 randomly selected, experienced psychiatrists and psychologists to describe a patient aged 14 to 18 in treatment for personality pathology. Clinicians completed the CBCL (parent-report version) and measures of adaptive functioning, personality pathology, and family and developmental history, which served as criterion variables to test the validity of the CBCL as completed by clinicians. Most CBCL scales demonstrated acceptable reliability. Validity estimates were impressive, and the data revealed clinically meaningful associations between specific CBCL scale scores and developmental and family history variables. Confirmatory factor analysis showed that the factorial structure of the clinician-report CBCL resembled that of the parent-report CBCL, with the exception of a substantially lower correlation between higher order internalizing and externalizing factors. The data suggest that clinical judgment can be both reliable and valid when quantified using psychometrically sound instruments.

Adolescent↗
PubMed2001

Simulated pain on the Symptom Checklist 90-Revised.

This study investigated whether a pain clinical sample and pain simulators could be distinguished by their responses on the Symptom Checklist 90-Revised (SCL-90-R). Fifty patients with a pain condition completed the SCL-90-R under normal instructions while 20 students responded under instructions to feign a pain disorder to obtain compensation but to attempt to avoid detection. Pain patients obtained generalized elevations, with the highest scores on Depression, Obsessive-Compulsive, and Somatization. The simulators exceeded the pain group on all clinical scales of the SCL-90-R, tending to greatly overestimate the degree of psychological distress in pain patients. Simulators had extreme elevations and were more likely to obtain a T score greater than 70 on each of the clinical scales. Sensitivity, specificity, positive and negative predictive power values, and optimal diagnostic cutoff scores for the clinical scales are reported. The recommended Positive Symptom Total (PST) cutoff score for "faking bad" in the SCL manual had poor specificity. The SCL-90-R warrants further study as an aid to identifying pain simulation.

Adult↗
PubMed2005

Mismatch of posttraumatic stress disorder (PTSD) symptoms and DSM-IV symptom clusters in a cancer sample: exploratory factor analysis of the PTSD Checklist-Civilian Version.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms.

Adult↗
PubMed2005

The Child Behavior Checklist as an indicator of posttraumatic stress disorder and dissociation in normative, psychiatric, and sexually abused children.

Expert ratings and confirmatory factor analyses were used to derive a posttraumatic stress disorder (PTSD), dissociation, and a combined PTSD/dissociation scale from the Child Behavior Checklist (CBCL). Validity was established by examining the relationship of these scales to features of sexual abuse thought to relate to severity and chronicity, as well as to self-report scales of PTSD and dissociation. In addition, this study examined differences between normative, psychiatric, and sexually abused children on the new scales. Both the sexual abuse and psychiatric sample differed significantly from the normative sample on all scales, but not from each other. Despite correlations of the dissociation and PTSD/dissociation combined scale with features of trauma and child self-report of PTSD and dissociation, the absence of differences between the clinical groups on the derived scales suggests that the scales measure generic, as opposed to trauma-related, distress.

Child↗
PubMed2006

The Acute Stress Checklist for Children (ASC-Kids): development of a child self-report measure.

This project aimed to develop and validate a brief, practical self-report measure of acute stress disorder (ASD) reactions (including ASD diagnostic criteria) in children and adolescents. A draft measure was reviewed for content validity by an expert panel, piloted with youth, and revised for clarity and coverage of key constructs. The new 29-item Acute Stress Checklist for Children (ASC-Kids) was administered to 176 youth age 8 to 17 who had a recent injury or intensive care unit admission. The ASC-Kids demonstrated strong test-retest reliability and internal consistency, as well as concurrent and predictive validity with other traumatic stress measures. Results of exploratory factor analyses were consistent with current conceptualizations of acute traumatic stress reactions. The ASC-Kids is a promising measure of child acute stress reactions.

Adolescent↗
PubMed2004

Toward better probing for hypomania of bipolar-II disorder by using Angst's checklist.

The reliability of the diagnosis of bipolar-II disorder (BP-II) is still a problem. Semi-structured interviews by clinicians might partly overcome this problem. The aims of this study were to find the degree of agreement in the diagnosis of BP-II between the Structured Clinical Interview for DSM-IV (SCID) and a semi-structured interview based on Angst's hypomania checklist (Angst et al., 2003), and to assess the priority among hypomanic symptoms for the diagnosis of BP-II. Remitted depression outpatients (N = 102) were interviewed during a follow-up visit using th Structured Clinical Interview for DSM-IV (SCID), and then with Angst's semi-structured interview, following DSMIV criteria. Bipolar I (BP-I) patients were excluded. Using the SCID, 29 patients were diagnosed BP-II, 26 BP-I, and 47 major depressive disorder (MDD). By the semi-structured interview 69 patients were diagnosed BP-II, 33 MDD, and none BP-I. Agreement for the diagnosis of BP-II between the two interviews was 53.9% (k = 0.18). Re-analysis, after deleting the SCID question on the impact on functioning (DSM-IV unclear boundary between BP-I and BP-II), increased agreement to 78.4% (k = 0.55). Elevated mood and overactivity (increased goal-directed activity) had th lowest agreement (k = 0.46 0.49). For predicting BP-II, overactivity had the highest sensitivity (94.2%), whil elevated mood had a sensitivity of 84.0%. Multivariate analysis for predicting BP-II (diagnosed by semi-structured interview), including all DSM-IV hypomanic symptoms, found that mood change and overactivity were the only independent predictors. Overactivity plus at least three symptoms (as suggested by Angst and Gamma, 2002) were present in 71 patients, of whom 91.5% also met DSM-IV criteria for hypomania. Overactivity and elevated mood were strongly associated (but not overactivity and irritability). Findings may support a diagnosis of BP-II based on Angst's semi-structured interview versus the fully structured SCID interview. While DSM-IV always requires mood change for the diagnosis of hypomania, the present findings may suggest that overactivity could have the same priority, as suggested by Angst et al. (2003) and by Akiskal et al. (1977, 2001, 2003).

Adult↗
PubMed2000

Secondary analysis from the Seychelles Child Development Study: the child behavior checklist.

Human exposure to methylmercury (MeHg), a known neurotoxin, is primarily from fish consumption. As part of a large study examining the association between MeHg exposure and child development in a population with high fish consumption we examined school-age behavior using the Achenbach Child Behavior Checklist (CBCL). The CBCL Total T score was a primary endpoint and was reported earlier to show no adverse association with prenatal or postnatal MeHg exposure. In this study we analyzed the T scores of the CBCL subscales to determine if more discrete aspects of measured behavior were associated with exposure. The Seychelles Child Development Study (SCDS) is a prospective, double blind, longitudinal evaluation of over 700 children. The index of prenatal exposure was maternal hair total mercury (T-Hg) in a segment growing during gestation. Postnatal exposure was T-Hg in the child's hair taken at 66 months of age. The child's primary caregiver completed the CBCL during the 66-month evaluation. No association between prenatal or postnatal MeHg exposure and the CBCL subscales was found. In Seychellois children exposed to MeHg from consumption of ocean fish we found no association between either prenatal or postnatal MeHg exposure and behavior as measured by the CBCL subscales.

Adult↗
PubMed1992

Assessment of validity and clinical application of an Italian version of the Rotterdam Symptom Checklist.

An Italian version of the Rotterdam Symptom Checklist (RSCL) has been validated in a sample of 147 healthy women and 61 breast cancer outpatients. The structure of the RSCL has been analysed by factor analysis reproducing results of the English version, and the psychological and physical subscales showed a good internal reliability (Chronbach's alpha 0.91; 0.87). The State-Trait Anxiety Inventory questionnaire and the RSCL were compared in the healthy women sample. A Pearson correlation coefficient (PCC) of 0.74 (p < 0.01) was found between the trait anxiety and RSCL psychological scores. Psychological (mean: 17.5; SD: +/- 5.4) and physical (mean: 37.8; SD: +/- 8.6) subscale scores were correlated in healthy women (PCC: 0.68; p < 0.01) and related to a general wellbeing item (PCC: 0.44; p < 0.01). The breast cancer outpatients showed scores for psychological and physical subscales similar to those in the healthy women sample. The Italian version of the RSCL seems comparable to the English version and could be useful in clinical research. Its use in longitudinal studies should be tested.

Aged↗
PubMed1992

Cluster analysis of child behavior checklists of 6 to 11-year-old males with varying degrees of behavior disorders.

Achenbach Child Behavior Checklist ratings were collected on boys aged 6 to 11 years screened as not having significant behavior problems, as clinic-referred boys, and as boys diagnosed as having Attention Deficit-Hyperactivity Disorder alone or together with Oppositional-Defiant Disorder or Conduct Disorder. Cluster analysis resulted in a classification system related to DSM-III-R classification of the boys and parent self-report of mildly antisocial acts. Clusters also enhanced the ability of the instrument to detect Attention Deficit Hyperactivity Disorder and disruptive behavior disorders.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Validity and reliability of Symptom Checklist '90 (SCL90) in an Argentine population sample.

Quantitative models to explore behavioural disorders are being used increasingly often for health care decision making. Unfortunately, there is a dearth of instruments in Argentina specifically designed for our population, and few researchers have focused on adapting and re-establishing psychometric criteria for instruments proven to be useful in other countries. The aims of this study were to assess the psychometric properties and to develop normative samples for a psychological status symptom inventory, the Symptom Checklist 90 (SCL90). We sought to determine the psychological symptom patterns both in physically healthy community-residing respondents and in physically ill patients in Argentina. The nonpatient sample was a random stratified one, made up of 484 individuals from the general population and representative with regard to gender, age, income and educational level. We also analysed a patient sample that included 105 persons with breast cancer. Results indicated acceptable reliability and validity levels as well as adequate sensitivity to detect differences between patients and nonpatients. We concluded that the SCL90 can be used to measure psychological status in Argentina, and the data presented in this paper can be utilized for comparisons with other similar instruments and with other populations.

Adult↗
PubMed1989

The Psychosomatic Symptom Checklist revisited: reliability and validity in a chronic pain population.

A psychometric evaluation of the SUNYA Revision of the Psychosomatic Symptom Checklist (PSC) was conducted with 405 chronic pain patients who completed the PSC as part of a diagnostic battery. Several properties of the measure were examined, including its reliability, internal consistency, discriminant validity, and factor structure. Contrary to a previous study, the measure demonstrated a modest reliability, a poor discriminant validity, and a multifactor structure that accounted for only a small proportion of the variance in the measure. Thus, the PSC did not appear to be an adequate measure of general psychosomatic distress when used with chronic pain patients. For these patients, the PSC may measure symptom clusters rather than general psychosomatic symptomatology. Since the PSC is used in various clinical populations, the results underscore the importance of investigating the properties of the measure in these populations.

Adult↗
PubMed1991

The utility of the Psychosomatic Symptom Checklist among hospitalized patients.

We examined the utility of the Psychosomatic Symptom Checklist in an inpatient medical setting with particular emphasis on the putative ability of the PSC to discriminate psychosomatic from nonpsychosomatic patients. First, 80 hospitalized psychosomatic patients were compared to 80 hospitalized medical patients on the PSC. Second, a sample of 187 psychosomatic patients was studied to examine the relationship among psychosomatic distress, depression, and functional impairment. The results indicate that while psychosomatic patients scored significantly higher than comparable medical patients on the PSC, discriminant analyses indicate that the PSC is not able to identify psychosomatic patients in an inpatient medical setting. Factor analyses and correlations show that the PSC is positively related to increased depression and decreased functional status. Results are interpreted in light of current psychosomatic theory.

Depression↗
PubMed1984

Psychometric properties of the SUNYA revision of the Psychosomatic Symptom Checklist.

The Psychosomatic Symptom Checklist (PSC), a questionnaire assessing psychosomatic symptoms, was administered to two separate samples of college students. For Sample 1 (N = 698), the questionnaire was readministered to three separate subsets at intervals of either 1 week (N = 143), 4 weeks (N = 74), or 8 weeks (N = 48). Each subset of subjects recompleted the PSC on only one of the three retest intervals. Based on the initial administration an analysis of the normative data revealed a mean total score of 23.7, suggesting a relatively low degree of psychosomatic symptoms in this group. Although total scores decreased slightly over time, test-retest correlations remained high (r greater than 0.80, P less than 0.0001). Individual item correlations was greater than r = 0.50 throughout. Sample 2 (N = 249) completed the PSC, Beck Depression Assertiveness Scale (RAS), and intercorrelations were computed between these measures. This analysis revealed little overlap between the psychosomatic complaints assessed by the PSC and other commonly used measures of psychological distress. Finally, a factor analysis revealed one major factor on which all but 2 of the 17 questionnaire items loaded significantly. These results suggest that the PSC is sensitive to psychosomatic distress and remains reliable over time.

Adolescent↗
PubMed1988

Empirically derived Symptom Checklist 90 subgroups of chronic pain patients: a cluster analysis.

Four hundred fifty-three chronic pain patients completed a Symptom Checklist 90 (SCL-90) and a comprehensive pain evaluation questionnaire. All patients were evaluated by a physician and rated on degree of pain pathology and pain behavior. The SCL-90 data were analyzed using two clustering procedures and replicated over two similar samples. Three distinct profiles emerged and represented high, medium, and low scores on the SCL-90. No differences were found between subgroups on demographic characteristics, compensation status, pain duration, or pain ratings. Patients in the high-profile subgroup showed the most emotional distress, reported that their pain interfered the most with all activities, and were most often judged to have high pain behavior. Little evidence was found to support a "denial" profile, as previously predicted. Further support was found for using the SCL-90 in assessing chronic pain patients.

Activities of Daily Living↗
PubMed1988

The mediating effect of age on the relationship between Child Behavior Checklist hyperactivity scores and neuropsychological test performance.

The relationship between hyperactivity and neuropsychological test performance at different age levels was examined. It was found that for young children (6 to 8 years of age, n = 90), there was no significant association between hyperactivity/attentional problems (as measured by the Hyperactivity scale of the Child Behavior Checklist) and performance on neuropsychological tasks thought to contain an attentional component (WISC-R Coding, Arithmetic, and Digit Span; WRAT Arithmetic; and the Benton Visual Retention Test). However, for older children (9 to 12 years of age, n = 92), there were significant and large negative correlations between CBC Hyperactivity scores and Coding, WRAT Arithmetic, and Benton VRT scores. Multiple regression analyses supported the above results (for Coding and WRAT Arithmetic), indicating that hyperactivity/inattention has a particularly deleterious effect on test performance (relative to same-age peers) as age increases.

Age Factors↗
PubMed1988

The adolescent activities checklist: reliability, standardization data, and factorial validity.

This study was conducted to provide standardization data and information on the reliability and factorial validity of the recently developed Adolescent Activities Checklist (AAC). A total of 563 adolescents in grades 7 through 12 served as subjects. Significant main effects for gender, race, and grade were obtained in a multivariate analysis of variance. On the basis of this information, standardization data were established for these three variables. Further investigation indicated that the internal consistency of the AAC was high. In addition, results of a principal components analysis conducted on the frequencies of the Unpleasant and Pleasant Activities subscales revealed four and three factors, respectively. For unpleasant activities, the major dimensions were found to occur in three situations--namely, social interactions, family situations, and school situations. Stressful events also occurred as one of the four unpleasant activities dimensions. For pleasant activities, three dimensions appeared: heterosocial behavior, reinforcing interpersonal situations, and social reinforcement.

Adolescent↗
PubMed1975

Discriminators of clinically defined emotional maladjustment. Predictive validity of the Behavior Problem Checklist and Devereux scales.

From a population of 130 boys between 7 and 14 years of age who had been clinically diagnosed as aggressive, hyperactive, or withdrawn, 32, 31, and 32 Ss, respectively, were randomly selected. All Ss were rated on the Behavior Problem Checklist (BPC) and the Devereux Elementary School Behavior rating scales (DESB) during the 1971-72 academic year. A descriptive intercorrelation matrix was generated for the 4 BPC scales and the 14 DESB scales. Three stepwise discriminant analyses were run: (a) BPC scales only, (b) DESB scales only, and (c) BPC and DESB scales combined. In terms of statistical and practical considerations, the four BPC subscales by themselves attained the optimal predictive accuracy (65%, or 62 of 95 children correctly identified).

Adolescent↗
PubMed1993

The criterion-related validity of the Childhood Autism Rating Scale and the Autism Behavior Checklist.

The present study sought to examine the relationship between two popular instruments for screening autistic children: the Childhood Autism Rating Scale (CARS) and the Autism Behavior Checklist (ABC). The sample included 77 individuals. The records of 48 subjects contained firm diagnoses of autism, while the suggestion of autism was found in the remaining records. Correlations between the two scales ranged from -.16 to .73 (median = .39). The validity coefficient between the two total scores was .67. Using cutoff scores recommended by the authors, an analysis of the sensitivity of the two instruments was conducted. The CARS correctly identified 98% of the autistic subjects; it identified 69% of the possibly autistic as autistic. The ABC correctly identified 88% of the autistic subjects, while it identified 48% of those subjects considered possibly autistic as autistic. A phi coefficient was computed to estimate the degree of relationship between the nominal classifications produced by the two instruments. A moderate relationship was found (r phi = .54). Implications of the results are discussed.

Adolescent↗