Reliability, validity, and preliminary normative data for the Children's Aggression Scale-Teacher Version.
ABSTRACT To provide preliminary psychometric data on the Children's Aggression Scale-Teacher Version (CAS-T), which was designed to assess severity and frequency of aggressive, as distinct from nonaggressive, disruptive behaviors.
The CAS-T has 23 items representing five domains: Verbal aggression, Aggression against objects and animals, Provoked physical aggression, Unprovoked physical aggression, and Use of weapons. The CAS-T was completed for 273 nonreferred boys and 67 clinically referred children (60 boys; 7 girls). Coefficient alpha was assessed separately in clinical and nonreferred groups. Validity was evaluated by comparing CAS-T scores of children with different disruptive behavior disorder diagnoses and by examining the relationship of CAS-T scores to other parent and teacher ratings.
The scale as a whole had excellent reliability as measured by coefficient alpha. Children with conduct disorder were rated significantly higher than those with oppositional defiant disorder, attention-deficit/hyperactivity disorder, and no disruptive behavior disorder diagnosis. Further, patterns of correlations with other rating scales provide strong support for the convergent and discriminant validity of the CAS-T.
The CAS-T may fill a gap in that it distinguishes among various types and severity of aggression, as distinct from oppositional-defiant behaviors.
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ABSTRACT: The dependability of externalizing behavior composites and subscale scores from the Behavior Assessment System for Children, Second Edition, Teacher Rating Scale—Child (Reynolds & Kamphaus, 2004) and the Achenbach System of Empirically Based Assessment, Teacher's Report Form for Ages 6 –18 (Achenbach & Rescorla, 2001) was investigated. Teacher pairs from six class-rooms each completed items contributing to the externalizing composites and subscales for 10 of their students on two occasions approximately 1–3 weeks apart. Pearson correlation coefficients examining consistency between raters, between instruments, and between measurement occasions were generally strong, but dependability coefficients were moderate when rater, instrument, and occa-sion were considered concurrently. Variance component estimates indicated that individual differences among students accounted for the largest proportion of total variance across all score comparisons, but differences between teacher ratings for particular students and between instruments accounted for relatively large pro-portions of error variance among subscale scores. The implications of simulta-neously considering multiple error sources for test users are discussed. Children's externalizing behaviors (e.g., disruptive, aggressive, overactive, and antiso-cial actions) cause problems for their teachers and their peers in school settings, but most children exhibit externalizing behaviors occa-sionally. However, the frequency and severity of these behaviors vary widely across children (Hinshaw & Lee, 2003; Kamphaus, Huberty, DiStefano, & Petoskey, 1997). Those children who display frequent and severe externalizing behaviors may not only experience the nega-tive consequences of these behaviors, such as poor school adjustment and impaired peer re-lationships, but also demonstrate a variety of associated problems, such as academic under-achievement and increased risk of substance use disorders (Barkley, Fischer, Smallish, & Fletcher, 2006; Barriga et al., 2002; Nigg et al., 2006). Assessments of children's externalizing behaviors may be completed for a number of reasons. They may be conducted to determine the presence of a disorder outlined in the Di-agnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSM-IV-TR; American Psychiatric Association, 2000), to determine whether the child meets eligibility criteria for special education services specified by law (e.g., the Individuals with Disabilities Education Improvement Act, 2004), or to match DSM-IV-TR disorders or behavioral constellations to empirically supported inter-ventions (Kazdin & Weisz, 2003; Kratochwill & Stoiber, 2002). Best practice in behavioral assessment requires practitioners to obtain in-formation using multiple assessment methods completed by multiple sources describing be-haviors across multiple settings (McConaughy & Ritter, 2002). School psychologists fre-quently include behavior rating scales as part of multisource, multimethod assessments be-cause these scales provide a time-and cost-effective way to obtain parent and teacher perceptions of the presence and severity of a child's behaviors in a broad range of problem areas (Kamphaus, Petoskey, & Rowe, 2000; Power & Ikeda, 1996). However, as with most assessment methods, there are basic measure-ment problems associated with the use of be-havior rating scales—namely response bias and error variance (Merrell, 2003). Whereas response bias (or response style) concerns the way that raters approach the task of complet-ing the rating scale (e.g., falling prey to the halo effect or severity effect), error variance stems from the nature of behavior rating scale assessment. Martin, Hooper, and Snow (1986) and Merrell (2003) describe four types of error variance that are particularly applicable to child behavior rating scales: temporal vari-ance, instrument variance, source variance, and setting variance.School psychology review 01/2008; 37:91-108. · 1.85 Impact Factor
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ABSTRACT: Disruptive behaviour disorders include conduct disorder, oppositional defiant disorder and disruptive behaviour not otherwise specified. Attention deficit hyperactivity disorder (ADHD) is frequently associated with disruptive behaviour disorders. The difficulties associated with disruptive behaviour disorders are demonstrated through aggression and severe behavioural problems. These often result in presentation to psychiatric services and may be treated with medications such as atypical antipsychotics. There is increasing evidence of a significant rise in the use of atypical antipsychotics for treating disruptive behaviour disorders in child and adolescent populations. To evaluate the effect and safety of atypical antipsychotics, compared to placebo, for treating disruptive behaviour disorders in children and youths. We searched the following databases in August 2011: CENTRAL (2011, Issue 3), MEDLINE (1948 to August Week 1), EMBASE (1980 to 2011 Week 32), PsycINFO (1806 to August Week 2 2011), CINAHL (1937 to current), ClinicalTrials.gov (searched 15 August 2011), Australian New Zealand Clinical Trials Registry (ANZCTR) (searched 15 August 2011), CenterWatch (searched 15 August 2011) and ICTRP (searched 15 August 2011). We included randomised controlled trials with children and youths up to and including the age of 18, in any setting, with a diagnosis of a disruptive behaviour disorder. We included trials where participants had a comorbid diagnosis of attention deficit hyperactivity disorder, major depression or an anxiety disorder. Two review authors independently selected the studies and disagreements were resolved by discussion. Two review authors extracted data independently. One review author entered data into Review Manager software and another checked it. We contacted trial authors for information about adverse effects and to provide missing data. We included eight randomised controlled trials, spanning 2000 to 2008. Seven assessed risperidone and one assessed quetiapine. Three of the studies were multicentre. Seven trials assessed acute efficacy and one assessed time to symptom recurrence over a six-month maintenance period.We performed meta-analyses for the primary outcomes of aggression, conduct problems and weight changes but these were limited by the available data as different trials reported either mean change scores (average difference) or final/post-intervention raw scores and used different outcome measures. We also evaluated each individual trial's treatment effect size where possible, using Hedges' g.For aggression, we conducted two meta-analyses. The first included three trials (combined n = 238) using mean difference (MD) on the Aberrant Behaviour Checklist (ABC) Irritability subscale. Results yielded a final mean score with treatment that was 6.49 points lower than the post-intervention mean score with placebo (95% confidence interval (CI) -8.79 to -4.19). The second meta-analysis on aggression included two trials (combined n = 57) that employed two different outcome measures (Overt Aggression Scale (modified) (OAS-M) and OAS, respectively) and thus we used a standardised mean difference. Results yielded an effect estimate of -0.18 (95% CI -0.70 to 0.34), which was statistically non-significant.We also performed two meta-analyses for conduct problems. The first included two trials (combined n = 225), both of which employed the Nisonger Child Behaviour Rating Form - Conduct Problem subscale (NCBRF-CP). The results yielded a final mean score with treatment that was 8.61 points lower than that with placebo (95% CI -11.49 to -5.74). The second meta-analysis on conduct problems included two trials (combined n = 36), which used the Conners' Parent Rating Scale - Conduct Problem subscale (CPRS-CP). Results yielded a mean score with treatment of 12.67 lower than with placebo (95% CI -37.45 to 12.11), which was a statistically non-significant result.With respect to the side effect of weight gain, a meta-analysis of two studies (combined n = 138) showed that participants on risperidone gained on average 2.37 kilograms more than those in the placebo group over the treatment period (MD 2.37; 95% CI 0.26 to 4.49).For individual trials, there was a range of effect sizes (ranging from small to large) for risperidone reducing aggression and conduct problems. The precision of the estimate of the effect size varied between trials. There is some limited evidence of efficacy of risperidone reducing aggression and conduct problems in children aged 5 to 18 with disruptive behaviour disorders in the short term.For aggression, the difference in scores of 6.49 points on the ABC Irritability subscale (range 0 to 45) may be clinically significant. For conduct problems, the difference in scores of 8.61 points on the NCBRF-CP (range 0 to 48) is likely to be clinically significant.Caution is required due to the limitations of the evidence and the small number of relevant high-quality studies. The findings from the one study assessing impact in the longer term suggest that the effects are maintained to some extent (small effect size) for up to six months. Inadequately powered studies produced non-significant results. The evidence is restricted by heterogeneity of the population (including below average and borderline IQ), and methodological issues in some studies, such as use of enriched designs and risk of selection bias. No study addressed the issue of pre-existing/concurrent psychosocial interventions, and comorbid stimulant medication and its dosage was only partially addressed. There is currently no evidence to support the use of quetiapine for disruptive behaviour disorders in children and adolescents.It is uncertain to what degree the efficacy found in clinical trials will translate into real life clinical practice. Participants in the studies were recruited from clinical services but those who agree to take part in the clinical trials are a subset of the overall population presenting for care. There are no research data for children under five years of age. Further high-quality research is required with large samples of clinically representative youths and long-term follow-up to replicate current findings.Cochrane database of systematic reviews (Online) 01/2012; 9:CD008559. · 5.94 Impact Factor
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ABSTRACT: The IOWA Conners Rating Scale is a widely used brief measure of inattentive-impulsive-overactive (IO) and oppositional-defiant (OD) behavior in children. This study examined the psychometric properties of this measure when completed by mothers and teachers. Results of confirmatory factor analyses indicated that a three-factor solution, conforming to current DSM-IV formulations of the disruptive behavior disorders, provided a better fit to the observed data than the currently used two-factor model, in which no distinction is made between inattentive and hyperactive-impulsive behaviors. Both new and currently used scale scores had good internal consistency and test–retest reliability and showed that boys’ scores were significantly higher than girls’ scores. Results held for both mother and teacher ratings. Clinical cutoff scores were proposed and performed reasonably well to screen for ADHD and ODD. Results support the IOWA Conners as a screening measure for the disruptive behavior disorders or as a tool for monitoring treatment response.Journal of Psychopathology and Behavioral Assessment 09/2007; 30(3):180-192. · 1.55 Impact Factor