The MacArthur Three-City Outcome Study: Evaluating Multi-Informant Measures of Young Children's Symptomatology

Stanford University Medical Center, CA, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 01/2000; 38(12):1580-90. DOI: 10.1097/00004583-199912000-00020
Source: PubMed


Three sites collaborated to evaluate the reliability and validity of 2 measures, developed in tandem to assess symptomatology and impairment in 4- to 8-year-old children: the Berkeley Puppet Interview Symptomatology Scales (BPI-S) and the Health and Behavior Questionnaire (HBQ).
In this case-control study, mothers, teachers, and children reported on multiple dimensions of children's mental health for 120 children (67 community and 53 clinic-referred children).
The BPI-S and the parent and teacher versions of the HBQ demonstrated strong test-retest reliability and discriminant validity on a majority of symptom scales. Medium to strong effect sizes (Cohen d) indicated that children in the clinic-referred group were viewed by all 3 informants as experiencing significantly higher levels of symptomatology than nonreferred, community children.
The availability of a set of multi-informant instruments that are psychometrically sound, developed in tandem, and developmentally appropriate for young children will enhance researchers' ability to investigate and understand symptomatology or the emergence of symptomatology in middle childhood.

Download full-text


Available from: Marilyn J Essex
  • Source
    • "The caregiver is most likely to initiate the referral for outpatient services, and young children are unlikely to have the patience, focus, or metacognition needed to complete many semistructured interviews. If the interview is redesigned to be developmentally appropriate for young children, it is difficult to connect with adolescent and adult interviews or diagnostic nosologies (e.g., Ablow et al., 1999; Wakschlag et al., 2012). However , if the diagnostic formulation is based solely on the caregiver interview, then there is no source of potentially disconfirming information . "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper meta-analyzes the diagnostic efficiency of checklists for discriminating pediatric bipolar disorder (PBD) from other conditions. Hypothesized moderators included (a) informant—we predicted caregiver report would produce larger effects than youth or teacher report; (b) scale content—scales that include manic symptoms should be more discriminating; and (c) sample design—samples that include healthy control cases or impose stringent exclusion criteria are likely to produce inflated effect sizes. Searches in PsycINFO, PubMed, and GoogleScholar generated 4,094 hits. Inclusion criteria were (a) sufficient statistics to estimate a standardized effect size, (b) age 18 years or less, and (c) at least 10 cases (d) with diagnoses of PBD based on semistructured diagnostic interview. Multivariate mixed regression models accounted for nesting of multiple effect sizes from different informants or scales within the same sample. Data included 63 effect sizes from 8 rating scales across 27 separate samples (N = 11,941 youths, 1,834 with PBD). The average effect size was g = 1.05. Random effect variance components within study and between study were significant, ps < .00005. Informant, scale content, and sample design all explained significant unique variance, even after controlling for design and reporting quality. Checklists have clinical utility for assessing PBD. Caregiver reports discriminated PBD significantly better than teacher and youth self report, although all 3 showed discriminative validity. Studies using “distilled” designs with healthy control comparison groups, or stringent exclusion criteria, produced significantly larger effect size estimates that could lead to inflated false positive rates if used as described in clinical practice.
    Full-text · Article · Nov 2015
  • Source
    • "The HBQ was derived from the Ontario Child Health Study measure designed to map onto DSM-III-R symptom criteria (Boyle et al., 1993). The HBQ-P has strong psychometric properties and has been used to assess child mental health across multiple ages from 4.5 years into adolescence (Ablow et al., 1999; Essex et al., 2006; Shirtcliff and Essex, 2008) The mental health scales have been shown to discriminate groups of children with and without signs of early psychopathology (Luby et al., 2002). The HBQ-P, administered in questionnaire format, assesses symptoms ranging from " never or not true " to " often or very true. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Prenatal exposure to serotonin reuptake inhibitor (SRI) antidepressants and maternal depression may affect prefrontal cognitive skills (executive functions; EFs) including self-control, working memory and cognitive flexibility. We examined long-term effects of prenatal SRI exposure on EFs to determine whether effects are moderated by maternal mood and/or genetic variations in SLC6A4 (a gene that codes for the serotonin transporter [5-HTT] central to the regulation of synaptic serotonin levels and behavior). Children who were exposed to SRIs prenatally (SRI-exposed N=26) and non-exposed (N=38) were studied at age 6 years (M=6.3 SD=0.5) using the Hearts & Flowers task (H&F) to assess EFs. Maternal mood was measured during pregnancy (3rd trimester) and when the child was age 6 years (Hamilton Depression Scale). Parent reports of child behavior were also obtained (MacArthur Health & Behavior Questionnaire). Parents of prenatally SRI-exposed children reported fewer child externalizing and inattentive (ADHD) behaviors. Generalized estimate equation modeling showed a significant 3-way interaction between prenatal SRI exposure, SLC6A4 variant, and maternal mood at the 6-year time-point on H&F accuracy. For prenatally SRI-exposed children, regardless of maternal mood, the H&F accuracy of children with reduced 5HTT expression (a short [S] allele) remained stable. Even with increasing maternal depressive symptoms (though all below clinical threshold), EFs of children with at least one short allele were comparable to children with the same genotype whose mothers reported few if any depressive symptoms – in this sense they showed resilience. Children with two long (L) alleles were more sensitive to context. When their mothers had few depressive symptoms, LL children showed extremely good EF performance – better than any other group. When their mothers reported more depressive symptoms, LL children’s EF performance was worse than that of any other group.
    Full-text · Article · Oct 2013 · Frontiers in Cellular Neuroscience
  • Source
    • ") measures mental health symptoms , physical health, and academic and social functioning; it discriminates between clinic-referred children and controls (Ablow et al., 1999) and corresponds well with Diagnostic and Statistical Manual of Mental Disorders (fourth edition) symptoms and diagnoses in children (Lemery-Chalfant et al., 2007). Finally, we included symptoms of major depressive disorder from the Diagnostic Interview Schedule for Children, Version IV (Fisher et al., 1997). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Rumination is an established cognitive vulnerability for depression. Despite substantial work on the environmental origins of rumination, the heritability of rumination has not been examined and it is not known whether rumination accounts for some of the genetic vulnerability associated with depression. 756 adolescent twins ages 12-14 years completed the Response Styles Questionnaire and multiple measures of depressive symptoms. Brooding correlated positively and distraction correlated negatively with concurrent depressive symptoms. Estimated heritabilites were 54% for depression, 21% for brooding, 37% for reflection, and 30% for distraction. Bivariate genetic analyses suggested that (1) individual differences in distraction share both genetic and environmental sources of variation with depression; and (2) although the heritable influences on brooding are small, these heritable influences account for the majority of the relationship between brooding and depression (h(2) = .62).
    Full-text · Article · Jul 2013
Show more