The empathy questionnaire for children and adolescents (EmQue-CA) in Chinese: Psychometric properties and measurement invariance

Diagnostic efficiency and psychometric properties of CBCL DSM-oriented scales in a large sample of Chinese school-attending students aged 5-16

BACKGROUND

Children and adolescents are vulnerable to various psychiatric disorders during the critical phase of individual development. In China, the child behavior checklist (CBCL) is a widely employed psychometric questionnaire for assessing children and adolescents. However, further validation of the psychometric properties and diagnostic effectiveness of the CBCL DSM-oriented scales is necessary. These scales were developed based on DSM diagnosis and require evaluation using a substantial sample of Chinese individuals.

METHODS

This study involved the analysis of a substantial dataset consisting of 72,109 samples collected from five provinces in China. Data was gathered using the CBCL (Parent Rating Scale), and rigorous assessments of reliability and validity were conducted. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID) and the diagnostic and statistical manual of mental disorders-IV (DSM-IV) interview were employed to diagnose the participants. To ensure the accuracy of the diagnoses, receiver operating characteristic curve (ROC curves) were utilized, and the Youden Index was calculated to determine the appropriate diagnostic cut-off point for each specific target diagnosis.

RESULTS

The study included a total sample of 72,109 cases, out of which 19,782 cases underwent MINI-KID assessment and structured or semi-structured interviews based on DSM-IV to clarify the diagnosis. Reliability and validity analyses showed that the reliability of the subscales and total scales was good, except for Anxiety Problems. The Cronbach's alpha for the CBCL DSM-oriented scales was 0.92. In addition, the validity of all scales was good (CFI = 0.80). For the sample with a clear diagnosis, all five subscales of the CBCL DSM-oriented scales showed fair diagnostic efficiency for the target diagnosis. Among them, the area under curves (AUC) of Mood disorder, Anxiety, Attention deficit and hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD) and Conduct disorder (CD) are 0.80, 0.74, 0.75, 0.74, 0.74. Among the three sample groups, the highest diagnostic efficiency was found in Affective Problems to Mania. The diagnostic cut-off point for each subscale on target diagnoses was clearly defined.

CONCLUSION

Overall, the reliability, validity and diagnostic efficiency of CBCL DSM-oriented scales in Chinese children and adolescents were within acceptable limits. In addition, we used ROC curves and cut-off points to predict the cut-off values of common child and adolescent psychiatric disorders mentioned in the CBCL DSM-oriented scales. This provides an important reference for the clinical application of the CBCL DSM-oriented scales in Chinese samples.

Psychometric properties of the empathy questionnaire for children and adolescents in a sample of Tanzanian adolescents

Construct definitions of empathy have sought to distinguish between different domains of empathetic capacity that are related to psychological distress or wellbeing. This study aims to validate the psychometric properties of the Empathy Questionnaire for Children and Adolescents (EmQue-CA) and to test for measurement invariance by gender in a sample of 579 very young adolescents (270 boys and 309 girls) ages 9-12 from Tanzania. Exploratory and confirmatory factor analysis were completed to assess the factor analytic structure of the EmQue-CA, indicating a three-factor model fit these data well. Concurrent validity was demonstrated through strong significant correlations with prosocial behavior and generosity measures. Convergent validity indicated the behavioral subdimension of empathy, intent to comfort, was significantly and negatively associated with externalizing behaviors. Measurement invariance by gender was not supported for these data due to configural invariance in covariance between cognitive empathy and intent to comfort latent constructs. These findings confirm the EmQue-CA is an important measure of three dimensions of empathy; affective empathy, cognitive empathy, and behavioral empathy (intent to comfort) in a sample of Tanzanian adolescents.

Evaluation of the Effectiveness of an Empathy Training on Empathy Skills, Life Satisfaction, and Relationship Quality for Chinese Adolescents and Their Mothers: A Mixed Methods Study

Using a pre- and post-test design, this study examined the changes in empathy skills, life satisfaction, and relationship quality among mainland Chinese adolescents (ages 13–15 years) and their mothers ( N = 108 dyads) following an empathy training intervention. Participants completed a 20-day empathy training, including two in-person group training sessions and daily journals on assigned topics. Participants’ mother-child relationship quality, mother-child conflict, life satisfaction, and empathy skills were measured three times, and selected participants were interviewed to explore their experience of the training. The research procedure followed protocols that were approved by an Institutional Review Board. ANOVAs were used to examine quantitative data and inductive analysis was used for qualitative data. The findings suggest that after the training, both adolescents and mothers reported significant benefits in mother-child relationship quality and life satisfaction. However, participants’ empathy skills (i.e., perspective taking and empathic concern skills) did not change. Possible mechanisms of the observed changes included the empathy skills (e.g., perspective taking skills) learned through the training and the reciprocal nature of positive changes within the mother-child dyad. The current study suggests that empathy training may benefit adolescents and their mothers, both within the relationship and in their general life satisfaction.