Psychosocial assessment in the general pediatric population: a multiple-gated screening and identification procedure

Utility of a New Spanish RQC and PSC in Screening with CBCL Validation

Various screening questionnaires have been established to identify psychopathology in children and adolescents. Some of these instruments include the pediatric symptom checklist (PSC), the pediatric symptom checklist (CBCL) and reporting questionnaire for children (RQC). However, many of the patients and their families may not speak English, and this can be a barrier to identifying and properly treating monolingual Spanish-speaking patients and families. There is a need for optimal mental health screening in Spanish speaking populations given the continued growth of the United States as a diverse country with complex demographic structure. Because of the diversity within the use of Spanish in Hispanic countries of origin, the aim of this study is to present unified Spanish versions of the RQC and PSC achieved through simultaneously and independently translating them into three versions of Spanish (RQC-SP and PSC-SP). To test the psychiatric validity of RQC-SP and PSC-SP, these both were administered simultaneously along with the Spanish version of the CBCL, which had already been well established. All three of these tools were given to Spanish speaking parents of pediatric outpatients (n = 22) while waiting for their clinic appointments. The RQC-SP had a correlation to the CBCL with R = 0.779 and p < 0.001. The RQC-SP as compared with the CBCL had a false negative of 0/8 (0.00) with a sensitivity of 8/8 = 1.00. The false positives were 2/14 (0.143) and specificity 12/15 (0.85). The PSC-SP correlated with the CBCL with R = 0.897 and p < 0.001. The PSC-SP correlation with the CBCL had false negative of 7/8 (0.875) and sensitivity of 1/8 (0.125) and false positive 0/14 (0.00) and specificity 14/14 (1.00). The RQC-SP and PSC-SP are brief, well-validated, reliable instruments designed.

Screening for psychosocial problems in 5-6-year olds: a randomised controlled trial of routine health assessments

OBJECTIVE

Children's psychosocial problems are often not identified accurately. The present study addresses the effect of training of Child Health Doctors (CHDs) in a structured method to identify psychosocial problems on the accuracy of this identification in children aged 5-6.

METHOD

The study was a randomised controlled trial (RCT) with a baseline and two follow-up measurements. A volunteer sample of 58 CHDs participated, randomly assigned to intervention or control condition. CHDs selected a population-based sample of 5-6-year-old children (n = 6375).

RESULTS

The first follow-up showed that sensitivity had improved by 9% and specificity by 5% in the intervention condition, especially in children with severe problems (odds ratio = 3.7; 95% confidence interval: 1.2-11.8). The second follow-up showed a decrease in sensitivity and specificity in both conditions.

CONCLUSION

The training improves identification of psychosocial problems, especially severe ones, although the availability of time and resources also influences the accuracy with which psychosocial problems are identified.

ThePreschool Feelings Checklist: a brief and sensitive screening measure for depression in young children

OBJECTIVE

Childhood depression is widely underrecognized in primary health care settings. This phenomenon appears to increase with younger age. Evidence has been provided for a valid depressive syndrome among preschool children. Based on the need for the earliest possible identification of depression, the development of a brief screening measure to capture young children with markers of depression from these community settings was developed and tested.

METHOD

A group of 174 preschool children underwent a comprehensive psychiatric assessment. The majority of this study group was ascertained from primary care settings using a 20-item checklist designed to capture depressive symptoms in young children. The assessment included the Diagnostic Interview Schedule for Children Version modified for young children and the Child Behavior Checklist. Ratings on the checklist were subsequently compared with these independent measures of psychopathology using several analytic strategies.

RESULTS

The Preschool Feelings Checklist demonstrated high internal consistency, and 16 items showed strong associations with independent diagnostic measures of internalizing symptoms and major depressive disorder. The Preschool Feelings Checklist demonstrated high specificity and sensitivity for the identification of major depressive disorder at a cutoff score 3 or more.

CONCLUSIONS

The Preschool Feelings Checklist is a brief and valid screening measure highly feasible for use in primary care settings. It demonstrated utility for the identification of preschoolers in need of formal mental health evaluation for depression.