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Clinical Referral (clinical + referral)
Selected AbstractsPatterns of comorbidity in panic disorder and major depression: findings from a nonreferred sampleDEPRESSION AND ANXIETY, Issue 2 2005Joseph Biederman M.D. Abstract Previous findings in referred adult samples document major depression as having important moderating effects on the patterns of comorbidity for panic disorder and major depression. This study evaluated whether these patterns of comorbidity are moderated by referral bias. Panic disorder (PD) and major depression (MD) were used to predict the risk for comorbid psychiatric disorders and functional outcomes using data from a large sample of adults who had not been ascertained on the basis of clinical referral (N=1,031). Participants were comprehensively assessed with structured diagnostic interview methodology to evaluate childhood and adult comorbid psychiatric disorders. PD increased the risk for anxiety disorders, independently of MD. MD increased the risk for mania, antisocial personality disorder, psychoactive substance use disorder, disruptive behavior disorders, overanxious disorder, social phobia, and generalized anxiety disorder, independently of PD. These results extend to nonreferred samples' previously reported findings documenting that MD has important moderating effects on patterns of comorbidity for PD and indicate that patterns of comorbidity for PD are not due to referral bias. Depression and Anxiety 21:55,60, 2005. © 2005 Wiley-Liss, Inc. [source] The Ages & Stages Questionnaire: Social,Emotional: A validation study of a mother-report questionnaire on a clinical mother,infant sample,INFANT MENTAL HEALTH JOURNAL, Issue 4 2010Björn Salomonsson Mother-report questionnaires of infant socioemotional functioning are increasingly used to screen for clinical referral to infant mental health services. The validity of the Ages & Stages Questionnaire: Social Emotional (ASQ:SE; J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002) was investigated in a sample of help-seeking mothers with young infants. It was compared with independent observer-rated dyadic interactions, and the quality of dyadic relationships was rated by expert clinicians. The ASQ:SE ratings also were compared with questionnaires on maternal psychological stress and distress. The ASQ:SE did not correlate significantly with either external ratings of dyadic interaction or clinically assessed relationship qualities, though the latter two were strongly associated with each other. In contrast, ASQ:SE scores were associated with questionnaires relating to maternal psychological distress. This was especially true for mothers classified as depressed. Furthermore, reports on the ASQ:SE were strongly predicted by maternal stress. The study points to some problems with the concurrent validity of the ASQ:SE in clinical samples. It also demonstrates a close link between mothers' psychological distress and their ratings of infant social and emotional functioning. Further research should investigate the extent to which the ASQ:SE specifically measures infant functioning or maternal distress, and how it functions in clinical versus nonclinical samples. Los cuestionarios en que las madres reportan el funcionamiento socio-emocional del infante se están usando más para determinar la necesidad de referir a los servicios de salud mental infantil. Se investigó la validez del Cuestionario de Edades y Niveles: Socio-emocional (ASQ:SE) en un grupo muestra de madres con infantes pequeños las cuales buscaban ayuda. Al grupo se le comparó con las interacciones de las díadas evaluadas por un observador independiente, y con la calidad de las relaciones de las díadas evaluadas por clínicos expertos. Los puntajes del ASQ:SE también fueron comparados con cuestionarios sobre el estrés y la ansiedad maternales sicológicas. Resultados: el ASQ:SE no se correlacionó significativamente ni con los puntajes externos de la interacción de la díada ni con las cualidades de la relación evaluadas clínicamente, aunque ambas fueron asociadas fuertemente una con la otra. En contraste, los puntajes de ASQ:SE fueron asociados con cuestionarios que se referían a la ansiedad mental psicológica maternal. Esto resultó verdadero sobretodo en los casos de madres clasificadas como depresivas. Es más, el estrés maternal predijo fuertemente los reportes sobre el ASQ:SE. Este estudio apunta hacia ciertos problemas con la validez concurrente del ASQ:SE en muestras clínicas. El mismo demuestra una conexión cercana entre la ansiedad mental psicológica maternal y los puntajes que las madres les dan al funcionamiento social y emocional del infante. La investigación futura debe enfocarse en hasta qué punto el ASQ:SE mide específicamente el funcionamiento del infante o la ansiedad mental de la madre, y cómo el mismo funciona en muestras clínicas versus aquellas que no lo son. Les questionnaires "rapport de la mère" de fonctionnement social et émotionnel du nourrison sont de plus en plus utilisés pour tester les enfants afin de les envoyer consulter en services de santé mentale du nourrisson. La validité du questionnaire "âge et étapes: social et émotionnel" (en anglais Ages and Stages Questionnaire: Social et Emotionnel, abrégé ASQ:SE en anglais) a été examinée chez un échantillon de mères de jeunes bébés cherchant de l'aide. Elle a été comparée à des interactions dyadiques évaluées par un observateur indépendant, la qualité des relations dyadiques étant évaluée par des cliniciens experts. Les évaluations ASQ:SE ont aussi été comparées aux questionnaires sur la détresse et le stress psychologique maternel. Résultats: Le questionnaire ASQ:SE n'a pas été fortement mis en corrélation avec soit les évaluations externes d'interaction dyadique soit les qualités de la relation évaluées cliniquement, bien que ces deux dernières aient été fortement liées les unes aux autres. Par contre, les scores ASQ:SE étaient liés aux questionnaires qui portaient sur la détresse psychologique maternelle. Ceci s'est surtout avéré vrai pour les mères classifiées comme déprimées. De plus, les rapports sur le ASQ:SE étaient frotement prédits par le stress maternel. Cette étude met en lumière certains problèmes avec la validité simultanée du questionnaire ASQ:SE dans les échantillons cliniques. Elle démontre aussi un lien étroit entre la détresse psychologique des mères et leurs évaluations du fonctionnement social et émotionnel du nourrisson. Des recherches plus approfondies devraient porter sur la mesure dans laquelle le questionnaire ASQ:SE mesure spécifiquement le fonctionnement du nourrisson ou la détresse maternelle, et comment il fonctionne dans des échantillons cliniques par rapport à non-cliniques. Fragebögen der sozial-emotionalen Funktionsweisen, die auf Elternurteilen beruhen, werden zunehmend zur Klärung der Frage eingesetzt, ob eine ärztliche Überweisung im Rahmen von psychischer Gesundheit im Kleinkindalter induziert ist. Die Gültigkeit des Fragebogens zum Alter und zu den Entwicklungsstufen "Sozial Emotional" (ASQ: SE) wurde von einer Gruppe Hilfe-suchender Mütter mit Kleinkindern entwickelt. Die Fragebögen wurden von unabhängigern Beobachter innerhalb dyadischer Interaktionen validiert. Zusätzlich überprüften erfahrene Kliniker die Qualität der dyadischen Beziehungen. Die Bewertungen mittels ASQ: SE wurden darüber hinaus mit Fragebogen zu mütterlichen psychologischem Stress und Ängste verglichen. Ergebnisse: Die ASQ: SE zeigte keine signifikant Korrelation mit den externen Ergebnissen der dyadischen Interaktion oder den klinisch beurteilten Beziehungsqualitäten, obwohl die beiden letzteren trotzdem in Zusammenhang standen. Im Gegensatz dazu zeigten die Ergebnisse des ASQ: SE einen Zusammenhang mit den Fragebögen zur mütterlichen psychischen Belastung. Dies galt vor allem für Mütter die als depressiv eingestuft wurden. Außerdem machten die Ergebnisse des ASQ: SE eindeutige Vorhersagen was den mütterlicher Stress anbelangt. Die Studie weist auf einige Probleme der übereinstimmenden Gültigkeit des ASQ: SE in klinischen Stichproben hin. Es zeigt aber auch eine enge Verbindung zwischen mütterlicher psychischer Belastung und ihren Bewertungen der sozialen und emotionalen Funktionsfähigkeit ihrer Säuglinge hin. Weitere Forschung sollte untersuchen, inwieweit der ASQ: SE gezielt Maßnahmen zur Steigerung der Funktionalität von Säuglingen oder mütterliche Not misst und in wie weit der Fragebogen im klinischen bzw. nicht-klinischen Setting Gültigkeit behält. [source] Factors affecting clinical referral of young children with a subdural haemorrhage to child protection agenciesCHILD ABUSE REVIEW, Issue 6 2003Tom Sanders Abstract The research on which this paper is based aimed to identify the social and legal consequences when young children sustain a suspected non-accidental subdural haemorrhage; and to examine the clinical and social factors that impact on clinical referral decisions. Data were collected from medical, social services, police and court ,les for information on the management of children with these injuries by various agencies in the South West of England and South Wales. Data were collected on the case management of young children from time of presentation to hospital through to referral to police and social services. The paper shows that children who are most at risk of shaking injuries are likely to be very young babies between 3 and 5 months of age. They are most likely to come from deprived households where parental stability is weak and where social support for the carers is limited. Referral of children by paediatricians to child protection agencies is not always carried out in cases where coexisting signs indicate a strong reason for referral. It is recommended that paediatricians and other clinicians involved in the care of young children should embark on a multidisciplinary process of assessment and training in the identi,cation of non-accidental head injury in very young children and babies, to reduce their risk of future harm. Copyright © 2003 John Wiley & Sons, Ltd. [source] Recognition and referral of girls with Attention Deficit Hyperactivity Disorder: case vignette studyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2009C. Groenewald Abstract Background Compared with boys, girls with Attention Deficit Hyperactivity Disorder (ADHD) are under-recognized. Parents commonly discuss concerns with teachers, who play an important role in the recognition and referral of children with ADHD. We investigated whether the predominating subtype of symptomatology influences teacher recognition of affected girls. Methods A total of 212 teachers from 40 randomly selected primary schools in England participated in a postal questionnaire study. The questionnaire consisted of a case vignette (based on DSM-IV criteria) describing a girl with either combined or predominantly inattentive subtype ADHD. Each school received an equal number of each type of vignette for distribution. Further questions elicited teachers' conceptualization of the girl's difficulties and need for specialist referral, their views on treatment modalities and demographic data. Results Most (98%) teachers recognized the presence of a problem but mainly conceptualized the girl's behaviour as reflecting attentional (89%) or emotional (62%) difficulties. Teachers were less likely to correctly identify a girl with inattentive than combined subtype ADHD (14% vs. 43%) or recommend clinical referral (50% vs. 59%) for her. Few (15%) teachers thought that medication might be helpful for a girl meeting diagnostic criteria for ADHD. Conclusions Teachers are able to recognize ADHD-related behaviours and impairments but conceptualize these as reflecting attentional or emotional difficulties rather than as relating to a disorder (ADHD). Teachers' conceptualization of ADHD and views about medication are important factors that could affect accurate recognition and referral. Improving teachers' knowledge about ADHD, especially the inattentive subtype, could assist in tackling gender-related barriers to care. [source] Estimating WISC-IV indexes: proration versus linear scalingJOURNAL OF CLINICAL PSYCHOLOGY, Issue 10 2008Laura A. Glass Abstract This investigation compared proration and linear scaling for estimating Wechsler Intelligence Scale for Children,Fourth Edition (WISC-IV) verbal comprehension (VCI) and perceptual reasoning (PRI) composites from all relevant two subtest combinations. Using 57 primary school students and 41 clinical referrals, actual VCI and PRI scores were highly correlated with estimated index scores based on proration and linear scaling (all rs,.90). In the school sample, significant mean score differences between the actual and estimated composites were found in two comparisons; however, differences between mean scores were less than three points. No significant differences emerged in the clinical sample. Results indicate that any of the two subtest combinations produced reasonably accurate estimates of actual indexes. There was no advantage of one computational method over the other. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1,6, 2008. [source] Relative clinical utility of three child symptom inventory-4 scoring algorithms for differentiating children with autism spectrum disorder vs. attention-deficit hyperactivity disorderAUTISM RESEARCH, Issue 6 2009Carla J. DeVincent Abstract Objective: The present study compared three separate Child Symptom Inventory-4 (CSI-4) scoring algorithms for differentiating children with autism spectrum disorder (ASD) from youngsters with attention-deficit/hyperactivity disorder (ADHD). Method: Parents/teachers completed the CSI-4, a DSM-IV-referenced rating scale, for 6 to 12-year-old clinical referrals with ASD (N=186) and ADHD (N=251). Algorithms were based on either all CSI-4 items (forward logistic regressions) or the 12 DSM-IV symptoms of pervasive developmental disorder (PDD) included in the CSI-4. Results: ROC analyses indicated generally good to excellent values for area under the curve, sensitivity, specificity, and positive predictive power. Algorithms for parent ratings were superior to teacher ratings. The algorithm based solely on PDD symptoms evidenced the greatest generalizability. Conclusion: Although algorithms generated from regression analyses produced greater clinical utility for specific samples, the PDD-based algorithm resulted in greater stability across samples. [source] | |||||||||||||