Kaplan + Sadock's Synopsis of Psychiatry, 11e

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Chapter 5: Examination and Diagnosis of the Psychiatric Patient

Table 5.5-6 Behavioral Assessment Procedures for Children

Test Name

Age Range

Description

Beck Youth

7–18 years

The BYI consists of five inventories of 20 questions each: depression, anxiety, anger, disruptive behavior, and self-concept. The five self-report inventories can be administered separately or in combination, with administration time only 5 minutes per inventory. The normative group is well stratified for age, sex, ethnicity, and socioeconomic status. Results provide clinical ranges for symptom severity, profile analysis for general understanding, and items or item clusters as probes for deeper understanding. Multidimensional scale, normed by age and sex, which measures behavior, emotions, and self-perceptions. Includes parent and teacher rating scales, a self-report of personality scale, a student observation system, and a structured developmental history. It is available in Spanish as well as English, and it provides an audio CD recording for individuals with reading problems. Assesses internalizing, externalizing, and school problems, atypical behavior, and adaptive skills. Both computer- and hand-scored versions are available. Multiaxial, empirically based scales, normed by age and sex that assess social competencies as well as behavioral/emotional problems. The CBCL 6–18, TRF 6–18, and YSR 11–18 were designed to obtain similar types of data in a similar format from parents, teachers, and youth. The behavior problem items on these scales cluster into eight subscales: anxious/depressed, withdrawn/ depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, and aggressive behavior. The analogous CBCL 1.5–5 extends the empirically based assessment to younger children. It includes an Emotionally Reactive subscale, but excludes the Social, Thought, and Rule-Breaking subscales. On the YSR, youths rate themselves for how true each item is within the past 6 months. A new scoring module (2007) displays problem-scale profiles and cross-informant bar graphs in relation to multicultural norms. Developed to accompany the CBCL 4–18 and TRF, this interview format was adapted to the cognitive levels and interactive style of 6- to 11-year-old children. It provides open-ended questions designed to elicit children’s reports on various important areas of their lives, including family, friends, school, activities, concerns, and fantasies. Also includes a kinetic family drawing, brief achievement tests, a screen for fine and gross motor abnormalities, and probe questions about problems attributed to the child by others. Factor-analytically derived, age and sex normed, behavioral rating scales for parents, teachers, and adolescent self-report. Both long and short forms available. A 90-item self-report scale that asks respondents to rate the subjective severity of psychological symptoms in nine areas: somatization, obsessive- compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. It yields three general indices: a Global Severity Index of overall psychological distress; a Positive Symptom Distress Index (designed to measure intensity of symptoms), and a Positive Symptom Total Index, which reports the number of self-reported symptoms. An 80-item self-report scale of self-concept and self-esteem in children. It yields a Total Self-Concept Score, along with subscale scores (Behavioral Adjustment, Freedom from Anxiety, Happiness and Satisfaction, Intellectual and School Status, Physical Appearance and Attributes, and Popularity) that permit more detailed interpretation. It is used in clinical settings to determine specific areas of conflict, typical coping and defense mechanisms, and appropriate intervention techniques.

Inventories–2 nd edition (BYI-II)

Behavior Assessment System for Children–2 nd edition (BASC-2)

Preschool: 2–5 years School age: 6–11 years Adolescent: 12–21 years

Child Behavior

CBCL 1.5–5 years TRF 1.5–5 years CBCL 6–18 years TRF 6–18 years YSR 11–18 years

Checklist (CBCL), Teacher’s Report Form (TRF), and Youth Self Report (YSR)

Semistructured

6–11 years

Clinical Interview for Children (SCIC)

Conners’ Rating Scales–Revised (CRS-R) and Conners-Wells’ Adolescent Self- Report Scale

Parent Rating Scales: 3–17 years Teacher Rating Scales: 5–17 years Adolescent Self-Report: 13–17 years

13 + years

Symptom

Checklist–90 Revised (SCL- 90-R)

Piers-Harris Children’s

7–18 years

Self Concept Scale–2 nd edition (PHCSCS-2)

DSM, Diagnostic and Statistical Manual of Mental Disorders.

Advantages and Disadvantages of Behavioral Approaches.  There are several advantages of the behavioral approaches to assessment of behavior and emotional function- ing in children and youth. These procedures are cost-effective in that they maximize the amount of information obtained with little clinician time. They often have convenient hand- score or computer scoring methodology, another cost-effective

aspect. Use of behavioral assessment increases the likelihood of obtaining information from multiple sources (e.g., teach- ers and parents) across multiple settings (e.g., school, home, and day care). These sources of information are necessary for some diagnoses, such as attention-deficit/hyperactivity disor- der (ADHD), and likely increase the validity of other diagno- ses. Many of the scales are empirically derived, factor-analytic