Alan S. Unis

Assessment of childhood depression: correspondence of child and parent ratings.

The present investigation evaluated the correspondence of child and parental reports of the childrens depression. One-hundred-four children (ages 5–13) hospitalized on a psychiatric intensive care service, 101 mothers, and 47 fathers independently completed several measures to assess severity and duration of the childrens depression. To validate the depression instruments, measures of hopelessness and self-esteem (completed by the children) and somatic complaints and internalizing (completed by the parents) were also included. The results indicated that different measures of depression completed by the same rater (child, mother, or father) were highly intercorrelated. However, there was little or no relationship between mother-child and father-child reports of the childrens depression for the same or different measures of depression. Childrens ratings of depression were positively correlated with hopelessness and parent ratings of somatic complaints and negatively correlated with self-esteem. Children independently diagnosed as depressed (DSM-III) were higher in severity of depression than nondepressed children on child and parent completed measures. The implications of the present results for further evaluation of child self-report and factors that may contribute to correspondence with parental report are highlighted.

Child, mother, and father evaluations of depression in psychiatric inpatient children

The agreement among children and their parents in evaluating the childrens depression was examined in 48 families. Newly admitted inpatient children (ages 6–13) and their mothers and fathers independently completed selfreport and interview measures to assess severity and duration of the childrens depression. The results indicated that different measures of depression completed by the same rater (child, mother, or father) were highly intercorrelated. Yet there was little or no relationship between childmother and child-father ratings of the childrens depression for the same or related measures of depression. Children independently diagnosed (DSM III) as depressed rated themselves and were rated by their parents as more depressed than nondepressed children. Even so, children consistently rated themselves as less depressed across the measures than did their parents. Parent ratings of the childrens depression and the correspondence of child-parent ratings varied as a function of several child and family variables, including child IQ, gender, race, and family welfare status.

Child and parent evaluations of depression and aggression in psychiatric inpatient children

This investigation examined the agreement between children and their parents on measures of depression and aggression. A total of 120 inpatient children (ages 7–13) and their mothers and fathers independently completed self-report and interview measures that focused on the childrens dysfunction. Children and their parents differed in their ratings of each symptom area, with children providing significantly less severe ratings than their parents. Children who met DSM III criteria for major depression or conduct disorder were significantly higher in their ratings of depression and aggression than children without these diagnoses, as reflected in both child and parent ratings. Child and parent ratings correlated in the low to moderate range on measures of childrens symptoms, whereas mother and father ratings correlated in the moderate to high range. The correspondence between children and parents did not vary as a function of symptom area (depression and aggression) or assessment format (self-report and interviews). The results suggest that children are able to rate the severity of their dysfunction, although they tend to provide lowerbound estimates than do their parents.

Effects of Parent Management Training and Problem‐solving Skills Training Combined in the Treatment of Antisocial Child Behavior

Abstract This investigation evaluated the combined effects of parent management training (PMT) and cognitive-behavioral problem-solving skills training (PSST) for the treatment of antisocial behavior. Psychiatric inpatient children (N = 40, ages 7 to 12) and their parents were assigned randomly to either PMT-PSST combined or to a contact-control condition. In the combined treatment, parents received PMT and the children received PSST. In the control condition, parents received contact meetings in which the childs treatment was discussed; children met with a therapist in individual sessions where they discussed activities on the ward. All children participated in a short-term hospital program before their return to the community. Children in the PMT-PSST condition showed significantly less aggression and externalizing behavior at home and at school and greater prosocial behavior and overall adjustment than contact-control children. These results were evident immediately after treatment and at a 1-year follow-up assessment.

EEG sleep "abnormalities" in preadolescent boys with a diagnosis of conduct disorder.

The electroencephalographic sleep of conduct-disordered and normal boys was compared using both standard and automated measurement techniques. While the standard sleep summary measures were not particularly robust in demonstrating group differences, automated measures revealed quite striking differences in delta sleep activity. Delta wave counts were significantly higher in conduct-disordered subjects than in normal subjects. These findings clearly support future applications of automated techniques to child samples and, if replicable and specific to conduct-disordered subjects, strongly suggest that an abnormality in the expression of slow-wave sleep may be present in at least some of these children.

Poor Peer Interactions and Social Isolation: A Case Report of Successful in Vivo Social Skills Training on a Child Psychiatric Inpatient Unit

The effects of social skills training comprising didactic instructions, coaching, modeling, feedback and reinforcement were examined in a child diagnosed Conduct Disorder and Attention Deficit Disorder in whom social isolation and poor peer interactions were prominent features. Treatment was implemented in the specific settings in which deficient social performance was noted using a multiple baseline design. Application of social skills training led to increased rates of appropriate interactions with peers and decreased rates of playing alone. In addition, pre- and posttreatment scores on the Child Behavior Checklist and School Behavior Checklist showed significantly decreased dysfunctional behaviors after training. Follow-up contact 1 and 12 months following discharge indicated that the child continued to socialize more with peers and to show improved adjustment.

Treatment of phobias in a hospitalized child

A 12-year-old girl, hospitalized on a psychiatric intensive care unit, was treated for phobias of school and unfamiliar males. Treatment focused on decreasing several avoidance responses and increasing prosocial approach responses. Treatment consisted of instruction, performance feedback, participant modeling and social reinforcement. Marked changes were evident when treatment was introduced in a multiple-baseline design across several phobic and prosocial behaviors. Treatment effects generalized beyond the persons and situation included in training, were reflected in overall global ratings by persons unfamiliar with the treatment, and were maintained up to a 7-week follow-up when the child returned to the hospital for reassessment. Contact with the child 21 weeks after discharge indicated that the gains were reflected in school attendance and social interaction in everyday situations.

BOOK REVIEWSThe Impact of Family Violence on Children and AdolescentsThe Impact of Family Violence on Children and Adolescents, Javad H. Kasbani, Wesley D. Allan, Sage Publications, Thousand Oaks, CA (1998), p. 111,

Definition and Nature of Family Violence Etiology of Family Violence Caregiver Violence toward Children Child Witnessing of Family Violence Psychological Maltreatment within the Family Cross-Cultural Perspective Assessment Strategies Intervention Strategies for the Violent Family The Resilient Child and Prevention Strategies Discussion and Future Directions for Research

21.00 (softcover).

Definition and Nature of Family Violence Etiology of Family Violence Caregiver Violence toward Children Child Witnessing of Family Violence Psychological Maltreatment within the Family Cross-Cultural Perspective Assessment Strategies Intervention Strategies for the Violent Family The Resilient Child and Prevention Strategies Discussion and Future Directions for Research