Bjørn Helge Handegård

A comparison of mental health problems in kinship and nonkinship foster care

ObjectiveKnowledge of the emotional and behavioural problems of children in kinship foster care is scarce.No data on such problems in European countries have been published. This study compares child psychiatric problems and placement characteristics of children living in kinship and nonkinship foster care.MethodsA total of 214 children in kinship and nonkinship foster care, aged 4–13, participated in the study. The Child Behavioral Checklist (CBCL) was completed by their foster parents and demography and placement information was collected.ResultsOf the nonkinship group, 51.8 % scored above the borderline on the CBCL Total Problem score, as did 35.8% of the kinship group. The kinship group had fewer previous placements, were more often fostered within their local community and had more contact with their biological parents. Kinship foster parents had lower social status, in terms of educational level.Variables significantly related to high level of the CBCL Total problems score were male gender and location of foster home outside community of birth family. Positive outcome was significantly associated with placement within the child’s own community, which in turn was related to kinship placement.ConclusionsPlacement in kinship foster care should be considered as a viable possibility.

Psychosocial interventions for disruptive and aggressive behaviour in children and adolescents: a meta-analysis

BackgroundThe effects of psychotherapy in reducing aggressive behaviours in children and adolescents using meta-analysis were estimated.MethodSixty-five studies were included, covering 4,971 cases. Teacher reported change in aggression, change in social functioning, and changes in parental distress were calculated.ResultsThe mean effect size (ES) of change in aggression in studies with untreated controls was 0.62 and in studies without untreated controls the ES was 0.95. In studies with or without untreated controls, the ESs in teacher reported aggression was 0.41 and 0.63, the ESs in changes in social functioning was 0.42 and 0.49, and the ESs in changes in parental distress was 0.39 and 0.47, respectively.ConclusionPsychosocial treatments aimed at reducing aggressive behaviour have positive effects and additional treatment effects are moderate. In the moderator analysis, studies with untreated controls obtained significantly larger ESs if the sample size was small. Similarly, in studies without untreated controls, studies presenting diagnostic information, and studies with younger children resulted in significantly larger ESs, and studies applying behavioural interventions obtained significantly larger ESs as compared to studies applying family therapeutic interventions. There is still a need to further develop effective outpatient interventions for children being disruptive, and especially for adolescents.

Eyberg Child Behavior Inventory (ECBI): Norwegian norms to identify conduct problems in children

This article presents the first Norwegian standardization of an assessment tool specifically designed to measure childhood conduct problems. Norwegian norms for the Eyberg Child Behavior Inventory (ECBI) based on data obtained from a random population sample (N= 4063) of children in the age range of 4 to 12 years are presented. The sample was drawn from rural and urban areas within three Norwegian town districts. Clinical and research advantages of having a properly standardized assessment tool for this specific subclass of childhood psychiatric problems in Norway are discussed.

Cross-informant correlations on social competence and behavioral problems in Sami and Norwegian preadolescents

In a community-based birth cohort from Arctic Norway, correlations between parents and teachers on child competence and behavioral problems were determined for Sami and Norwegian 11–12 year-olds, using as instruments the child behavior checklist (CBCL), teacher report form (TRF), and the impact supplement of the extended strength and difficulties questionnaire (SDQ). Parent–teacher correlations on child behavioral problems were generally high in the Norwegian group, but low in the Sami group. Cross-cultural differences in cross-informant correlations were highest regarding externalizing and attention problems. Parent–teacher correlations on total impact of child difficulties also differed between the ethnic groups. Once again, a lower correlation was found for the Sami children. The discrepancy between parents’ and teachers’ perception of problems that needed attention was highest for the Sami, and lowest for the Norwegians. The Sami parents reported fewer perceived difficulties and less impact of problems than did the Norwegian parents. In contrast, no ethnic differences emerged for teachers’ ratings. The paper discusses how cultural norms might influence the reports of child problems. It demonstrates the importance of combining parent and teacher reports of child behavior problems in minority and indigenous children, who often live under different cultural norms in home and school contexts.

Social competence and emotional/behavioral problems in a birth cohort of Sami and Norwegian preadolescents in Arctic Norway as reported by mothers and teachers

In a 7-year follow-up birth cohort from the general population in the Sami core area in Finnmark, Arctic Norway, we examined mothers’ and teachers’ reports of social competence and emotional/behavioral problems among 71 indigenous Sami and 77 Norwegian 11–12-year-olds. The instruments used were the Child Behavior Checklist (CBCL) for parents and the Teacher Report Form (TRF). No ethnic differences were found on competence scales. Total Problems reported by Sami and Norwegian mothers were low in comparison with the overall mean found in multicultural meta-studies. Sami mothers reported lower Total Problems and Attention Problems than did Norwegian mothers. There were no ethnic differences on the TRF measures. Consistent with other international studies, mothers and teachers rated girls higher than boys on social competence and boys higher than girls on Externalizing and Attention Problems. Gender differences were larger on the TRF than on the CBCL. The very low problem ratings made by the Sami mothers indicate that there is a need for specific clinical cut-off points to distinguish between clinically referred and non-referred children in this indigenous Arctic population.

Teacher Report of Children's Problem Behavior on The Sutter-Eyberg Student Behavior Inventory-Revised (SESBI-R) in a Norwegian Sample of Preschool and School Children.

In the present study, the applicability of The Sutter–Eyberg Student Behavior Inventory—Revised (SESBI-R) was explored within a Norwegian sample of 983 children aged 3–8 years. By using an exploratory factor analysis the same 2-factor solution as the original SESBI-R was supported by Principal Component Analysis. Good internal consistency (alpha > .96) was found for both the SESBI-R Intensity and Problem scales. Teachers in Norway report relatively low levels of behavior problems among children in day-care units and school-aged boys receive higher Intensity and Problem scores than girls. The results show that the SESBI-R is a reliable assessment tool that can be used in the Norwegian population for efficient screening of behavior of conduct-disordered children.

Parents seeking help in child rearing: who are they and how do their children behave?

Purpose – The main aim of this study is to explore characteristics of parents who signed up for parenting classes offered to the universal population and their reasons for participation.Design/methodology/approach – Data were obtained from parents in a study on parent training for children aged two to eight years (n=189), and a follow up survey on these parents (n=118).Findings – Parents had high education, were married, and employed in full time jobs. The mean age of the children was under four years, and their Intensity and Problem scores on ECBI were higher than the Norwegian mean scores for their age group. Parent stress, parental concern, and parenting practices predicted the ECBI Intensity scores to a rather large extent.Practical implications – Parents with high SES risk factors may not come forward to participate in face‐to‐face mental health promotion interventions even if the parenting intervention is offered in a non‐stigmatising way.Originality/value – By offering a universal health promoting ...

Does the Incredible Years Teacher Classroom Management Training programme have positive effects for young children exhibiting severe externalizing problems in school?: a quasi-experimental pre-post study

BackgroundYoung children exhibiting severe externalizing problems in school are at risk of developing several poor outcomes. School-based intervention programs have been found to be effective for students with different problems, including those with behavioral problems, emotional distress, or social problems. The present study investigated whether the IY-TCM programme, as a universal stand-alone school intervention programme, reduced severe child externalizing problems as reported by the teacher, and evaluated if these children improved their social competence, internalizing problems, academic performances and student- teacher relationship as a result of the IY TCM training.MethodsA quasi-experimental pre-post study was conducted, including 21 intervention schools and 22 control schools. Children in 1st – 3rd grade (age 6–8 years) assessed by their teacher as having severe externalizing problems on the Sutter–Eyberg Student Behavior Inventory-Revised (SESBI-R) total Intensity score, were included in the study, N = 83 (65 boys and 18 girls). Treatment effects were evaluated using 3- level linear mixed models analysis.ResultsIn our study we found no differences in change between the two conditions from baseline to follow-up in externalizing problems, social skills, internalizing problems and closeness with teacher. The intervention condition did however show advantageous development in terms of student-teacher conflicts and increased academic performances.ConclusionThe IY Teacher Classroom Management program is not sufficient being a stand-alone universal program in a Norwegian primary school setting, for students with severe externalizing problems. However; some important secondary findings were found. Still, young school children with severe externalizing problems are in need of more comprehensive and tailored interventions.

Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study

BackgroundTo examine demographic and clinical characteristics as potential predictors of change for children and youth with emotional disorders treated at two child and adolescent mental health outpatient services (CAMHS) in Norway.MethodsThe study was of naturalistic observational type with “treatment as usual” (TAU). The sample consisted of 84 children and youth with emotional disorders. The Health of the Nation Outcome Scale (HONOSCA), and the Children’s Global Assessment Scale (CGAS) were administered at intake (T0), during the assessment (T1) and approximately six months after assessment (T2). Change was analysed by means of the linear mixed models procedure.ResultsFor the HONOSCA total score, youths with a diagnosis of depression had statistically higher symptom severity levels at baseline and significantly lower change rates as compared to youths with an anxiety disorder.ConclusionsThe current study adds to the limited knowledge of predictors of rate of change for children and adolescents with emotional disorders treated within CAMHS. Our results point to a special need to improve clinical care for depressed children and adolescents. Important limitations comprising the external validity of the study concern missing data, a small study sample, and lack of information regarding the content and extent of the service provided.

Agreement on diagnoses of mental health problems between an online clinical assignment and a routine clinical assignment

We examined the agreement between diagnoses assigned based on the Development and Well Being Assessment (DAWBA) information collected online, and ordinary day-to-day diagnostic assignment by Child and Adolescent Mental Health Service (CAMHS) clinicians. Diagnoses were compared for 286 patients. Raw agreement for diagnostic categories was 74-90%, resulting in kappa values of 0.41-0.49. Multinomial regression models for ‘emotional diagnosis’ and ‘hyperkinetic/conduct diagnosis’ were significant (P < 0.001). Age, gender and number of informants significantly contributed to the explanation of agreement and disagreement. Agreement on mental health diagnoses may be sufficient to replace routine clinical assignment of diagnoses with an online clinical assignment, thereby saving time and resources.