Donald H. McKnew

The development of a child assessment interview for research and clinical use

The Child Assessment Schedule (CAS) was developed to address the need for a standardized child interview that could be used for research and clinical purposes. The CAS has several distinguishing characteristics: (1) Questions and responses are standardized, (2) the format was designed to enhance rapport with the child, and (3) information necessary for DSM III childhood diagnoses is explicitly solicited. The CAS was administered to 32 child outpatients, 18 inpatients, and 37 normal controls. Derived scores were obtained for total psychopathology, 11 content areas, and 9 symptom complexes. Interrater reliability for the total CAS score was quite high. The CAS was able to discriminate among the three groups in total score indicating degree of psychopathology, on 9 of the 11 content areas, and on 8 of the 9 symptom complexes. Significant correlations were found between the CAS and maternal report of child behavior and between the CAS and child selfreport of internal affects. It was concluded that the CAS has adequate reliability and validity, although further research is indicated.

The Child Assessment Schedule (CAS) diagnostic interview: a report on reliability and validity.

This paper describes data relevant to the reliability and validity of the Child Assessment Schedule (CAS). The CAS, a diagnostic instrument for children, was designed for clinical assessment as well as collection of research data. Information relevant to making a differential diagnosis is solicited within a format of standardized questions and response items. Two independent reliability studies have been conducted with a total of 63 children. Interrater reliability for the total CAS score was found to be high in both studies (0.91 and 0.90). High interrater reliability was also demonstrated for subscales of the CAS. Data relevant to the concurrent validity of the CAS are also presented.

Lithium in children of lithium-responding parents

Six offspring of manic-depressive patients, whose parents were lithium responders, were selected on the basis of their incapacitating psychopathology for treatment with lithium. The children ranged in age from 6 to 12. A double-blind, crossover design was used over 16-18 weeks. Weekly ratings were done, and average evoked potentials (EPs) were measured at each crossover. Two children diagnosed as having a bipolar affective disorder had a clear-cut response to lithium and were strong augmenters on the EP. This, taken together with the similarity of the EP changes on lithium to those occurring in adult patients treated with lithium, supports a physiological parallel between bipolar affective illness in adults and children.

Depression among incarcerated delinquents

The authors examined the prevalence of depression among incarcerated delinquents and nonincarcerated, nondelinquent adolescents and reported a prevalence of 18% and 4%, respectively. The possible effect of incarceration on the development of depression was also studied. DSM-III diagnostic criteria for major depressive disorders were used. Of the 100 delinquents admitted consecutively to a detention center, 11 showed evidence of depression both during and before incarceration, while seven developed a depressive disorder in the center. With regard to specific symptoms, 100% of the depressed incarcerated adolescents were found to suffer from sleep difficulties, and 94% experienced disturbances of appetite. Psychomotor retardation or agitation were the symptoms least commonly observed.

Urinary Metabolites in Chronically Depressed Children

Abstract Three groups of children were examined—chronically depressed inpatients, orthopedic inpatients screened for psychopathology, and a control group of physically and emotionally healthy outpatients. The urinary metabolites studied were norepinephrine (NE), vanillylmandelic acid (VMA), and 3-methoxy-4-hydroxyphenylethylene glycol (MHPG). Only MHPG showed a significant difference between the groups: the outpatient control group had the highest mean vaalues—1,092 μg/m 2 ± 109; the depressed patients, 735 μg/m 2 ± 64; and the orthopedic patients, 504 μg/m 2 ± 32. The discussion centers on the possible relationship between the activity and the MHPG values in these children. VMA and NE values would seem to rule out activity as the cause of the differences seen. Finally, a theory concerning a reactive suppression of the arousal system is proposed to explain the low MHPG values in the orthopedic patients.