Willy-Tore Mørch

The Strengths and Difficulties Self-Report Questionnaire as a screening instrument in Norwegian community samples

Abstract.This study reports on the application of the Norwegian self-report version of the Strengths and Difficulties Questionnaire (SDQ-S). The application of the SDQ-S was not motivated by a wish to reveal the prevalence of psychiatric disorders, but rather to set the stage for routine screening as part of schools’ efforts to inform themselves about the life of adolescents at school. The survey included 4167 young people aged 11 to 16 years, attending 66 primary and secondary schools in Northern Norway. The respondents comprised 80.2% of the total population in these grades in the target area. Structural analysis of the instrument, including confirmatory factor analysis, internal consistency and intra- and cross-scale correlations revealed somewhat variable psychometric properties. Model modification suggested several ways of improving the structural psychometric properties of the SDQ-S. Norwegian cut-off points were similar to those found in other Scandinavian studies. About one third of the subjects reported at least minor perceived difficulties, while about 5% reported definite or severe difficulties. These difficulties were strongly associated with all symptom scales. Girls reported a significantly higher level of emotional problems and better prosocial functioning. Boys reported significantly higher scores on the externalising scales and on peer problems. The SDQ-S may be judged as an efficient and economical screening instrument for preventive research on large community samples. However, efforts should be made to improve its psychometric structure.

Parent training for young Norwegian children with ODD and CD problems: Predictors and mediators of treatment outcome

Participants were 121 children, aged 4-8 years referred for conduct problems, and their mothers. A parent training intervention was implemented in two outpatient clinics in Norway. Treatment responders were defined as children scoring below a cut-off on the Eyberg Child Behavior Inventory, a score below an optimal cut-off for children in day-care and school as reported by teachers, in addition to a 30% reduction or greater in observed negative parenting. Self-reported parenting practices were explored as potential mediators. The results of logistic regression analyses showed that high levels of maternal stress, clinical levels of ADHD, and being a girl predicted a poorer outcome in conduct problems at home, while pretreatment clinical levels of ADHD predicted a poorer outcome as perceived by the teachers. Harsh and inconsistent parental disciplining emerged as significant partial mediators of changes in conduct problems, highlighting the importance of altering parenting practices to modify young childrens conduct problems.

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.

Five- to six-year outcome and its prediction for children with ODD/CD treated with parent training

BACKGROUND While short-term effects of parent training (PT) have been extensively evaluated, long-term outcome and present predictors of a diagnosis for children with ODD/CD treated with parent training are very limited. METHOD In the present study, diagnostic status as outcome and predictors of treatment response were examined in a 5-6-year follow-up. Out of 99 children who had been treated in a randomised controlled trial evaluating the effects of The Incredible Years parent training (PT) or combined parent training and child treatment (PT+CT) programme, 54.5% participated in the 5-6-year follow-up study. Their diagnostic status was determined with the Kiddie-SADS interview. RESULTS While all children qualified for a diagnosis of ODD/CD before treatment, 5-6 years later, two-thirds no longer received such a diagnosis, the same proportion as found at the 1-year follow-up. The most powerful pre-treatment predictors of diagnostic status at the 5-6-year follow-up were living with mother only and being a girl. At post-treatment the most powerful predictor was found to be high levels of child externalising problems. CONCLUSION The findings of the study support the maintenance of positive long-term results for young children treated with parent training because of serious conduct problems, and identify characteristics of children and families in need of added support to parent training programmes.

Comparison of Mother, Father, and Teacher Reports of ADHD Core Symptoms in a Sample of Child Psychiatric Outpatients

Objective: To explore the significance of adding father ratings to mother and teacher ratings in the assessment of ADHD symptoms in children. Method: The ADHD Rating Scale–IV, the Child Behavior Checklist, and the Teacher Report Form were filled out by all three informants for a sample of 48 clinically referred children (79% boys) aged 6 to 15 (M = 10.1) years. Results: Correspondence between father and teacher reports on ADHD-specific symptoms (intraclass correlation coefficient [ICC] = .38) exceeded that between mothers and teachers (ICC = .23). Fathers rated their children as having fewer problems than did mothers and teachers on Total scale scores and the Inattention subscale of the ADHD Rating Scale–IV. Mother ratings were more sensitive to an ADHD diagnosis, whereas father ratings better predicted an ADHD diagnosis requiring the two-setting criterion. Conclusion: The choice of parent informant and informant combination had a considerable impact on parent–teacher concordance and estimates of ADHD symptoms and subtypes in the child.

Mentally retarded persons as parents: Prevalence and the situation of their children

This paper describes a research program on mentally retarded parents and their children. For this nation-wide study, two structured questionnaires were sent to all municipalities in Norway. Both questionnaires were sent to public health nurses and were followed-up by a structured telephone interview based on the questionnaires. The primary aim of the study was to survey the number of children born to mentally retarded parents. In addition, the childrens needs and functional abilities were to be assessed. Twenty-three mentally retarded persons had given birth in the course of the past twelve months. A total of 126 children with mentally retarded parents were identified, with an incidence of 27 children per year, and a prevalence of approximately 430 children under 16 years of age in a population of 4 mill, people with a mean of 1.05 child per family. About 43% of the children of mentally retarded parents appeared to have learning difficulties. Forty percent of the children suffered from failures of care. Between 25% and 68% of the children with learning problems had poorly developed motor or language abilities, sense modalities or psycho-social status.

Care-Based Moral Reasoning in Norwegian and Canadian Early Adolescents: A Cross-National Comparison

A sample of 79 Norwegians, 11 through 13 years of age, was assessed on a care-based morality measure, the Ethic of Care Interview (ECI). Content analyses of the adolescents’real-life moral dilemmas also were conducted. The Norwegian scores were compared with those of 46 Canadians of the same age. No gender differences on the ECI or in real-life moral conflict content were found in Norway. In contrast, in Canada, girls scored significantly higher on the ECI than did boys, and more girls than boys generated relational real-life dilemmas, whereas more boys than girls generated nonrelational dilemmas. Furthermore, more Canadian than Norwegian girls scored at ECI Level 2 (conventions of goodness, caring for others). Norway and Canada might differ in female gender role expectations, which probably is associated with girls’moral reasoning. The results indicated that North American findings should not be viewed necessarily as representative even of other similar Western societies.

Some Issues in Staff Training and Improvement.

In 1988, Norways parliament instituted the systematic deinstitutionalization of the nations health care system for mentally retarded persons. Professionals have recognized that deinstitutionalization will succeed only if treatment personnel can provide effective treatment for their clients. A study is presented in which 152 hands-on staff members were assigned to 76 clients with moderate to severe mental retardation. The study asked whether staff training in behaviorally oriented treatment and assessment would produce greater improvement in the behavior of clients and staff than would training in treatment alone. Data failed to support this hypothesis, but did provide clear evidence that both clients and staff improved with staff training. The assessment of such programs is seen to be of great importance in view of the fact that deinstitutionalization will leave the majority of mentally retarded clients in Norway in the care of persons who have received such limited forms of training.

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.