Measuring Serious Emotional Disturbance in Children Workshop Summary (2016) / Chapter Skim
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3 Measurement Challenges for Population Surveys
3 Measurement Challenges for Population Surveys
Pages 27-38
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From page 27... ...
Szatmari said that there is widespread agreement in the literature on the prevalence estimates of many disorders, with or without impairment, and this is especially true in the area of disruptive behavior disorders -- oppositional defiant disorder, attention deficit hyperactivity disorder (ADHD) , conduct disorder -- across developmental stages.
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From page 28... ...
The team also wants to document child mental health needs and assess health system response by linking data on children with serious emotional disturbance to administrative databases, such as those for education and social services. The researchers also want to better understand the influence of
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From page 29... ...
This was updated for the OCHS-S to make it congruent with the DSM IV. The disorders measured are ADHD, conduct disorder, oppositional defiant disorder, major depressive disorder, specific phobia, social phobia, separation anxiety disorder, generalized anxiety disorder, and substance use disorders.
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From page 30... ...
Unfortunately, not enough data exist from longitudinal studies. Some treatment studies provide experimental information on impairment and symptoms, but most focus on symptoms, and significant improvement in symptoms does not necessarily signify significant improvement in impairment.
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From page 31... ...
Szatmari argued that the impairment associated with ADHD can be different from the impairment associated with anxiety or mood disorders. A related question is whether measures of impairment need to be developmentally specific and whether measures exist that are relevant at different developmental stages.
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From page 32... ...
More work is needed to develop instruments appropriate for each developmental stage, but having a global measure of impairment that is independent of symptoms and disorder makes a lot of sense: otherwise, the causal relationships are too entangled. LESSONS FROM AUSTRALIA Ian Hickie (University of Sydney)
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From page 33... ...
Hickie noted that there are also positive aspects to the DSM system: for example, the early diagnostic interview schedules were very useful to Australian researchers in the 1990s, when several national surveys were introduced, many based on methods developed in the United States. These early efforts were very useful because the then-prevalent public perception in Australia was that mental disorders in children were rare and that substantial resource investments were not needed.
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From page 34... ...
As Szatmari noted, surveys from across the world all show the same prevalence rates, and the surveys also consistently show that when impairment is factored in, the rates are lower. Getting the estimates right is easier for adolescents than younger children, but if the age of onset is obtained, those data can inform resource allocation and interventions.
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From page 35... ...
The Brisbane Longitudinal Study of Adolescent Twins is one example of such research, which has provided useful data on the persistence of impairment. Australia also faces challenges similar to other countries for telephone surveys, which are becoming increasingly difficult to field as more households abandon landlines.
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From page 36... ...
Despite its simplicity, the SDQ has good mathematical properties. For example, at least in the United Kingdom, the mean SDQ difficulties score can be used to predict the prevalence rate of mental disorders as judged by a much longer, independent diagnostic assessment.
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From page 37... ...
Heather Ringeisen asked Goodman about whether he has done any research on the possibility of shortening the SDQ to a handful of essential items, for example, five or six items that would be well suited for use in time-sensitive national surveys. For example, the National Health Interview Survey includes a five-item version of the SDQ, and an additional impact item.
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From page 38... ...
If there are difficulties, several follow-up questions are asked, including whether the difficulties cause distress and whether the difficulties interfere with everyday life in the key areas of family, learning, leisure, and peer relationships. The impact score is derived on the basis of the follow-up questions about distress and interference with everyday life.
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