Assessment of type A behavior in preschoolers

Teachers and mothers of 219 four-year-old preschoolers assessed their children for Type A behavior pattern using the Matthews Youth Test for Health (MYTH). The sample was derived from five day care centers with Black, White, and Hispanic teachers and students from middle and lower class families. This study indicates that Type A behavior can be identified in four-year-old preschoolers on the basis of ratings by their teachers. A statistically significant difference was found between the ratings of Type A/B characteristics by teachers and those by mothers; however, these were not related to the sex or ethnicity of the children. Repeated measurements of Type A ratings in a subsample of the children at age five showed no significant change among boys or girls. However, repeated measurements at age six on a second subsample showed that boys had lower mean scores, i.e. were more Type B at age six than at age four.     

Assessment of type A behavior in children: a comparison of two instruments

The agreement of classifications yielded from two instruments used to assess children's Type A-Type B behavior, the Matthews Youth Test for Health (MYTH) and Hunter-Wolf (HWolf), was evaluated with a sample of rural children from the southern United States. Fifth grade children (N = 276) served as subjects. MYTH and HWolf scores were found to be only weakly correlated and the agreement of Type A-Type B classifications occurred at a rate only slightly above chance. To assess the psychometric properties of the instruments, both were subjected to factor analysis and reliability/internal consistency estimates were obtained and compared with previous results. A factor structure remarkably similar to that of previous reports was found for the MYTH but not the HWolf. The results closely parallel those of another recent report and provide further support for the recommendation that these instruments should not be considered interchangeable measures of Type A behavior and that when multiple measures cannot be employed for research, the investigator should use the MYTH. Caution is indicated in interpreting scores of either measure, however, since neither has yet been shown to relate to later development of coronary heart disease.     

Measurement assessment of the type A coronary prone behavior pattern and hyperactivity/problem behaviors in children: are they related? The Bogalusa Heart Study

The purpose of this study was to contribute to concept clarification regarding identification of the Type A behavior pattern in children. To accomplish this, two measurement techniques for assessing Type A behavior in children (MYTH and Hunter-Wolf) were compared to a third (a teacher-rated measure of hyperactivity: the Conners), since this latter measure, although often used to diagnose hyperactive children, seemed also to measure some Type A-like behaviors. The Hunter-Wolf also included a self-assessment of Type A behavior. The conceptual and measurement issue was: Are teachers rating Type A or hyperactive/problem behaviors in children? Fifty-five teachers participated. They rated 253 students, aged 8 to 17 years, in a biracial community. The clear overlap between teacher-assessed Type A and the Conners hyperactivity measure was demonstrated when the best predictor of teacher-assessed Type A measure was the Conners. This was especially true for black males and white females. Little relationship existed between teacher-assessed Type A and self-assessment. The conclusions suggest that implications drawn from teacher-assessed Type A behavior in children may be inadequate because of potential ethnic and gender artifactual measurement error.     

Validation of the Chinese Version of the Children’s ChronoType Questionnaire (CCTQ) in school-aged children

ABSTRACT

The Children’s ChronoType Questionnaire (CCTQ) is a valid and reliable measure for assessing prepubertal children aged 4–11 years. The CCTQ is a parent-reported, 27-item questionnaire consisting of sleep-wake parameters for scheduled and free days (16 items), a morningness/eveningness scale (M/E, 10 items), and a five-point, single-item, chronotype score. The CCTQ has been translated into different languages, but a Chinese version is not available. In the present study, we aimed to produce a Chinese version of the CCTQ and test its validity and reliability on school-aged children. A total of 555 children aged 7–11 years were recruited from five primary schools. The parents were told to complete the CCTQ and record their child’s sleep pattern in a 7-day sleep diary. Sixty-six children and their parents were invited to participate in determining the test-retest reliability of the CCTQ over a 2-week interval, and their sleep patterns were assessed using a sleep diary. The internal consistency of the Chinese CCTQ M/E score as measured by Cronbach’s alpha was acceptable (0.74). Regarding the test-retest reliability of the instrument, moderate to strong Spearman’s correlation coefficients were found for most of the CCTQ – sleep-wake items (ρ = 0.52–0.86) and for the CCTQ-M/E total score (ρ = 0.78). For the concurrent validity, Spearman’s correlations between the sleep-wake parameters of the CCTQ and the sleep diary were moderate to high on both the scheduled days (ρ = 0.54 to 0.87) and free days (ρ = 0.36 to 0.60). For the correlations measured with actigraphs, significant correlations were found in the CCTQ sleep-wake parameters, including bedtime, get-up time, sleep latency, sleep period, time in bed, and mid-sleep point on both the scheduled (ρ = 0.31 to 0.76) and free days (ρ = 0.27 to 0.52), but not in sleep latency and sleep period on free days. The results of the present study suggest that the Chinese version of the CCTQ is a reliable and valid tool for assessing chronotypes in Chinese school-aged children in Hong Kong.     

The validity and reliability of the 1RM bench press using chain-loaded resistance

The purposes of this study were to determine the validity and test-retest reliability of the 1 repetition maximum (1RM) chain-loaded, free-weight bench press (CBP) and to examine possible learning effects that may occur between the test-retest measurements. Nine resistance-trained men (20.58 +/- 1.31 years, 188.24 +/- 9.29 cm, 92.07 +/- 16.94 kg) and seven resistance-trained women (20.42 +/- 0.98 years, 175.61 +/- 9.32 cm, 73.61 +/- 10.80 kg) participating in Division II college basketball completed this study. Two familiarization sessions took place using light to moderate loads to learn proper technique. The subjects completed a 1RM test on the traditional plate-loaded bench press 4 days before completion of the CBP 1RM, which was followed by 4 days of rest before completing the retest. Intraclass correlation coefficients (ICC) and the percent coefficients of variation (CV) were used to determine relative and absolute test-retest reliability. Concurrent validity was determined from the Pearson correlation coefficients between the CBP and the plate-loaded bench press. Test-retest differences were analyzed with the paired t-test. ICC and CV for the men (r = 0.99, 1.4%) and women (r = 0.93, 3.5%), respectively indicate that highly reproducible 1RM scores can be found with the CBP. High validity was also found with high correlations between the CBP and plate-loaded bench press for the men (r = 0.95) and women (r = 0.80). A statistically significant (p = 0.04) but clinically small (2.57 kg) shift in the mean occurred between the CBP test and retest for the men, whereas no change occurred for the women. The data indicate that valid and reliable 1RM scores can be found after two familiarization sessions in men and women athletes who have previous resistance training experience.     

Test-retest reliability and construct validity of the ENERGY-parent questionnaire on parenting practices, energy balance-related behaviours and their potential behavioural determinants: the ENERGY-project

ABSTRACT: BACKGROUND: Insight in parental energy balance-related behaviours, their determinants and parenting practices are important to inform childhood obesity prevention. Therefore, reliable and valid tools to measure these variables in large-scale population research are needed. The objective of the current study was to examine the test-retest reliability and construct validity of the parent questionnaire used in the ENERGY-project, assessing parental energy balance-related behaviours, their determinants, and parenting practices among parents of 10-12 year old children. FINDINGS: We collected data among parents (n = 316 in the test-retest reliability study; n = 109 in the construct validity study) of 10-12 year-old children in six European countries, i.e. Belgium, Greece, Hungary, the Netherlands, Norway, and Spain. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC) and percentage agreement comparing scores from two measurements, administered one week apart. To assess construct validity, the agreement between questionnaire responses and a subsequent interview was assessed using ICC and percentage agreement. All but one item showed good to excellent test-retest reliability as indicated by ICCs > .60 or percentage agreement [greater than or equal to] 75%. Construct validity appeared to be good to excellent for 92 out of 121 items, as indicated by ICCs > .60 or percentage agreement [greater than or equal to] 75%. From the other 29 items, construct validity was moderate for 24 and poor for 5 items. CONCLUSIONS: The reliability and construct validity of the items of the ENERGY-parent questionnaire on multiple energy balance-related behaviours, their potential determinants, and parenting practices appears to be good. Based on the results of the validity study, we strongly recommend adapting parts of the ENERGY-parent questionnaire if used in future research.     

Genetic and environmental influences on the associations between attention problems and other problem behaviors.

Problem behavior in children shows a high degree of co-occurrence, both within the domains of internalizing and externalizing behaviors and across domains. Maternal ratings of 207 same- and opposite-sex twin pairs on the Child Behavior Checklist (CBCL/4-18; Achenbach, 1991) were used to determine the etiology of these associations. In the current sample of 4- to 11-year-old children (mean age: 7.6 years) phenotypic correlations were .68 between Internalizing and Externalizing, between .41 and .66 within the internalizing scales, and between .58 and .71 within the externalizing scales. Correlations across domains on the scale level were of similar magnitude. Genetic and shared environmental correlations were generally high, with the exception of the somatic complaints scale which showed low genetic correlations with other scales. These findings of uniformly high shared etiology was seen within and across domains. For example, Attention Problems showed genetic correlations of .65 with Delinquent Behavior and .76 with Aggressive Behavior; the genetic correlations of Attention Problems with internalizing scales were .71 for Anxious/Depressed and .79 for Withdrawn; a low genetic correlation was only shown for the Somatic Complaints scale (r(g) = .16). Although the magnitude of shared environmental contributions was lower, the environmental correlations were close to unity, indicating that the same family environmental factors were involved in aspects of problem behavior when assessed across domains. Results for the Attention Problems scale were similar to other disruptive behavior, justifying its inclusion with the externalizing scales.     

Reliability and Validity of the KIPPPI: An Early Detection Tool for Psychosocial Problems in Toddlers

Background

The KIPPPI (Brief Instrument Psychological and Pedagogical Problem Inventory) is a Dutch questionnaire that measures psychosocial and pedagogical problems in 2-year olds and consists of a KIPPPI Total score, Wellbeing scale, Competence scale, and Autonomy scale. This study examined the reliability, validity, screening accuracy and clinical application of the KIPPPI.

Methods

Parents of 5959 2-year-old children in the Rotterdam area, the Netherlands, were invited to participate in the study. Parents of 3164 children (53.1% of all invited parents) completed the questionnaire. The internal consistency was evaluated and in subsamples the test-retest reliability and concurrent validity with regard to the Child Behavioral Checklist (CBCL). Discriminative validity was evaluated by comparing scores of parents who worried about their child’s upbringing and parent’s that did not. Screening accuracy of the KIPPPI was evaluated against the CBCL by calculating the Receiver Operating Characteristic (ROC) curves. The clinical application was evaluated by the relation between KIPPPI scores and the clinical decision made by the child health professionals.

Results

Psychometric properties of the KIPPPI Total score, Wellbeing scale, Competence scale and Autonomy scale were respectively: Cronbach’s alphas: 0.88, 0.86, 0.83, 0.58. Test-retest correlations: 0.80, 0.76, 0.73, 0.60. Concurrent validity was as hypothesised. The KIPPPI was able to discriminate between parents that worried about their child and parents that did not. Screening accuracy was high (>0.90) for the KIPPPI Total score and for the Wellbeing scale. The KIPPPI scale scores and clinical decision of the child health professional were related (p<0.05), indicating a good clinical application.

Conclusion

The results in this large-scale study of a diverse general population sample support the reliability, validity and clinical application of the KIPPPI Total score, Wellbeing scale and Competence scale. Also, the screening accuracy of the KIPPPI Total score and Wellbeing scale were supported. The Autonomy scale needs further study.     

Effect of long-term treatment of hyperactive children with methylphenidate.

Summary: Three groups of hyperactive children were compared by various measures of outcome 5 years after initial evaluation: 24 who were treated with methylphenidate for 3 to 5 years during the follow-up period, 22 treated with chlorpromazine for 18 months to 5 years, and 20 who had received no medication during the follow-up period. The three groups were matched with respect to age, IQ, socioeconomic class and sex. No statistically significant differences were found between the three groups on the following measures of outcome: emotional adjustment, delinquency, Wechsler Intelligence Scale for Children, Bender Gestalt visual-motor test and academic performance (as measured by number of grades failed). Initially there was a significant difference between the three groups on ratings of hyperactivity and family diagnosis. Hyperactivity scores decreased significantly over the 5 years; family diagnosis ratings changed little. Analysis of covariance for these two measures showed no difference in degree of improvement between the three groups. Our impression was that methylphenidate was helpful in making hyperactive children more manageable at home and at school, but did not significantly affect their outcome after 5 years of treatment.     

Professional burnout and its relation to job characteristics, satisfaction, and control

Burnout scores for 104 professionals in the fields of college student personnel, health and mental health, administration and miscellaneous other professionals were correlated with ratings on 13 job characteristics, and ratings of satisfaction with, and control over, these characteristics. Results indicate significant positive correlations between the burnout scores and 10 of the 13 job characteristics. Significant positive correlations were found for burnout and all 13 items of job satisfaction. Significant negative correlations were found for 6 of the items where control was rated. Demographic variables of age, sex, marital status, employment status of spouse, dependents, number of hours worked, and being on call showed no significant correlations with burnout. Recommendations are made for continued research and theory building which take into account the concept of control over one's work environment.     

Assessing Long-Term Test-Retest Reliability of the CPT-IP in Schizophrenia

Background

The Continuous Performance Test-Identical Pairs version (CPT-IP) is a well-established measure of sustained attention, and its more challenging versions are particularly suited to detect subtle processing deficits in patients with schizophrenia. However, while there are few longitudinal samples for the CPT-IP, no study has addressed stability for more than two month in patients with schizophrenia. Assessing long-term test-retest reliability of the CPT-IP would facilitate the ability of clinicians to draw conclusions from studies involving interventions as long term cognitive or pharmacological treatments. The present study assessed 12 month test-retest reliability for the two most challenging versions of CPT-IP (4-digit and shapes) in a matched sample of clinically stable schizophrenia outpatients and healthy controls.

Methods

Fifty clinically stable schizophrenia outpatients and 50 healthy controls were assessed with the CPT-IP for the 4-digit and shape conditions. From these, 40 patients and 47 controls were reassessed with an average interval of 12.3 months between test sessions. Test-retest reliability was analyzed with Pearson correlations and results were compared with previous data involving healthy controls and short-term studies in patients with schizophrenia.

Results

Especially d’ and hit rate discriminated well between patients with schizophrenia and healthy controls for both CPT-IP conditions and at both test sessions. Healthy controls demonstrated sufficient long term test-retest correlations of d’, hit rate and reaction time for both the 4-digit and shape conditions. However, in schizophrenia patients, long-term reliability correlations were at best moderate for d’ and hit rate only.

Conclusions

The current study provides further evidence that d’ and hit rate yield consistent cross-sectional discrimination sensitivity. At best moderate long-term test-retest reliability of d’ in schizophrenia outpatients may be not sufficient for practical use of this measure in long term clinical trials.     

Measurement of global self-esteem in dementia. Reliability and validity of Brinkman's self-esteem scale

In a person-centered approach to dementia-care, the self-concept of people suffering from dementia receives more and more attention. There is, however, a lack of direct measures of self-esteem, which is the evaluative component of the self-concept. An 8-item scale to tap global self-esteem was administered to 245 consecutive visitors of a psychogeriatric day care centre. Mokken scale analysis revealed a scalability coefficient of H = 0.44, which is in the medium range. The item responses were explained by a double monotonicity model, allowing for a reliable ordering of subjects and items on the latent trait 'self-esteem'. One-week test-retest reliability on the self-esteem scale was 0.68. Scalability and reliability were about equal across subgroups differing in severity of dementia. Patients were asked to give themselves a rating (1-10) for their estimated sense of self-worth. These ratings correlated 0.55 with scores on the self-esteem scale. Self-esteem was negatively related to measures of depression, fatigue and loneliness, but not to the level of cognitive impairment of the patient. As an independent measure of subjective well-being, self-esteem deserves particular attention in the assessment and treatment of dementia patients.     

Social and biological measures of hyperactivity and inattention: Are they describing similar underlying constructs of child behavior?

Abstract

The relationship between 27 different measures of hyperactive, impulsive, and inattentive behavior, including those considered to be more objective and those considered more influenced by social factors, is examined using a normal sample of 219 Mexican children, ages 6 to 12. Measures were based on activity monitoring by accelerometry, ethological observation of attentional and movements states in the classroom, cognitive testing using the TOVA continuous performance test (CPT), and parents’ and teachers’ reports on ratings scales and symptom checklists. Factor analysis was used to examine to what degree these different measures are reporting similar underlying constructs (factors) of hyperactivity and inattention. Parent and teacher ratings appear to be describing underlying constructs that are distinct from those described by the other measures, but measures based on CPT, observation, and activity monitoring did not factor together either, nor more highly correlate to each other. Analysis combining all the measures showed that parent and teacher ratings factored together based on who was reporting the behavior, rather than the behavior being reported. The findings underscore that each type of measurement of hyperactivity, impulsivity, and inattention measures a different aspect of a complex behavioral phenomenon, rather than some better measuring than others the same underlying factor.     

Psychometric properties of the Danish Strength and Difficulties Questionnaire: the SDQ assessed for more than 70,000 raters in four different cohorts

Background

The Strength and Difficulties Questionnaire (SDQ) is a brief behavioural five factor instrument developed to assess emotional and behavioural problems in children and adolescents. The aim of the current study was to evaluate the psychometric properties for parent and teacher ratings in the Danish version of SDQ for different age groups of boys and girls.

Methods

The Danish versions of the SDQ were distributed to a total of 71,840 parent and teacher raters of 5-, 7- and 10- to 12-year-old children included in four large scale Danish cohorts. The internal reliability was assessed and exploratory factor analyses were carried out to replicate the originally proposed five factor structure. Mean scores and percentiles were examined in order to differentiate between low, medium and high levels of emotional and behavioural difficulties.

Results

The original five factor structure could be substantially confirmed. The Conduct items however did not solely load on the proposed Conduct scale and the Conduct scale was further contaminated by non-conduct items. Positively worded items tended to load on the Prosocial scale. This was more so the case for teachers than for parents. Parent and teacher means and percentiles were found to be lower compared to British figures but similar to or only slightly lower than those found in the other Nordic countries. The percentiles for girls were generally lower than for boys, markedly so for the teacher hyperactivity ratings.

Conclusions

The study supports the usefulness of the SDQ as a screening tool for boys and girls across age groups and raters in the general Danish population.     

A comparison of two isometric tests of trunk flexor endurance

This study was performed to determine the test-retest reliability and the relationship between 2 tests of trunk flexor muscular endurance-a prone bridge and a modified V-sit. Hold times (in seconds) were measured on 60 healthy volunteers from a University community (17 men, 43 women). Both tests were performed at 1-week intervals. The test-retest reliability of each test was assessed with a subgroup of 10 participants during 3 additional testing sessions at 1-week intervals. One examiner collected all data. Intraclass correlation coefficients (2, 1) with the prone bridge were 0.95 and 0.71 with the modified V-sit. The mean hold time was 92.8 ± 44.4 seconds during the prone bridge and 141.7 ± 104.1 seconds during the modified V-sit. Pearson's correlation coefficients between the 2 tests ranged from r = 0.52 (men + women) to r = 0.87 (men only). Intersession reliability with a single examiner was higher with the prone bridge compared with that in the modified V-sit. Modifications to the V-sit resulted in a lower test-retest reliability than was previously reported. Correlations between prone bridge and modified V-sit test scores were low, which may be attributable to the differences in the level of trunk flexor muscle activation between the tests.     

Did Parents and Teachers Struggle with Child Survivors 20 Months after the 2011 Earthquake and Tsunami in Japan? A Retrospective Observational Study

Background

On March 11, 2011, Japan was struck by the earthquake and tsunami. Twenty months after the disaster, we collected information on the difficulties faced by parents and teachers in dealing with the post-traumatic symptoms of child survivors. The aim of this study was to evaluate the relationship between post-traumatic symptoms in children and parents’ and teachers’ difficulties in dealing with children who survived the huge disaster.

Methods

The subjects included 12,524 children from elementary, middle, and junior high schools in Ishinomaki City. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on post-traumatic symptoms, was distributed among the children, and Strength and Difficulties Questionnaire (SDQ), a self-rating questionnaire on difficulties in dealing with children, was given to their parents and teachers. With PTSSC-15, a valid response was obtained from 10,909 (89.5%) participants. With SDQ for teachers and parents, valid responses were obtained from 10,577 (86.7%) and 7052 (83.9%) participants, respectively.

Results

PTSSC-15 scores were significantly higher (P<0.001) in girls than in boys from the junior high school. These effect sizes were less than 0.30. Correlations of teachers’ SDQ scores and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and all children. Likewise, correlations between SDQ scores assigned by parents (excluding “prosocial behavior”) and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and at all school levels.

Conclusion

This study elucidated that the difficulties faced by parents and teachers while dealing with child survivors significantly low correlate with the child’s post-traumatic symptoms caused by the 2011 earthquake and tsunami. Thus, it is important that clinicians should not only evaluate post-traumatic symptoms with a self-rating questionnaire but also try to objectively evaluate whether there were day-to-day difficulties caused by the post-traumatic symptoms.     

Genetic and environmental influences on Anxious/Depression during childhood: a study from the Netherlands Twin Register

For a large sample of twin pairs from the Netherlands Twins Register who were recruited at birth and followed through childhood, we obtained parental ratings of Anxious/Depression (A/D). Maternal ratings were obtained at ages 3 years (for 9025 twin pairs), 5 years (9222 pairs), 7 years (7331 pairs), 10 years (4430 pairs) and 12 years (2363 pairs). For 60-90% of the pairs, father ratings were also available. Multivariate genetic models were used to test for rater-independent and rater-specific assessments of A/D and to determine the genetic and environmental influences on individual differences in A/D at different ages. At all ages, monozygotic twins resembled each other more closely for A/D than dizygotic twins, implying genetic influences on variation in A/D. Opposite sex twin pairs resembled each other to same extent as same-sex dizygotic twins, suggesting that the same genes are expressed in boys and girls. Heritability estimates for rater-independent A/D were high in 3-year olds (76%) and decreased in size as children grew up [60% at age 5, 67% at age 7, 53% at age 10 (60% in boys) and 48% at age 12 years]. The decrease in genetic influences was accompanied by an increase in the influence of the shared family environment [absent at ages 3 and 7, 16% at age 5, 20% at age 10 (5% in boys) and 18% at age 12 years]. The agreement between parental A/D ratings was between 0.5 and 0.7, with somewhat higher correlations for the youngest group. Disagreement in ratings between the parents was not merely the result of unreliability or rater bias. Both the parents provided unique information from their own perspective on the behavior of their children. Significant influences of genetic and shared environmental factors were found for the unique parental views. At all ages, the contribution of shared environmental factors to variation in rater-specific views was higher for father ratings. Also, at all ages except age 12, the heritability estimates for the rater-specific phenotype were higher for mother ratings (59% at age 3 and decreasing to 27% at age 12 years) than for father ratings (between 14 and 29%). Differences between children, even as young as 3 years, in A/D are to a large extent due to genetic differences. As children grow up, the variation in A/D is due in equal parts to genetic and environmental influences. Anxious/Depression, unlike many other common childhood psychopathologies, is influenced by the shared family environment. These findings may provide support for why certain family therapeutic approaches are effective in the A/D spectrum of illnesses.