Suchergebnisse

Objective: This study examines whether the Child Behavior Checklist (CBCL) can be used as an accurate psychiatric screening tool for children in community mental health settings. Method: Associations, logistic regression models, and receiver operating characteristic (ROC) analysis were used to test the predictive relationship between the CBCL and structured interview-derived diagnoses. Results: Associations between CBCL subscales and specific diagnoses were found, replicating results of previous research. Multivariate models and ROC scoring led to correct diagnostic predictions in a large majority of participants. Corresponding sensitivities, however, were deemed inadequate as they indicated that the screen would miss an unacceptably high number of cases. Conclusions: Using the CBCL as a diagnostic screening tool would result in a large number of cases being missed by the screen. Although the CBCL is unlikely to accurately identify children with specific diagnoses, it could be used as a triage tool to inform practitioners if an in-depth structured diagnostic interview is necessary.

BackgroundDistinguishing a disorder of persistent and impairing grief from normative grief allows clinicians to identify this often undetected and disabling condition. As four diagnostic criteria sets for a grief disorder have been proposed, their similarities and differences need to be elucidated.MethodsParticipants were family members bereaved by US military service death (N = 1732). We conducted analyses to assess the accuracy of each criteria set in identifying threshold cases (participants who endorsed baseline Inventory of Complicated Grief ⩾30 and Work and Social Adjustment Scale ⩾20) and excluding those below this threshold. We also calculated agreement among criteria sets by varying numbers of required associated symptoms.ResultsAll four criteria sets accurately excluded participants below our identified clinical threshold (i.e. correctly excluding 86-96% of those subthreshold), but they varied in identification of threshold cases (i.e. correctly identifying 47-82%). When the number of associated symptoms was held constant, criteria sets performed similarly. Accurate case identification was optimized when one or two associated symptoms were required. When employing optimized symptom numbers, pairwise agreements among criteria became correspondingly 'very good' (κ = 0.86-0.96).ConclusionsThe four proposed criteria sets describe a similar condition of persistent and impairing grief, but differ primarily in criteria restrictiveness. Diagnostic guidance for prolonged grief disorder in International Classification of Diseases, 11th Edition (ICD-11) functions well, whereas the criteria put forth in Section III of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are unnecessarily restrictive.