Multiple Systems

1. Multiple Systems • Importance of measuring: • Affective • Behavioral • Cognitive • Physiological (biochemical, neurological, etc.)

2. Multiple Methods of Measurement, I • Questionnaires: Advantages • Inexpensive, easy, quick • Obtain child’s perspective • Obtain perspective of multiple informants • However, multiple informants may not agree. Then what?

3. Multiple Methods of Measurement, II • Questionnaires: Disadvantages • Researchers impose the structure • Memory limitations • Participants unwilling, or unable, to accurately report on behavior or experience • Can be tedious, especially for children and adolescents

4. Multiple Methods of Measurement, III • Observational methods, advantages: • More ‘objective’ • Tasks can be engaging to small children, and may require no verbal responses • Can do detailed analysis of behavior, and sequential analysis • Examples of tasks: play a game with child; ask child to do clean-up; Gottman space-ship

5. Multiple Methods of Measurement, IV • Observational methods, disadvantages: • Can be artificial, if done in lab • However, lab has advantage of being standardized, and allow for manipulation of variables often not possible in naturalistic settings • Helps to observe on repeated occasions • Rare events may not be observed, especially if naturalistic (no manipulation)

6. Multiple Methods of Measurement, V: Physiological • Provide measures of emotional activation, ability to soothe after stress, attention. Requires collaboration with experts in order to accurately calibrate and interpret • Cardiovascular: • includes baseline heart rate • change in heart rate • vagal tone (parasympathetic system—high vagal tone associated with higher reactivity, suppression of vagal tone associated with attending and shifting attention, ability to self-soothe) • blood pressure.

7. Multiple Methods of Measurement: Physiological, C’t’d • Functional MRI’s (measurement of brain activation) • HPA (hypothalamic-pituitary-adrenocortical) system • E.g., lower threshold for cortisol activation associated with higher wariness, inhibition, shyness

8. Multiple Methods of Measurement, VI • Other measurement approaches: • Continuous performance tests, to measure attention • Intelligence, learning, memory • Projectives

9. Assessing of Child Psychopathology: Diagnostic Interviews • Structured Diagnostic Interviews: DISC, DICA, CAS. Semi-structured: K-SADS. • Younger children may not understand some questions, and difficulty with time intervals • Test-retest reliability of children’s responses to structured interviews is not very good • E.g.: 9 year-olds reported 33% more symptoms in initial interview vs. retest several days later • Ages 10-13: 24% decline • Ages 14-18: 16% decline • This is much smaller among adults • Implications for analyses of change, growth

10. DISC Test-Retest Reliability • Parent informant: • Disruptive Disorders.56 to .68 • Depressive Disorders: MDD= .55, Dys=.30 • Anxiety Disorders: .45 to .60 • Youth Informant: • ADHD: .10, ODD: .18, CD: .64 • Depressive: MDD: .37, Dys: .43 • Anxiety disorders: .27 to .39

11. Concurrent Validity of DISC • These are structured interview vs. clinician diagnoses made after interview (kappas) • Parent informant: • ADHD=.72, ODD = .59, CD = .74. • Depressive: MDD=.60, Dys = .35 • Anxiety disorders: .OAD: .60, SAD: .29, SoPh: .53 • Youth informant: • ADHD=.27, ODD=.54, CD=.77 • Depressive: MDD=.79, Dys=.54 • Anxiety: OAD=.23, SAD=.59, SoPh=.45 • Combined (either) parent and youth: • ADHD=.70, ODD=.65, CD=.80 • MDD=.63, Dys=.37 • Anxiety= .40 to .51

12. Empirically Derived Systems of Psychopathology Assessment • Generally, use standardized checklists of behavior problems rated on scales • Use multivariate statistics to identify groupings or syndromes of problems (patterns of problems that co-occur) • Derived using large samples of children, generally analyzing separately for boys and girls of differing ages. • Thus, norms (and cutpoints) can vary by age and gender (e.g., ADHD may look different in boys vs girls)

13. Empirically Derived Systems, C’t’d • Allow for quantitative assessment along syndromes (continuous) rather than categorical diagnosis • Assessment/analysis can be done separately by different informants (teachers, parents, youths). Or, syndromes that are common across informants can be compared (“cross-informant”). • Examples of syndromes: anxious/depressed, attention problems, delinquent behavior, Social problems, somatic complaints, Thought problems, Withdrawn.

14. Validity of Empirically Derived Systems • Anxious/Depressed syndrome scores higher for children with clinician diagnoses of depressive or anxiety disorders (vs. other clinic youth) • Attention Problems,.Delinquent Behavior, and Aggressive Behavior scores higher among youth with disruptive behavior disorders

15. Critiques of Empirically Derived Systems • Broad-band (internalizing, externalizing) are often highly correlated (e.g., .5 to .6). • Cannot be used to describe rare problems that are important, severe • Informant may respond to checklist item even if they cannot make a sound judgment • No information about duration or severity of symptoms, age of onset, impairment • Syndromes based on co-occurrence of problems in a sample, but problems may not co-occur within a person (I.e., it is ‘variable-centered’, not ‘person-centered’).