Clinical Assessment of Interpersonal Relations (CAIR) in Student Adjustment: A Comprehensive Approach

1. Bruce A. Bracken, PhD

2. About the Author Bruce A. Bracken, PhD Professor The College of William & Mary School of Education P.O. Box 8795 Williamsburg, VA 23187-8795 757.221.1712 babrac@wm.edu http://babrac.people.wm.edu/

3. Presentation Outline Multidimensional Adjustment and Assessment of Students’ Interpersonal Relations Clinical Assessment of Interpersonal Relations (CAIR) • Development Goals • Key Features • Description: Scales, Support Model, Relationship Characteristics • Norm Characteristics and Technical Adequacy • Administration and Scoring • Interpretation • Case Study

4. Multifaceted Nature of Adjustment • Multidimensional, context-dependent model of adjustment, with six primary life domains: • Three intra-personal domains • Affect • Competence • Physical • Three interpersonal domains • Social • Academic • Family

5. Developmental Nature of PsychosocialAdjustment • Adjustment becomes increasingly differentiated with age • Life domains differentiate as a function of exposure

6. AssessmentTriangulation Other Sources- Direct Observation - Indirect Approaches (e.g., Projective Techniques) - Background Information - Clinical Interview Behavioral and Psychosocial Adjustment Third-Party Report- CAB Parent/Teacher Social Skills Scale - Sociometry Self-Report - Clinical Assessment of Interpersonal Relations

7. CAIRClinical Assessment of Interpersonal Relations

8. CAIR Features • Self-report (student completed) • Ages 9 to 19 years • Third grade reading level • 35 items repeated on each of five scales • • Male Peers, Female Peers • Mother, Father • Teacher • Reflects three interpersonal domains • Social • Family • Academic

9. CAIR Features • Twenty - minute completion time • Theoretically based • Four dimensions of relationship support • Fifteen relationship characteristics • Allows for prorating • Single-parent situations • Skipped Items • Norm-referenced and Ipsative interpretation options • Mandatory element of Emotional Disturbance diagnosis

10. CAIR Features • Uses a Four-point Item response format • Strongly Agree • Agree • Disagree • Strongly Disagree • Provides score reporting consistent with CAB, CAD, CAT and most personality tests • Standard scores (T-scores) • Percentile ranks • Confidence intervals • Qualitative classifications • Graphical profile display

11. Constructing the CAIR:A Multidimensional, Multi-Step, Multi-Year Process

12. DEFINITION “The unique and relatively stable behavioral pattern that exists or develops between two people as a result of individual and extra-individual influences.” INTERPERSONAL SUPPORT • Esteem Support • Informational Support • Instrumental Support • Social Support 15 RELATIONSHIP CHARACTERISTICS • Companionship • Emotional Support • Guidance • Emotional Comfort • Reliance • Understanding • Conflict Resolution • Identification • Respect • Empathy • Intimacy • Affect • Acceptance • Shared Values INTERPERSONAL RELATIONS DEFINED

13. Serious Emotional Disturbance Defined Disabilities Education Act (IDEA), Public Law 101-476 defines SED as: “…one or more of the following characteristicsover a long period of time and to a marked degree that adversely affectseducational performance– (A) An inability to learn that cannot be explained by intellectual,sensory, or health factors; (B) An inability to build or maintain satisfactory interpersonalrelationships with peers and teachers; (C) Inappropriate types of behavior or feelings under normal circumstances; (D) A general pervasive mood of unhappiness or depression; (E) A tendency to develop physical symptoms or fears associated withpersonal or school problems."

14. Item ConstructionConsiderations • Self-report measure of students’ perceptions of relationship qualities using Likert format • Four-point forced-choice scale to avoid noncommittal responses • Consistent item format for all five scales • Both positively and negatively connoted conditions depicted • Simple language, third-grade reading level

15. Item ConstructionConsiderations 6. Items reflect 15 core relationship qualities 7. Item content universal to all 9 – 19 year-olds 8. Non-timed instrument 9. CAIR can be administered by paraprofessionals, but must be interpreted by professionals 10. Items collectively sample the universe of content and contexts associated with relationships

16. Adjustment Disorder - with Anxiety - with Conduct Disturbance Antisocial Personality Attention Deficit Disorder Autistic Disorder Avoidant Disorder Avoidant Personality Body Dysmorphic Disorder Borderline Personality Childhood Disintegrative Disorder Communication Disorder Conduct Disorder Delusional Disorder Depression Psychiatric Conditions Related to Interpersonal Relations

17. Dysthymic Disorder Histrionic Personality Identity Disorder Intermittent Explosive Disorder Learning Disorders Narcissistic Personality Oppositional Defiant Disorder Paranoid Personality Pervasive Developmental Disorder Schizoid Personality Schizophrenia Schizotypal Disorder Sexual Disorders Social Phobia Specific Phobias Psychiatric Conditions Related to Interpersonal Relations

18. Behavioral Correlates of Interpersonal Relations • Adolescent and adult psychosocial adjustment(Parker & Asher, 1987) • Future sex role development(Fagot, 1977) • Expression of intimacy(Buhrmester, 1990) • Moral development(Berndt, McCartney, Caparulo, & Moore, 1984) • Emotional security and understanding of the social structure (Panella, Cooper, & Henggeler, 1982) • Childhood and adolescent aggression(Dodge, Coie, & Brakke, 1982; Hartup, 1979)

19. Behavioral Correlates of Interpersonal Relations • Juvenile crime(Parker & Asher, 1987) • Risk of dropping out of school(Elliott & Voss, 1974) • Behavioral disturbance(Panella & Henggeler, 1986) • Learning disabilities(Bryan, 1974, 1982; Dishion, 1990) • Mentally retardation (Gottlieb, Semmel, & Veldman, 1978) • Social isolation(Wanlass & Prinz, 1982) • Bad conduct discharge from the military(Roff, 1961) • Emotional Disturbance (IDEA)

20. Intra-individual Factors Related to Interpersonal Relations • Position in birth order(Schacter, 1964: Sells & Roff, 1964) • Parents' style of nurturance and providing care(Baumrind, 1967, 1971; Hinde & Tamplin, 1983; MacDonald & Parke, 1984) • Parental mental health(Becker, Peterson, Hellmer, Shoemaker, & Quay, 1959; Forehand, Long, Brody, & Fauber, 1986; Glueck & Glueck, 1950; Maccoby & Martin, 1983, 1990; Phares & Compas, 1992) • Marital conflict and divorce between parents(Emery, 1982; Gottman & Katz, 1989; Grych & Fincham, 1992; Hetherington, 1979; McCord, McCord, & Thurber, 1962) • Parent-child conflict(Montemayor, 1982) • Physical or sexual abuse or maltreatment(George & Main, 1979; Kinard, 1980; Reidy, 1977)

21. Inter-individual Factors Related to Interpersonal Relations • Physical attractiveness (Cavoir & Dokecki, 1973; Dion & Berscheid, 1974; Kennedy, 1990; Langlois & Downs, 1979) • Physical health(Lotyczewski, Cowen, & Weissberg, 1986) • Unusualness of the child's name(McDavid & Farari, 1966) • Ability to express humor(McGhee, 1980) • Perceived social competence(Gresham & Elliott, 1989)

22. Technical Quality • Norms • Reliability • Internal Consistency • Stability • Validity • Content Validity • Developmental Validation • Construct Validity • Contrasted Groups Validity • Independent Research Efforts

23. Standardization Sample

24. Standardization Sample Sample Sample Sample United States Characteristic Size Percentage* Percentage U.S. Region Northeast 173 6.93 20.20 South 1310 52.50 35.00 North Central 563 22.57 23.90 West 449 17.99 20.90 * Percentages are computed on the number of cases coded, with missing data omitted from calculations. Total sample size = 2501 subjects.

25. U.S. and CAIRFamily Constellations Family U.S. CAIR TypePopulation Sample Intact Family 65% 57% Foster Home 1% 1% Reconstituted 10% 14% Single-Parent 22% 17% CAIR Sample does not sum to 100% due to unreported data. Single-parent families may be due to never married, separation, divorce, or death of parent.

26. CAIR Scale Internal Consistencyand Stability .96

27. CAIR Theoretical Foundation:Content Validity

28. CAIR Theoretical Model

29. Developmental Validation: Students’ Relationshipswith their Parents

30. Developmental Validation: Students’ Relationshipswith their Peers

31. Developmental Validation: Students’ Relationshipswith their Teachers

32. Female Students’ Relationships by Race

33. Male Students’ Relationships by Race

34. Construct Validity:Factor Analysis Factor One: Father Scale Factor Three: Mother Scale

35. Construct Validity:Factor Analysis Factor Four: Male Peers Scale Factor Five: Female Peers Scale Two Items with Primary (non-significant) Loadings on Teachers’ Scale

36. Construct Validity:Factor Analysis Factor Two: Teachers Scale

37. CAIR – Multidimensional Self-Concept Correlations

38. CAIR – CAT-C Parent-Completed Correlations

39. CAIR – CAT- C Child-CompletedCorrelations

40. CAIR – CAD Correlations

41. CAIR – CAB Scale Correlations

42. CAIR – CAB Externalizing Correlations

43. Summary of Independent CAIR Research Clinic Samples: • Poorer relations on all scales; diminished self-concepts Runaways: • Poorer Mother, Father, Teacher relations; exaggerated opposite-sex Peer relations Delinquents: • Poorer Mother relations; 81.5% classification rate; 88.4% non-delinquent classification rate Gay, Lesbian, Bisexual Adolescents: • Poorer Mother, Father, Male and Female Peer relations Parenting Style: • Students with Authoritative Mothers reported better Mother relations than students with Authoritarian or Permissive Mothers

44. Interpreting the CAIR

45. Clinical Interpretation Quantitative and Qualitative Interpretation Process 5-Step Interpretation Process • Consider CAIR total scale score (i.e., Total Relationship Index) • Consider CAIR scale scores individually and in combination • Compare scale scores with data acquired from different sources (e.g., sociometry, CAB Social Skills) • Explore 15 relationship characteristics • Contrast student’s performance on the CAIR in light of other available information (e.g., referral, background)

46. CAIR Relationship Classifications CAIR Relationships are classified by descriptive categories related to degree of relationship strength or weakness > 70 = Significant Relationship Strength 60 to 69 = Mild Relationship Strength 40 to 59 = Normal Range 30 to 39 = Mild Relationship Weakness < 29 = Significant Relationship Weakness

47. Ipsative Interpretation:Deviations from Average Scale Score Scale p < .05 p < .01 Mother 8 9 Father 7 9 Male Peers 8 10 Female Peers 8 10 Teacher 9 11

48. Ipsative Interpretation:Example CAIR Scale Mean Ipsative Scale Score d Classification Mother 69 +10 Strength Father 53 -6 Weakness Male Peers 40 -19 Weakness Female Peers 62 +3 Average Teacher 69 +10 Strength Mean Score 59

49. Calculation of Normative and Ipsative Profiles