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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-28201

Aebi, M. Diagnostic Accuracy of Self and Parent Rating Scales in the Prediction of Psychiatric Diagnoses in Children and Adolescents. 2009, University of Zurich, Faculty of Arts.

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Abstract

Although parent and self rating scales are often used in clinical and research settings, their
accuracy in the prediction of psychiatric disorders according to ICD-10 or DSM-IV often
remains unclear. In the present thesis the diagnostic accuracy of three parental rating scales
in the prediction of Attention-Deficit-Hyperactivity Disorder (ADHD) and Oppositional Defiant
Disorder (ODD) and two self rating scales in the prediction of adolescent depression were
tested in three separate studies. The first study found the recently introduced DSM-oriented
attention problem scale of the Child Behavior Checklist (CBCL) more adequate than the
previous empirical defined attention problem scale in the identification of ADHD. This was in
particular true for subjects in a clinical sample referred for various psychiatric disorders. A
cut-off score of 5 was recommended for clinical practice. In a second study a sample of
adolescents with clinical depression was compared to a sample of unreferred community
controls. The Youth Self Report (YSR) and the Center of Epidemiological Studies-
Depression Scale (CES-D) showed excellent ability in the discrimination of these two
samples. A range of acceptable cut-off scores between 5 and 9 on the YSR affective
problem scale and between 12 and 31 on the CES-D scale served best in the prediction of
clinical depressive episodes in adolescents. In a third study the Conners’ Parent Ratings
Scale Revised (CPRS-R) and the parent version of the Strength and Difficulties
Questionnaire (PSDQ) were tested in the prediction of ODD in a large transnational sample
of ADHD referred children and adolescents. Furthermore, the construct validity of three
previously described dimensions of ODD was examined and finally the accuracy of the
CPRS-R and the PSDQ were tested in the prediction of these separate ODD dimensions.
The CPRS-R oppositional scale and the PSDQ conduct problem scale showed adequate
diagnostic accuracy. Furthermore, the construct validity of three ODD dimensions labeled
ODD-irritable, ODD-headstrong and ODD-hurtful was confirmed. Furthermore, our results
convincingly show that a three factor structure of ODD is more appropriate than a single
general factor of ODD. The CPRS-R emotional lability scale was able to predict ODD-irritable
significantly. Overall, these three studies confirmed the diagnostic accuracy of clinical rating
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scales in the prediction of psychiatric disorders in youth. Furthermore, these results are of
clinical importance as newer and diagnosis-oriented rating scales showed better diagnostic
accuracy and can be recommended for the initial psychiatric assessment of children and
adolescents. However, despite the good validity of rating scales, further information on age
of onset, continuity, impairment, specificity of symptoms and information about other
psychiatric disorders should be included in order to arrive at the final diagnosis.

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Additional indexing

Item Type:Dissertation
Referees:Steinhausen H C, Wilkening F
Communities & Collections:04 Faculty of Medicine > Center for Child and Adolescent Psychiatry
DDC:610 Medicine & health
Language:English
Date:2009
Deposited On:22 Jan 2010 14:17
Last Modified:08 Mar 2013 15:59
Number of Pages:115
Related URLs:http://opac.nebis.ch/F/?local_base=NEBIS&con_lng=GER&func=find-b&find_code=SYS&request=005804342

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