Academic journal article International Journal of Clinical and Health Psychology

Syndromes of Collateral-Reported Psychopathology for Ages 18-59 in 18 Societies

Academic journal article International Journal of Clinical and Health Psychology

Syndromes of Collateral-Reported Psychopathology for Ages 18-59 in 18 Societies

Article excerpt

Globalization is a theme of our times. World communities are becoming increasingly diverse as traditional boundaries between societies are changing. Mental health professionals increasingly need clinical constructs and methods for operationalizing such constructs that can be used with people of many different backgrounds.

One approach is to define constructs on the basis of experts' knowledge and judgments, as exemplified by the American Psychiatric Association's (2013) Diagnostic and Statistical Manual (DSM) and the World Health Organization's (2010) International Classification of Disease (ICD). A second approach derives constructs from statistical analyses of problems reported for samples of individuals. This approach can be applied to various kinds of data, including experts' judgments of individuals' problems. An early example is Wittenborn's (1951) factor analysis of psychiatrists' and nurses' ratings of U.S. inpatients on 55 symptoms, which yielded nine syndromes resembling diagnostic constructs of that era.

The statistical approach can also be applied to selfreported problems. As an example, Goekoop et al. (1992) derived five factors from exploratory factor analysis (EFA) of 192 Dutch outpatients' interview reports regarding 65 items of the Comprehensive Psychopathological Rating Scale (Asberg, Montgomery, Perris, Schalling, & Sedvall, 1978). In a study of 91 UK Tourette syndrome patients, EFA of 11 selfrated personality and psychopathology measures yielded obsessionality and anxiety/depression factors (Eapen, Fox- Hiley, Banerjee, & Robertson, 2004).

The statistical approach has been used to derive syndrome constructs from a broad spectrum of problems assessed by the Adult Self-Report (ASR), which is designed for clinical, research, and epidemiological assessment of 18-59-year-olds (Achenbach & Rescorla, 2003). Literate respondents can rate its 120 problem items in about 15 minutes, or it can be administered by lay interviewers. The items describe particular kinds of behavioral, emotional, social, and thought problems, which are rated 0 = not true, 1 = somewhat or sometimes true, or 2 = very true or often true, based on the preceding 6 months. Every item had to meet at least one of the following criteria: (a) it discriminated significantly between individuals referred for mental health or substance use services versus demographically similar individuals not referred for services; (b) it was identified by international experts as being very consistent with > 1 DSM diagnostic category; (c) it loaded significantly on at least one of eight syndromes derived by EFAs and confirmatory factor analyses (CFAs) of self-ratings by 2,968 U.S. referred and nonreferred 18-59-year-olds (Achenbach & Rescorla, 2003). The syndromes are designated as Anxious/ Depressed, Withdrawn, Somatic Complaints, Thought Problems, Attention Problems, Aggressive Behavior, Rule- Breaking Behavior, and Intrusive. The first three syndromes aggregate into a broad-band Internalizing scale, while the last three aggregate into an Externalizing scale, based on second-order factor analyses.

The syndrome scales scored from the ASR have been found to correlate significantly with scales of the Symptom Checklist-90-Revised (Derogatis, 1994) in a U.S. clinical sample. Most of the syndrome scales have also been found to correlate significantly with MMPI scales in a Turkish nonclinical sample (Achenbach & Rescorla, 2003). Over 100 published studies have reported use of the ASR (Bérubé & Achenbach, 2014).

Beyond self-reports

Assessment of adult psychopathology tends to rely on data obtained mainly from the person being assessed. However, reports by other informants may not agree with self-reports. For example, Meyer et al. (2001) found a mean kappa of only .18 between diagnoses based solely on adults' self-reports versus diagnoses based on collateral reports. Meyer et al. also found that 70% of personality disorder diagnoses based on clinical interviews with adult patients were wrong when compared with diagnoses made from multiple sources of data. …

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