Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologi... more Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family members. The FHE was administered to one informant in
Journal of the American Academy of Child & Adolescent Psychiatry, 1992
One of the issues confronting the field of child psychiatric epidemiology is devising ways to agg... more One of the issues confronting the field of child psychiatric epidemiology is devising ways to aggregate discrepant reports from multiple informants obtained in structured diagnostic assessments of children and adolescents. The present report uses data from an epidemiological community survey to attempt to address this issue. The results obtained through statistical procedures designed to identify the "optimal" informant for specific symptomatic criteria and diagnoses do not seem to offer a clear-cut advantage over a simple combinatorial rule that identifies symptomatic criteria as positive when they are acknowledged as positive by either parent or child informants.
Journal of the American Academy of Child & Adolescent Psychiatry, 1993
Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were don... more Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were done to provide information on the comorbidity of four major diagnostic domains (attention deficit disorders, conduct/oppositional disorders, depression and anxiety disorders). A high level of comorbidity was found among these four domains of child and adolescent psychopathology. In general the patterns of comorbidity were not affected by whether the data was put together by a clinician or by means of a computer algorithm scoring a structured interview. The patterns were not affected in any major way by who the informants were in the diagnostic process. Minor differences were found in certain comorbidity patterns depending on the sex and age of the subjects. Comorbidity was associated with level of impairment and to service utilization.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To examine the relationship of depressive and disruptive disorders with patterns of mental health... more To examine the relationship of depressive and disruptive disorders with patterns of mental health services utilization in a community sample of children and adolescents. Data were from the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The sample consisted of 1,285 child (ages 9-17 years) and parent/guardian pairs. Data included child psychopathology (assessed by the Diagnostic Interview Schedule for Children), impairment, child need and use of mental health services, and family socioeconomic status. After adjusting for potential confounding factors, disruptive disorder was significantly associated with children's use of mental health services, but depressive disorder was not. For school-based services, no difference was found between the 2 types of disorders. Parents perceived greater need for mental health services for children with disruptive disorders than for those with depression. Conversely, depression was more related to children's perception of mental health service need than was disruptive disorder. The findings highlight the need for more effective ways to identify and refer depressed children to mental health professionals, the importance of improving school-based services to meet children's needs, and the necessity to better educate parents and teachers regarding the identification of psychiatric disorders, especially depression.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To investigate the extent to which adolescents in the community with current substance use disord... more To investigate the extent to which adolescents in the community with current substance use disorders (SUD) experience co-occurring psychiatric disorders. Diagnostic data were obtained from probability samples of 401 children and adolescents, aged 14 to 17 years, and their mothers/caretakers, who participated in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The rates of mood and disruptive behavior disorders are much higher among adolescents with current SUD than among adolescents without SUD. Comparison with adult samples suggests that the rates of current comorbidity of SUD with psychiatric disorders are the same among adolescents as adults, and lower for lifetime disruptive disorders/antisocial personality disorder among adolescents than adults. The high rate of coexisting psychiatric disorders among adolescents with SUD in the community needs to be taken into account in prevention and treatment programs.
Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were und... more Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were undertaken to provide information on the comorbidity patterns of ADHD. A high level of comorbidity was found among ADHD and other diagnostic categories, particularly the conduct/oppositional group. Comorbidity was associated with level of impairment and with service utilization.
The objective of this epidemiological study was to examine, using an ecological perspective, whic... more The objective of this epidemiological study was to examine, using an ecological perspective, which individual and distal contextual factors (familial, social and cultural) are associated with bullying other children across two different sites. Our sample included 1,271 Puerto Rican children 10 and older years of age at baseline residing in the South Bronx in New York and in the Standard Metropolitan Area in San Juan and Caguas, Puerto Rico. Bullying others was assessed through parents' and children's response to one item in the conduct disorder section of the Diagnostic Interview Schedule for Children Version IV (DISC IV). Child, family, social and cultural factors were examined as independent variables with bullying others as dependent variable in hierarchical models adjusting for gender, maternal education, poverty, single parent household and site. Prevalence of bullying others was 15.2% in South Bronx versus 4.6% in Puerto Rico (p<0.0001). Poor social adjustment and a...
Using data from the MECA Study, this report examines the prevalence of Conduct Disorder (CD), Opp... more Using data from the MECA Study, this report examines the prevalence of Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and various levels of antisocial behavior and their correlates among three ethnic groups: Hispanics, subdivided into Island Puerto Ricans and Mainland Hispanics; African Americans; and Mainland Non-Hispanic, Non-African Americans. Correlates considered include stressful life events, birth defects, low birth weight, learning difficulties, teen mothers, family environment, marital adjustment, social competence, parental monitoring, and family relationships. Logistic regression was used to determine the association of outcomes with individual correlates and of interaction terms with ethnicity. Differences between adjusted rates and observed rates of disorders and levels of antisocial behaviors are compared to estimate the extent to which each correlate explains the group differences in rates. Island Puerto Ricans had a lower prevalence of CD, ODD, and vario...
This study examines whether certain psychiatric disorders are associated more closely with advers... more This study examines whether certain psychiatric disorders are associated more closely with adverse life events than other disorders are, and whether some adverse life events are associated with a specific group of disorders (e.g., depressive disorders), but not with other disorders (e.g., anxiety disorders). A probability sample of youth aged 9-17 at 4 sites is used (N = 1,285). Univariate and multivariate logistic regressions identify specific relationships between 25 adverse life events and 9 common child and adolescent psychiatric disorders, measured by the Diagnostic Interview Schedule for Children. Conduct Disorder, Oppositional Defiant Disorder, Major Depressive Disorder, and Dysthymia are significantly associated with many of the adverse life events examined, whereas Attention Deficit/Hyperactivity Disorder, Agoraphobia, and Social Phobia are related to very few. This study suggests that certain psychiatric disorders may be more closely associated with adverse life events tha...
Informant-related determinants of item attenuation, that is, the drop-off in symptom endorsement ... more Informant-related determinants of item attenuation, that is, the drop-off in symptom endorsement rates at retest, were examined in an enriched community subsample of 245 parent-child pairs drawn from the National Institute of Mental Health Methods for Epidemiology of Child and Adolescent Mental Disorders Study. Youngsters and their parents were interviewed with the Diagnostic Interview Schedule for Children (Version 2.3; DISC-2.3) on two occasions with a mean test-retest interval of 12 days. Item attenuation rates were high for both informants, with adults failing to confirm 42% and children 58% of baseline responses at retest. Stepwise regressions revealed that item attenuation at DISC-P retest was higher for adult informants who were younger, and who reported on older and less impaired children. On the DISC-C, attenuation was higher for children who were less impaired, rated as doing worse in school, and who had a longer test-retest interval. These results are broadly consistent w...
In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, yo... more In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, youths with earlier ages of onset of conduct problems engaged in more conduct problems than youths with later ages of onset when current age and gender were controlled. Specifically, youths with earlier ages of onset were more likely to engage in several types of physical aggression, frequent lying, theft, and vandalism and were less likely to engage in only truancy. There also was an inverse relation between age of onset and level of functional impairment, mental health service use, and meeting diagnostic criteria for conduct disorder, attention-deficit hyperactivity disorder, and oppositional defiant disorder. Within the limits of cross-sectional data, these results support the hypothesis that key aspects of the heterogeneity of conduct problems among youths are related to the age of onset of conduct problems.
The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit ... more The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consumption, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gender, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender.
Journal of the American Academy of Child & Adolescent Psychiatry, 1997
To examine the association between physical abuse and selected psychosocial measures in a communi... more To examine the association between physical abuse and selected psychosocial measures in a community-based probability sample of children and adolescents. A sample of 9- through 17-year-olds (N = 665) and their caretakers in New York State and Puerto Rico were interviewed in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Assessments included the Columbia Impairment Scale, the Instrumental and Social Competence Scale, the Diagnostic Interview Schedule for Children, the Peabody Picture Vocabulary Test, and questions regarding physical abuse. Regression analyses were conducted controlling for family income, family psychiatric history, perinatal problems, physical health, and sexual abuse. A history of physical abuse was reported in 172 (25.9%) of the sample. It was significantly associated with global impairment, poor social competence, major depression, conduct disorder, oppositional defiant disorder, agoraphobia, overanxious disorder, and generalized anxiety disorder but not with suicidality, school grades, or receptive language ability. A community probability sample of children and adolescents demonstrated significant associations between physical abuse and psychopathology, after controlling for potential confounders. This supports comprehensive screening for psychopathology among physically abused children and for physical abuse among those with psychopathology. Interventions aimed at improving social competence may be indicated.
Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologi... more Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family members. The FHE was administered to one informant in
Journal of the American Academy of Child & Adolescent Psychiatry, 1992
One of the issues confronting the field of child psychiatric epidemiology is devising ways to agg... more One of the issues confronting the field of child psychiatric epidemiology is devising ways to aggregate discrepant reports from multiple informants obtained in structured diagnostic assessments of children and adolescents. The present report uses data from an epidemiological community survey to attempt to address this issue. The results obtained through statistical procedures designed to identify the &quot;optimal&quot; informant for specific symptomatic criteria and diagnoses do not seem to offer a clear-cut advantage over a simple combinatorial rule that identifies symptomatic criteria as positive when they are acknowledged as positive by either parent or child informants.
Journal of the American Academy of Child & Adolescent Psychiatry, 1993
Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were don... more Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were done to provide information on the comorbidity of four major diagnostic domains (attention deficit disorders, conduct/oppositional disorders, depression and anxiety disorders). A high level of comorbidity was found among these four domains of child and adolescent psychopathology. In general the patterns of comorbidity were not affected by whether the data was put together by a clinician or by means of a computer algorithm scoring a structured interview. The patterns were not affected in any major way by who the informants were in the diagnostic process. Minor differences were found in certain comorbidity patterns depending on the sex and age of the subjects. Comorbidity was associated with level of impairment and to service utilization.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To examine the relationship of depressive and disruptive disorders with patterns of mental health... more To examine the relationship of depressive and disruptive disorders with patterns of mental health services utilization in a community sample of children and adolescents. Data were from the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The sample consisted of 1,285 child (ages 9-17 years) and parent/guardian pairs. Data included child psychopathology (assessed by the Diagnostic Interview Schedule for Children), impairment, child need and use of mental health services, and family socioeconomic status. After adjusting for potential confounding factors, disruptive disorder was significantly associated with children&amp;amp;#39;s use of mental health services, but depressive disorder was not. For school-based services, no difference was found between the 2 types of disorders. Parents perceived greater need for mental health services for children with disruptive disorders than for those with depression. Conversely, depression was more related to children&amp;amp;#39;s perception of mental health service need than was disruptive disorder. The findings highlight the need for more effective ways to identify and refer depressed children to mental health professionals, the importance of improving school-based services to meet children&amp;amp;#39;s needs, and the necessity to better educate parents and teachers regarding the identification of psychiatric disorders, especially depression.
Journal of the American Academy of Child & Adolescent Psychiatry, 1999
To investigate the extent to which adolescents in the community with current substance use disord... more To investigate the extent to which adolescents in the community with current substance use disorders (SUD) experience co-occurring psychiatric disorders. Diagnostic data were obtained from probability samples of 401 children and adolescents, aged 14 to 17 years, and their mothers/caretakers, who participated in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The rates of mood and disruptive behavior disorders are much higher among adolescents with current SUD than among adolescents without SUD. Comparison with adult samples suggests that the rates of current comorbidity of SUD with psychiatric disorders are the same among adolescents as adults, and lower for lifetime disruptive disorders/antisocial personality disorder among adolescents than adults. The high rate of coexisting psychiatric disorders among adolescents with SUD in the community needs to be taken into account in prevention and treatment programs.
Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were und... more Secondary analyses of the data from the Puerto Rico Child Psychiatry Epidemiologic Study were undertaken to provide information on the comorbidity patterns of ADHD. A high level of comorbidity was found among ADHD and other diagnostic categories, particularly the conduct/oppositional group. Comorbidity was associated with level of impairment and with service utilization.
The objective of this epidemiological study was to examine, using an ecological perspective, whic... more The objective of this epidemiological study was to examine, using an ecological perspective, which individual and distal contextual factors (familial, social and cultural) are associated with bullying other children across two different sites. Our sample included 1,271 Puerto Rican children 10 and older years of age at baseline residing in the South Bronx in New York and in the Standard Metropolitan Area in San Juan and Caguas, Puerto Rico. Bullying others was assessed through parents' and children's response to one item in the conduct disorder section of the Diagnostic Interview Schedule for Children Version IV (DISC IV). Child, family, social and cultural factors were examined as independent variables with bullying others as dependent variable in hierarchical models adjusting for gender, maternal education, poverty, single parent household and site. Prevalence of bullying others was 15.2% in South Bronx versus 4.6% in Puerto Rico (p<0.0001). Poor social adjustment and a...
Using data from the MECA Study, this report examines the prevalence of Conduct Disorder (CD), Opp... more Using data from the MECA Study, this report examines the prevalence of Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and various levels of antisocial behavior and their correlates among three ethnic groups: Hispanics, subdivided into Island Puerto Ricans and Mainland Hispanics; African Americans; and Mainland Non-Hispanic, Non-African Americans. Correlates considered include stressful life events, birth defects, low birth weight, learning difficulties, teen mothers, family environment, marital adjustment, social competence, parental monitoring, and family relationships. Logistic regression was used to determine the association of outcomes with individual correlates and of interaction terms with ethnicity. Differences between adjusted rates and observed rates of disorders and levels of antisocial behaviors are compared to estimate the extent to which each correlate explains the group differences in rates. Island Puerto Ricans had a lower prevalence of CD, ODD, and vario...
This study examines whether certain psychiatric disorders are associated more closely with advers... more This study examines whether certain psychiatric disorders are associated more closely with adverse life events than other disorders are, and whether some adverse life events are associated with a specific group of disorders (e.g., depressive disorders), but not with other disorders (e.g., anxiety disorders). A probability sample of youth aged 9-17 at 4 sites is used (N = 1,285). Univariate and multivariate logistic regressions identify specific relationships between 25 adverse life events and 9 common child and adolescent psychiatric disorders, measured by the Diagnostic Interview Schedule for Children. Conduct Disorder, Oppositional Defiant Disorder, Major Depressive Disorder, and Dysthymia are significantly associated with many of the adverse life events examined, whereas Attention Deficit/Hyperactivity Disorder, Agoraphobia, and Social Phobia are related to very few. This study suggests that certain psychiatric disorders may be more closely associated with adverse life events tha...
Informant-related determinants of item attenuation, that is, the drop-off in symptom endorsement ... more Informant-related determinants of item attenuation, that is, the drop-off in symptom endorsement rates at retest, were examined in an enriched community subsample of 245 parent-child pairs drawn from the National Institute of Mental Health Methods for Epidemiology of Child and Adolescent Mental Disorders Study. Youngsters and their parents were interviewed with the Diagnostic Interview Schedule for Children (Version 2.3; DISC-2.3) on two occasions with a mean test-retest interval of 12 days. Item attenuation rates were high for both informants, with adults failing to confirm 42% and children 58% of baseline responses at retest. Stepwise regressions revealed that item attenuation at DISC-P retest was higher for adult informants who were younger, and who reported on older and less impaired children. On the DISC-C, attenuation was higher for children who were less impaired, rated as doing worse in school, and who had a longer test-retest interval. These results are broadly consistent w...
In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, yo... more In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, youths with earlier ages of onset of conduct problems engaged in more conduct problems than youths with later ages of onset when current age and gender were controlled. Specifically, youths with earlier ages of onset were more likely to engage in several types of physical aggression, frequent lying, theft, and vandalism and were less likely to engage in only truancy. There also was an inverse relation between age of onset and level of functional impairment, mental health service use, and meeting diagnostic criteria for conduct disorder, attention-deficit hyperactivity disorder, and oppositional defiant disorder. Within the limits of cross-sectional data, these results support the hypothesis that key aspects of the heterogeneity of conduct problems among youths are related to the age of onset of conduct problems.
The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit ... more The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consumption, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gender, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender.
Journal of the American Academy of Child & Adolescent Psychiatry, 1997
To examine the association between physical abuse and selected psychosocial measures in a communi... more To examine the association between physical abuse and selected psychosocial measures in a community-based probability sample of children and adolescents. A sample of 9- through 17-year-olds (N = 665) and their caretakers in New York State and Puerto Rico were interviewed in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Assessments included the Columbia Impairment Scale, the Instrumental and Social Competence Scale, the Diagnostic Interview Schedule for Children, the Peabody Picture Vocabulary Test, and questions regarding physical abuse. Regression analyses were conducted controlling for family income, family psychiatric history, perinatal problems, physical health, and sexual abuse. A history of physical abuse was reported in 172 (25.9%) of the sample. It was significantly associated with global impairment, poor social competence, major depression, conduct disorder, oppositional defiant disorder, agoraphobia, overanxious disorder, and generalized anxiety disorder but not with suicidality, school grades, or receptive language ability. A community probability sample of children and adolescents demonstrated significant associations between physical abuse and psychopathology, after controlling for potential confounders. This supports comprehensive screening for psychopathology among physically abused children and for physical abuse among those with psychopathology. Interventions aimed at improving social competence may be indicated.
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Papers by Hector Bird