Epidemiological studies have shown that mental disorders are associated with reduced health-relat... more Epidemiological studies have shown that mental disorders are associated with reduced health-related quality of life, high levels of health care utilization, and work absenteeism. However, measurement of the burden of mental disorders by using population-based methods in large working populations, such as the U.S. military, has been limited. Analysis of hospitalizations among all active-duty military personnel (16.4 million person-years) from 1990 to 1999 and ambulatory visits from 1996 to 1999 was conducted by using the Defense Medical Surveillance System. Rates of hospitalization, ambulatory visits, and attrition from military service were compared for persons with mental disorder diagnoses and those with diagnoses in 15 other ICD-9 disease categories. Mental disorders was the leading category of discharge diagnoses among men and the second leading category among women; 13% of all hospitalizations and 23% of all inpatient bed days were attributed to mental disorders. Six percent of the military population received ambulatory services for mental disorders annually in 1998 and 1999. Among a 1-year cohort of personnel, 47% of those hospitalized for the first time for a mental disorder left military service within 6 months. This attrition rate was significantly different from the rate of only 12% after hospitalization for any of the 15 other disease categories (range=11%-18%) (relative risk=4.04, 95% confidence interval=3.91-4.17). The difference remained significant after controlling for effects of age, gender, and duration of service. Mental disorders appear to represent the most important source of medical and occupational morbidity among active-duty U.S. military personnel. These findings provide new population-based evidence that mental disorders are common, disabling, and costly to society.
To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that milita... more To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that military ambulatory data systems (like other medical data collected for administrative purposes) have limitations, and to the extent that only primary diagnoses are reported, the prevalence rates of alcohol and substance-related comorbidity are underestimated.
To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that milita... more To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that military ambulatory data systems (like other medical data collected for administrative purposes) have limitations, and to the extent that only primary diagnoses are reported, the prevalence rates of alcohol and substance-related comorbidity are underestimated.
Epidemiological studies have shown that mental disorders are associated with reduced health-relat... more Epidemiological studies have shown that mental disorders are associated with reduced health-related quality of life, high levels of health care utilization, and work absenteeism. However, measurement of the burden of mental disorders by using population-based methods in large working populations, such as the U.S. military, has been limited. Analysis of hospitalizations among all active-duty military personnel (16.4 million person-years) from 1990 to 1999 and ambulatory visits from 1996 to 1999 was conducted by using the Defense Medical Surveillance System. Rates of hospitalization, ambulatory visits, and attrition from military service were compared for persons with mental disorder diagnoses and those with diagnoses in 15 other ICD-9 disease categories. Mental disorders was the leading category of discharge diagnoses among men and the second leading category among women; 13% of all hospitalizations and 23% of all inpatient bed days were attributed to mental disorders. Six percent of the military population received ambulatory services for mental disorders annually in 1998 and 1999. Among a 1-year cohort of personnel, 47% of those hospitalized for the first time for a mental disorder left military service within 6 months. This attrition rate was significantly different from the rate of only 12% after hospitalization for any of the 15 other disease categories (range=11%-18%) (relative risk=4.04, 95% confidence interval=3.91-4.17). The difference remained significant after controlling for effects of age, gender, and duration of service. Mental disorders appear to represent the most important source of medical and occupational morbidity among active-duty U.S. military personnel. These findings provide new population-based evidence that mental disorders are common, disabling, and costly to society.
1. Among the 1.4 million active duty United States military service members, 6% receive outpatien... more 1. Among the 1.4 million active duty United States military service members, 6% receive outpatient treatment for a mental disorder each year. Over 25% of these service members leave military service within 6 months, a rate that is more than two times higher than the rate following treatment for any other illness category. There is clearly a need to define psychiatric research priorities and an unprecedented opportunity to enhance the field of psychiatric research in general using the well-characterized military population. The first ...
SUMMA R Y The purp ose of the pre sent study was to describe the development and assess the psych... more SUMMA R Y The purp ose of the pre sent study was to describe the development and assess the psychometr ic properties of the Short Mood and Feelings Questionnai re (SMFQ). The SMFQ is a brief, easy-to-administer, self-repor t measure of childhood and adolesce nt depression, designed for the rapi d evaluation of core depressive symptomatology or for use in epidemio logical studi es. The SMFQ's content and criterion-related validity were examined in a sample of 173 8-16 year-olds, comp rised of both psychiatric and unselected pediatric cont rols. Results revealed substantial correlations between the SMFQ, the Children's Depression Inventory (CD I) and the Diagnostic Interview Schedule for Children (DISC) depress ion scale. The SMFQ successfully discriminated the clinically-referred psychiat ric subjects from the pediatric contro ls. Within the pediatric (general population) sample, the SMFQ discriminated DISC-diagnosed childre n with depressive disorder from non-depressed subjects. Exploratory factor analyses, along with a high internal consis tency, suggested that the SMFQ was a unifactorial scale. In sum , the SMFQ appears to be a prom ising tool for both the swift assessment of core depressive symptomato logy and as a screening measure for depression in child psychiatric epidemiological studies.
In this article, the authors review the available medical and psychological literature relating h... more In this article, the authors review the available medical and psychological literature relating hypoglycemia and psychopathology. Issues surrounding the proper assessment of hypoglycemia are discussed. The research suggests that many persons carrying the popular diagnosis of hypoglycemia do not meet stringent diagnostic criteria. However, these inaccurately diagnosed individuals often exhibit psychiatric symptomatology, particularly somatization and depression. Also, many persons exhibiting low blood glucose levels do not report symptoms. The evidence supports a relationship between low andlor rapidly declining blood glucose levels and transient cognitive, affective, and somatic symptoms. The limited evidence does not support a relationship between hypoglycemia and panic disorder, maior depression, aggression, or somatizing personality features. Implications for the clinician are discussed.
The development of a new, comprehensive and multicomponent treatment for socia l phobia is descri... more The development of a new, comprehensive and multicomponent treatment for socia l phobia is described. Initial results of a pilot study with the new treatment also are reported. The treatment was found to be effective with severe (generalized) social phobics, most of whom had co-occurri ng Axis I and/or II conditions. In addition to significant change on a host of outcome variables, a normative-based endstate functioning index was used to determine treatment efficacy. The results are discussed with respect to the implementation of the treatment and in terms of the need for a comprehensive approach to treating social phobia.
SUMMARY In the present study, the factor composition of a new, brief, easy-to-admin ister, depres... more SUMMARY In the present study, the factor composition of a new, brief, easy-to-admin ister, depression inventory for children and ado lescents, the Short Mood and Feelings Questionnaire (SMFQ), was examined. Using longitud inal data from the Pittsburgh Youth Study , confirmat ory facto r analyses were computed to evaluate the age-invariance of a single-factor SMFQ structu re. Results provided strong support for the unidimensiona l structure of the SMFQ across grades 1-10 in a large sample of boys. Factor loading corre lations across age groups were substan tial suggesting developmenta l continuit y in item (symptom) salience for the latent variable of depressi on. The magn itude of the mean facto r loadings increased with age, suggesting that the depression construc t was measure d with less error as the children matured. In sum , the SMFQ appears to prov ide a brief and reliable measure of a core depression construct in children and adolescents.
In the first decade of the 21st century, men and women in the U.S. military experience the highes... more In the first decade of the 21st century, men and women in the U.S. military experience the highest levels of operational tempo since the Vietnam War, and early evidence suggests that service members are paying a substantial price in terms of adverse mental health outcomes (e.g., Hoge et al., 2004). Persistent and pervasive disruptions and dysfunction in intimate relationships in a substantial proponion of veterans who demonstrate posttraumatic stress symptomology (e.g., Jordan et al., 1992) exemplify this concern. Hence, the costs of current conflicts will extend beyond individual service members to relational "casualties" in military families, characterized by marital discord, family violence, and spousal abuse. Interest in military family violence has captured the imagination of the public, stemming in part from highly publicized coverage of rare tragic events (e.g., the 2002 homicide-suicides at Ft. Bragg) and media reports of research suggesting elevated rates of violence in military in comparison with civilian marital relationships. Given current workload demands in conjunction with hazardous duty assignments, a literature review of intimate panner violence in the military is pertinent. In this chapter, we cover the prevalence, risk factors, and consequences of male to female ~ntimate partner violence in the U.S. military. We do, however, acknowledge the occurrence of female to male intimate partner violence in civilian and military populations, but as the majority of civilian reports and substantiated military cases involve female victims (e.g., Field & Caetano, 2005 and Beals, 2003, respectively), we will focus primarily on male perpetrated family violence. We also briefly cover
The goal of these analyses was to use existing data to provide an empirically-based estimate of t... more The goal of these analyses was to use existing data to provide an empirically-based estimate of the prevalence in the population of Serious Emotional Disturbance (SED) in children and adolescents, to assist States in their task, required under PL 102-321, of including such estimates in their applications for Block Grant funds. Seven data sets were identified that could provide estimates of SED. The principal investigators agreed on common definitions of the key components of SED: a psychiatric diagnosis and significant functional impairment. Two definitions of impairment were used: domain-specific (impairment in one or more of three areas of functioning) and global (in the worst 10% over all). They also defined a set of correlates and risk factors for SED: age, gender, race/ethnicity, and poverty. Investigators then reanalyzed their own data, using these standard definitions, and calculated the proportion of SED youth who received mental health care. The median estimate of SED with global impairment was 5.4%, with a range from 4.3% to 7.4%. Estimates of SED with domain-specific impairment ranged from 5.5% to 16.9% (median 7.7%). Rates were slightly higher in boys. There were no clear ethnic differences. Poverty doubled the risk of SED. Only one SED
This study examined potential changes in perceptions of therapeutic (" working ") alliance during... more This study examined potential changes in perceptions of therapeutic (" working ") alliance during a child's initial diagnostic interview from the parent's perspective. The major study objective was to determine whether parental perceptions of alliance vary by group (video teleconferencing [VTC], face-to-face [FTF]) over time (Pre, Post intake). It was predicted that parental alliance would be more favorable after an FTF encounter relative to a VTC intervention. Participants were recruited and enrolled in two study cohorts between August 2000 and October 2005. Parents completed the Parental Perceptions of Alliance Questionnaire (PPAQ) immediately before (pre-PPAQ) and after (post-PPAQ) their interview. Analysis of variance (ANOVA) tests showed that the mean PPAQ scores of FTF groups being higher than that of VTC groups (controlling for time) was statistically significant, F(1,144) = 4.14, p = 0.04. However, upon further analysis, the interaction effect was not significant, F(1,144) = 1.20, p = 0.28. Findings from the current exploratory study suggest that, at least following an intake child psychiatric examination, parents' perceptions of therapeutic alliance are stronger than they were before intake for those conducted in an FTF format as well as through VTC.
SUMMARY Background: Though adult psychiatric disorders have been found to be substantial sources ... more SUMMARY Background: Though adult psychiatric disorders have been found to be substantial sources of burden for family caretakers, little attention has bcco paid to the measurement or burden resulting from children's psychiatric disturbance, or to its mcasuremenl. The purpose or the present study was lo describe the development and characteristics or such a measure, the Child and Adolescent Burden Assessment (CABA). Methods: The psychometric properties of the CABA were examined in both general population and clinical samples. Psychometric properties assessed included factor composition, internal consistency, test-retest reliability, and criterion-related validity. Results : Factor analyses demonstrated a robust general 'burden' construct in both the community and clinical samples. Internal consistency reliability estimates were high (coefficient tx > .80). Test-retest stability over a one-week period was adequate (ICC = 0.67) in a small clinical sample. Criterion-related validity was supported in comparisons of mean burden levels between community and clinical samples. Conclusions: The CABA appealfi to be a promising instrument for the measurement or family burden associated with childhood psychiatric disoriders. Psychomet.rically, the CABA pcrfonns adequately. Theoretically, the burden construct may prove useful in models or service use, mental health outcomes, and the progress of family adaptation.
Authors alone are responsible for opinions expressed in the contribution and for its clearance th... more Authors alone are responsible for opinions expressed in the contribution and for its clearance through their federal health agency, if required. ABSTRACT Military spouses must contend with unique issues such as a mobile lifestyle, rules and regulations of military life, and frequent family separations including peacekeeping and combat deployments. These issues may have an adverse effect on the health of military spouses. This study examined the mental health status, rates of care utilization, source of care, as well as barriers and stigma of mental health care utilization among military spouses who were seeking care in military primary care clinics. The data show spouses have similar rates of mental health problems compared to soldiers. Spouses were more likely to seek care for their mental health problems and were less concerned with the stigma of mental health care than were soldiers. Services were most often received from primary care physicians, rather than specialty mental health professionals, which may relate to the lack of availability of mental health services for spouses on military installations.
Investigated the social support available to families of children born with craniofacial anomalie... more Investigated the social support available to families of children born with craniofacial anomalies and the perceived degree of satisfaction derived from these relationships. Thirty-six children (1 month to 5 years old) born with craniofacial deformities (FD) were matched by age and sex to 36 children with no significant physical or behavioral problems. The Social Support Questionnaire-Revised, the Revised Denver Developmental Screening Test, and a semistructured interview were administered. Results indicated that parents of FD children reported less available social support and were significantly less satisfied with their support. Parents of children who had more severe physical impairments and were rated as less attractive reported having less available and less satisfying social support. In particular, the social competence of the child was the most important predictor of parental social support. This result is interesting as the parents of FD children appeared to underreport the presence of behavioral-psychological problems in their children.
Epidemiological studies have shown that mental disorders are associated with reduced health-relat... more Epidemiological studies have shown that mental disorders are associated with reduced health-related quality of life, high levels of health care utilization, and work absenteeism. However, measurement of the burden of mental disorders by using population-based methods in large working populations, such as the U.S. military, has been limited. Analysis of hospitalizations among all active-duty military personnel (16.4 million person-years) from 1990 to 1999 and ambulatory visits from 1996 to 1999 was conducted by using the Defense Medical Surveillance System. Rates of hospitalization, ambulatory visits, and attrition from military service were compared for persons with mental disorder diagnoses and those with diagnoses in 15 other ICD-9 disease categories. Mental disorders was the leading category of discharge diagnoses among men and the second leading category among women; 13% of all hospitalizations and 23% of all inpatient bed days were attributed to mental disorders. Six percent of the military population received ambulatory services for mental disorders annually in 1998 and 1999. Among a 1-year cohort of personnel, 47% of those hospitalized for the first time for a mental disorder left military service within 6 months. This attrition rate was significantly different from the rate of only 12% after hospitalization for any of the 15 other disease categories (range=11%-18%) (relative risk=4.04, 95% confidence interval=3.91-4.17). The difference remained significant after controlling for effects of age, gender, and duration of service. Mental disorders appear to represent the most important source of medical and occupational morbidity among active-duty U.S. military personnel. These findings provide new population-based evidence that mental disorders are common, disabling, and costly to society.
To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that milita... more To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that military ambulatory data systems (like other medical data collected for administrative purposes) have limitations, and to the extent that only primary diagnoses are reported, the prevalence rates of alcohol and substance-related comorbidity are underestimated.
To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that milita... more To the Editor: Regarding the letter by Dr. Staudenmeier and Dr. David Brown, we agree that military ambulatory data systems (like other medical data collected for administrative purposes) have limitations, and to the extent that only primary diagnoses are reported, the prevalence rates of alcohol and substance-related comorbidity are underestimated.
Epidemiological studies have shown that mental disorders are associated with reduced health-relat... more Epidemiological studies have shown that mental disorders are associated with reduced health-related quality of life, high levels of health care utilization, and work absenteeism. However, measurement of the burden of mental disorders by using population-based methods in large working populations, such as the U.S. military, has been limited. Analysis of hospitalizations among all active-duty military personnel (16.4 million person-years) from 1990 to 1999 and ambulatory visits from 1996 to 1999 was conducted by using the Defense Medical Surveillance System. Rates of hospitalization, ambulatory visits, and attrition from military service were compared for persons with mental disorder diagnoses and those with diagnoses in 15 other ICD-9 disease categories. Mental disorders was the leading category of discharge diagnoses among men and the second leading category among women; 13% of all hospitalizations and 23% of all inpatient bed days were attributed to mental disorders. Six percent of the military population received ambulatory services for mental disorders annually in 1998 and 1999. Among a 1-year cohort of personnel, 47% of those hospitalized for the first time for a mental disorder left military service within 6 months. This attrition rate was significantly different from the rate of only 12% after hospitalization for any of the 15 other disease categories (range=11%-18%) (relative risk=4.04, 95% confidence interval=3.91-4.17). The difference remained significant after controlling for effects of age, gender, and duration of service. Mental disorders appear to represent the most important source of medical and occupational morbidity among active-duty U.S. military personnel. These findings provide new population-based evidence that mental disorders are common, disabling, and costly to society.
1. Among the 1.4 million active duty United States military service members, 6% receive outpatien... more 1. Among the 1.4 million active duty United States military service members, 6% receive outpatient treatment for a mental disorder each year. Over 25% of these service members leave military service within 6 months, a rate that is more than two times higher than the rate following treatment for any other illness category. There is clearly a need to define psychiatric research priorities and an unprecedented opportunity to enhance the field of psychiatric research in general using the well-characterized military population. The first ...
SUMMA R Y The purp ose of the pre sent study was to describe the development and assess the psych... more SUMMA R Y The purp ose of the pre sent study was to describe the development and assess the psychometr ic properties of the Short Mood and Feelings Questionnai re (SMFQ). The SMFQ is a brief, easy-to-administer, self-repor t measure of childhood and adolesce nt depression, designed for the rapi d evaluation of core depressive symptomatology or for use in epidemio logical studi es. The SMFQ's content and criterion-related validity were examined in a sample of 173 8-16 year-olds, comp rised of both psychiatric and unselected pediatric cont rols. Results revealed substantial correlations between the SMFQ, the Children's Depression Inventory (CD I) and the Diagnostic Interview Schedule for Children (DISC) depress ion scale. The SMFQ successfully discriminated the clinically-referred psychiat ric subjects from the pediatric contro ls. Within the pediatric (general population) sample, the SMFQ discriminated DISC-diagnosed childre n with depressive disorder from non-depressed subjects. Exploratory factor analyses, along with a high internal consis tency, suggested that the SMFQ was a unifactorial scale. In sum , the SMFQ appears to be a prom ising tool for both the swift assessment of core depressive symptomato logy and as a screening measure for depression in child psychiatric epidemiological studies.
In this article, the authors review the available medical and psychological literature relating h... more In this article, the authors review the available medical and psychological literature relating hypoglycemia and psychopathology. Issues surrounding the proper assessment of hypoglycemia are discussed. The research suggests that many persons carrying the popular diagnosis of hypoglycemia do not meet stringent diagnostic criteria. However, these inaccurately diagnosed individuals often exhibit psychiatric symptomatology, particularly somatization and depression. Also, many persons exhibiting low blood glucose levels do not report symptoms. The evidence supports a relationship between low andlor rapidly declining blood glucose levels and transient cognitive, affective, and somatic symptoms. The limited evidence does not support a relationship between hypoglycemia and panic disorder, maior depression, aggression, or somatizing personality features. Implications for the clinician are discussed.
The development of a new, comprehensive and multicomponent treatment for socia l phobia is descri... more The development of a new, comprehensive and multicomponent treatment for socia l phobia is described. Initial results of a pilot study with the new treatment also are reported. The treatment was found to be effective with severe (generalized) social phobics, most of whom had co-occurri ng Axis I and/or II conditions. In addition to significant change on a host of outcome variables, a normative-based endstate functioning index was used to determine treatment efficacy. The results are discussed with respect to the implementation of the treatment and in terms of the need for a comprehensive approach to treating social phobia.
SUMMARY In the present study, the factor composition of a new, brief, easy-to-admin ister, depres... more SUMMARY In the present study, the factor composition of a new, brief, easy-to-admin ister, depression inventory for children and ado lescents, the Short Mood and Feelings Questionnaire (SMFQ), was examined. Using longitud inal data from the Pittsburgh Youth Study , confirmat ory facto r analyses were computed to evaluate the age-invariance of a single-factor SMFQ structu re. Results provided strong support for the unidimensiona l structure of the SMFQ across grades 1-10 in a large sample of boys. Factor loading corre lations across age groups were substan tial suggesting developmenta l continuit y in item (symptom) salience for the latent variable of depressi on. The magn itude of the mean facto r loadings increased with age, suggesting that the depression construc t was measure d with less error as the children matured. In sum , the SMFQ appears to prov ide a brief and reliable measure of a core depression construct in children and adolescents.
In the first decade of the 21st century, men and women in the U.S. military experience the highes... more In the first decade of the 21st century, men and women in the U.S. military experience the highest levels of operational tempo since the Vietnam War, and early evidence suggests that service members are paying a substantial price in terms of adverse mental health outcomes (e.g., Hoge et al., 2004). Persistent and pervasive disruptions and dysfunction in intimate relationships in a substantial proponion of veterans who demonstrate posttraumatic stress symptomology (e.g., Jordan et al., 1992) exemplify this concern. Hence, the costs of current conflicts will extend beyond individual service members to relational "casualties" in military families, characterized by marital discord, family violence, and spousal abuse. Interest in military family violence has captured the imagination of the public, stemming in part from highly publicized coverage of rare tragic events (e.g., the 2002 homicide-suicides at Ft. Bragg) and media reports of research suggesting elevated rates of violence in military in comparison with civilian marital relationships. Given current workload demands in conjunction with hazardous duty assignments, a literature review of intimate panner violence in the military is pertinent. In this chapter, we cover the prevalence, risk factors, and consequences of male to female ~ntimate partner violence in the U.S. military. We do, however, acknowledge the occurrence of female to male intimate partner violence in civilian and military populations, but as the majority of civilian reports and substantiated military cases involve female victims (e.g., Field & Caetano, 2005 and Beals, 2003, respectively), we will focus primarily on male perpetrated family violence. We also briefly cover
The goal of these analyses was to use existing data to provide an empirically-based estimate of t... more The goal of these analyses was to use existing data to provide an empirically-based estimate of the prevalence in the population of Serious Emotional Disturbance (SED) in children and adolescents, to assist States in their task, required under PL 102-321, of including such estimates in their applications for Block Grant funds. Seven data sets were identified that could provide estimates of SED. The principal investigators agreed on common definitions of the key components of SED: a psychiatric diagnosis and significant functional impairment. Two definitions of impairment were used: domain-specific (impairment in one or more of three areas of functioning) and global (in the worst 10% over all). They also defined a set of correlates and risk factors for SED: age, gender, race/ethnicity, and poverty. Investigators then reanalyzed their own data, using these standard definitions, and calculated the proportion of SED youth who received mental health care. The median estimate of SED with global impairment was 5.4%, with a range from 4.3% to 7.4%. Estimates of SED with domain-specific impairment ranged from 5.5% to 16.9% (median 7.7%). Rates were slightly higher in boys. There were no clear ethnic differences. Poverty doubled the risk of SED. Only one SED
This study examined potential changes in perceptions of therapeutic (" working ") alliance during... more This study examined potential changes in perceptions of therapeutic (" working ") alliance during a child's initial diagnostic interview from the parent's perspective. The major study objective was to determine whether parental perceptions of alliance vary by group (video teleconferencing [VTC], face-to-face [FTF]) over time (Pre, Post intake). It was predicted that parental alliance would be more favorable after an FTF encounter relative to a VTC intervention. Participants were recruited and enrolled in two study cohorts between August 2000 and October 2005. Parents completed the Parental Perceptions of Alliance Questionnaire (PPAQ) immediately before (pre-PPAQ) and after (post-PPAQ) their interview. Analysis of variance (ANOVA) tests showed that the mean PPAQ scores of FTF groups being higher than that of VTC groups (controlling for time) was statistically significant, F(1,144) = 4.14, p = 0.04. However, upon further analysis, the interaction effect was not significant, F(1,144) = 1.20, p = 0.28. Findings from the current exploratory study suggest that, at least following an intake child psychiatric examination, parents' perceptions of therapeutic alliance are stronger than they were before intake for those conducted in an FTF format as well as through VTC.
SUMMARY Background: Though adult psychiatric disorders have been found to be substantial sources ... more SUMMARY Background: Though adult psychiatric disorders have been found to be substantial sources of burden for family caretakers, little attention has bcco paid to the measurement or burden resulting from children's psychiatric disturbance, or to its mcasuremenl. The purpose or the present study was lo describe the development and characteristics or such a measure, the Child and Adolescent Burden Assessment (CABA). Methods: The psychometric properties of the CABA were examined in both general population and clinical samples. Psychometric properties assessed included factor composition, internal consistency, test-retest reliability, and criterion-related validity. Results : Factor analyses demonstrated a robust general 'burden' construct in both the community and clinical samples. Internal consistency reliability estimates were high (coefficient tx > .80). Test-retest stability over a one-week period was adequate (ICC = 0.67) in a small clinical sample. Criterion-related validity was supported in comparisons of mean burden levels between community and clinical samples. Conclusions: The CABA appealfi to be a promising instrument for the measurement or family burden associated with childhood psychiatric disoriders. Psychomet.rically, the CABA pcrfonns adequately. Theoretically, the burden construct may prove useful in models or service use, mental health outcomes, and the progress of family adaptation.
Authors alone are responsible for opinions expressed in the contribution and for its clearance th... more Authors alone are responsible for opinions expressed in the contribution and for its clearance through their federal health agency, if required. ABSTRACT Military spouses must contend with unique issues such as a mobile lifestyle, rules and regulations of military life, and frequent family separations including peacekeeping and combat deployments. These issues may have an adverse effect on the health of military spouses. This study examined the mental health status, rates of care utilization, source of care, as well as barriers and stigma of mental health care utilization among military spouses who were seeking care in military primary care clinics. The data show spouses have similar rates of mental health problems compared to soldiers. Spouses were more likely to seek care for their mental health problems and were less concerned with the stigma of mental health care than were soldiers. Services were most often received from primary care physicians, rather than specialty mental health professionals, which may relate to the lack of availability of mental health services for spouses on military installations.
Investigated the social support available to families of children born with craniofacial anomalie... more Investigated the social support available to families of children born with craniofacial anomalies and the perceived degree of satisfaction derived from these relationships. Thirty-six children (1 month to 5 years old) born with craniofacial deformities (FD) were matched by age and sex to 36 children with no significant physical or behavioral problems. The Social Support Questionnaire-Revised, the Revised Denver Developmental Screening Test, and a semistructured interview were administered. Results indicated that parents of FD children reported less available social support and were significantly less satisfied with their support. Parents of children who had more severe physical impairments and were rated as less attractive reported having less available and less satisfying social support. In particular, the social competence of the child was the most important predictor of parental social support. This result is interesting as the parents of FD children appeared to underreport the presence of behavioral-psychological problems in their children.
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