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Factor analysis of the Pediatric Symptom Checklist with a chronically ill pediatric population
Laura Stoppelbein1, Leilani Greening, Sara Sytsma Jordan
1Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Insights
The Pediatric Symptom Checklist (PSC) effectively screens for behavioral and emotional dysfunction in chronically ill children. Its reliability and factor structure support use in pediatric settings for these populations.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Psychometrics
Background:
- The Pediatric Symptom Checklist (PSC) is a common tool for identifying behavioral and emotional issues in children.
- Its applicability to chronically ill pediatric populations requires validation.
Purpose of the Study:
- To evaluate the psychometric properties and factor structure of the PSC in chronically ill children.
- To determine if the PSC is a reliable screening tool for behavioral and emotional dysfunction in this specific group.
Main Methods:
- Parents of 404 children (ages 6-17) with insulin-dependent diabetes mellitus or sickle cell disease completed the PSC.
- Psychometric analyses included internal consistency (Cronbach's alpha) and test-retest reliability.
- Principal components analysis with promax rotation was used to determine the factor structure.
Main Results:
- High internal consistency (Cronbach's alpha = .89) and acceptable test-retest reliability (r = .77) were observed.
- A four-factor solution emerged, including internalizing, externalizing, attention, and chronic illness-related problems.
- A three-factor solution, excluding chronic illness items, showed strong similarity to a primary care sample's factor structure.
Conclusions:
- The PSC demonstrates strong psychometric properties for screening behavioral and emotional dysfunction in chronically ill children.
- Findings support the clinical utility of the PSC in tertiary care pediatric settings for these populations.
- Further research with diverse chronic illness groups is recommended for broader generalizability.
Abstract:
The psychometric properties and factor structure of a widely used screening measure for behavioral and emotional dysfunction, the Pediatric Symptom Checklist (PSC), was extended to a population of chronically ill children. Parents of 404 children ranging from 6 to 17 years of age and diagnosed with either insulin-dependent diabetes mellitus (IDDM) or sickle cell disease (SCD) completed the PSC while waiting for a routine medical appointment. The measure's internal consistency was found to be high, Cronbach's alpha = .89, and test-retest reliability across 4 months was observed to be acceptable, r = .77. A principal components analysis with an oblique (promax) rotation yielded a four-factor solution with factors that included items representative of internalizing, externalizing, attention, and chronic illness-related problems, respectively. Cronbach alpha estimates ranged from .78 to .83 for the first three factors but was lower for the chronic illness-related problems factor (Cronbach's alpha = .60). A three-factor solution and reliability estimates were recomputed without the chronic illness items that yielded the same reliability estimates for each of the three factors and for the full scale. The three-factor solution was also found to be similar to a published factor structure obtained with a primary care sample, r(c) = .90-.91. The findings lend support to extending the PSC's clinical utility to tertiary care pediatric settings. Further research is recommended with a broader range of chronic illness groups to increase generalizability.
