Problem behavior in international adoptees: III. Diagnosis of child psychiatric disorders
F C Verhulst1, H Versluis-den Bieman, J van der Ende
1Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands.
Insights
International adoptees show higher rates of psychiatric disorders, particularly conduct disorders. The Child Behavior Checklist (CBCL) effectively estimates prevalence in epidemiological studies.
Area of Science:
- Psychiatry
- Developmental Psychology
- Epidemiology
Background:
- Problem behavior in international adoptees requires further clinical investigation.
- Previous epidemiological studies established a baseline for problem behaviors.
Purpose of the Study:
- To conduct a clinical extension of epidemiological findings on problem behavior in international adoptees.
- To validate the Child Behavior Checklist (CBCL) for estimating psychiatric disorder prevalence.
Main Methods:
- Clinical interviews with 132 14-year-old international adoptees and parents.
- Utilized Child Behavior Checklist (CBCL) scores for participant selection.
- Obtained clinical severity ratings and DSM-III-R diagnoses.
Main Results:
- High correlations (r=0.63, r=0.45) between CBCL scores and clinical ratings validated the tool.
- A 28% prevalence rate of psychiatric disorders was observed in the adoptee sample (36% boys, 22% girls).
- Elevated conduct disorders were noted, characterized by antisocial behaviors and relationship problems.
Conclusions:
- The Child Behavior Checklist (CBCL) is a reliable tool for epidemiological studies on child psychiatric disorders.
- International adoptees exhibit a higher prevalence of psychiatric disorders compared to general populations.
- Conduct disorders are a significant concern in this population, manifesting as antisocial behavior and affect issues.
Abstract:
This study is a clinical extension of two previous epidemiological studies on problem behavior in international adoptees. In depth pictures were obtained by clinical interviews of 132 14-year-old international adoptees and their parents. Children were selected on the basis of previously obtained Child Behavior Checklist (CBCL) scores. Clinical severity ratings and DSM-III-R diagnoses were obtained. The correlations of r = 0.63 and r = 0.45 between clinical severity ratings and CBCL problem and competence scores, respectively, indicated that the results from the authors' extensive epidemiological survey and the clinical evaluation, which took place more than 10 months later, converged. The results showed that the CBCL may be used in epidemiological studies to obtain an estimate of the prevalence of psychiatric disorders in children. The 28% prevalence rate of psychiatric disorders in this sample of 14-year-old international adoptees (22% rate for girls, 36% for boys) was somewhat higher than for general population samples reported in comparable studies. Conduct disorders were elevated in the sample. The behavior of disordered adopted children was characterized by antisocial behaviors, poor relationships, and problems of affect.
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