An Exploratory Survey of Career Choice, Training, and Practice Trends in Early Career Child and Adolescent Psychiatrists and Fellows.

OBJECTIVE: A pilot survey was created to sample early career child and adolescent psychiatrists (CAPs) and fellows to identify factors contributing to recruitment, satisfaction, and general practice trends. METHOD: A 44-item survey was developed based on a previous study of early career CAPs and discussion at an early career forum. Participants were recruited at a professional meeting and through emails sent to all 125 US training program directors. RESULTS: Only 184 out of 2209 responses were received. Approximately two-thirds were female and one-third had completed fellowship. Most decided to pursue a career in child psychiatry during medical school and expected full time salaries between $175,000 and $250,000 after fellowship. Forty-five percent owed more than $150,000 in educational debt. The top reasons for pursuing a career in child psychiatry included the following: working with children, working in an interesting field, and helping society. Males (x = 85.7, SD 22.9) compared with females (x = 77.5, SD 25.3) were more interested in pursuing full time work. A higher proportion of participants were confident in prescribing medications (x = 79.9, SD 17.1) compared with providing psychotherapy (X = 63.3, SD 23.9). CONCLUSIONS: The vast majority of early career CAPs were recruited during medical school, motivated by altruistic reasons, and rated high confidence in their career choice despite significant student loan debt. Training directors should consider increasing competency in psychotherapeutic skills. Early child psychiatry exposure and a means of addressing physician debt are needed to improve recruitment to this specialty.

Psychometric properties of the Peer Interactions in Primary School (PIPS) Questionnaire.

BACKGROUND: Recently, national and international scientific and popular press has focused on bullying and victimization. Unfortunately, many interventions that address bullying and victimization are yet to be empirically validated. One problem is the lack of a psychometrically sound instrument for the measurement of bullying and victimization. METHODS: To alleviate this shortcoming, the Peer Interactions in Primary School Questionnaire (PIPS) was developed and tested. Twenty-two questions designed to capture direct and indirect forms of bullying and victimization were created at a third-grade reading level. Psychometric data were collected from administration of the questionnaire to 270 students in third through sixth grades at three different elementary schools. An exploratory factor analysis yielded two factors (bullying and victimization). RESULTS: Internal consistency for the questionnaire was high (Cronbach's alpha = .90). Intraclass correlation coefficients (ICCs) and Spearman's rho established that test-retest reliability was high for both scales: bullying (ICC = .84; rho = .76) and victimization (ICC = .88; rho = .87). Significant Kruskal-Wallis tests of relationships between PIPS scales and items on the Olweus Bullying/Victimization Questionnaire and the Strengths and Difficulties Questionnaire supported concurrent validity. Bullying and victimization were widespread, as 89.5% of children experienced some form of victimization and 59.0% of students participated in some form of bullying. CONCLUSION: With these data, the PIPS is the first self-report bullying and victimization measure designed for elementary school use determined reliable (internally consistent and reproducible) and valid. The PIPS is a tool that could be used in the design and evaluation of school-based bullying/victimization interventions.

Provider recognition of psychosocial problems in low-income Latino children.

The purpose of this study was to determine the frequency of identification of psychosocial problems in Latino children by primary care providers (PCPs). This was a cross-sectional study of 269 low-socioeconomic status (SES), Latino children, ages 2-16 years, seen at a community clinic for well-child care. Primary care providers completed a World Health Organization checklist, which organized provider assessment of child psychosocial problems. Clinicians identified one or more psychosocial problems in 39.8% of children. Clinicians recognized only 20% of children with clinically significant aggression symptoms, 18% of children with clinically significant attention/hyperactivity symptoms, and none (0%) of the children with clinically significant anxiety/depression symptoms with clinical data from parent-completed child-behavior checklists used as the benchmark. Despite high rates of identification of psychosocial problems in a low-SES, Latino population, PCPs still miss symptoms of mental health difficulties, especially anxiety and depression. Since symptoms of anxiety and depression are likely to be more pronounced in Latino populations, there is a continued need for improvement in detection of mental health concerns among these children.