P-Factor(s) for Youth Psychopathology Across Informants and Models in 24 Societies.

OBJECTIVE: Although the significance of the general factor of psychopathology (p) is being increasingly recognized, it remains unclear how to best operationalize and measure p. To test variations in the operationalizations of p and make practical recommendations for its assessment, we compared p-factor scores derived from four models. METHODS: We compared p scores derived from principal axis (Model 1), hierarchical factor (Model 2), and bifactor (Model 3) analyses, plus a Total Problem score (sum of unit-weighted ratings of all problem items; Model 4) for parent- and self-rated youth psychopathology from 24 societies. Separately for each sample, we fitted the models to parent-ratings on the Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and self-ratings on the Youth Self-Report (YSR) for 25,643 11-18-year-olds. Separately for each sample, we computed correlations between p-scores obtained for each pair of models, cross-informant correlations between p-scores for each model, and Q-correlations between mean item x p-score correlations for each pair of models. RESULTS: Results were similar for all models, as indicated by correlations of .973-.994 between p-scores for Models 1-4, plus similar cross-informant correlations between CBCL/6-18 and YSR Model 1-4 p-scores. Item x p correlations had similar rank orders between Models 1-4, as indicated by Q correlations of .957-.993. CONCLUSIONS: The similar results obtained for Models 1-4 argue for using the simplest model - the unit-weighted Total Problem score - to measure p for clinical and research assessment of youth psychopathology. Practical methods for measuring p may advance the field toward transdiagnostic patterns of problems.

Effects of individual differences, society, and culture on youth-rated problems and strengths in 38 societies.

BACKGROUND: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents' ratings of their offspring's mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents' reports are essential for clinical assessment of their offspring, they reflect parents' perceptions of the offspring. Consequently, clinical assessment also requires self-reports from the offspring themselves. To test effects of individual differences, society, and culture on youths' self-ratings of their problems and strengths, we analyzed Youth Self-Report (YSR) scores for 39,849 11-17 year olds in 38 societies. METHODS: Indigenous researchers obtained YSR self-ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. RESULTS: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. CONCLUSIONS: Like parents' ratings, youths' self-ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self-rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths' self-reports should thus not be minimized by societal/cultural differences, which-while important-can be taken into account with appropriate norms, as can gender and age differences.

Parent-teacher agreement on children's problems in 21 societies.

Parent-teacher cross-informant agreement, although usually modest, may provide important clinical information. Using data for 27,962 children from 21 societies, we asked the following: (a) Do parents report more problems than teachers, and does this vary by society, age, gender, or type of problem? (b) Does parent-teacher agreement vary across different problem scales or across societies? (c) How well do parents and teachers in different societies agree on problem item ratings? (d) How much do parent-teacher dyads in different societies vary in within-dyad agreement on problem items? (e) How well do parents and teachers in 21 societies agree on whether the child's problem level exceeds a deviance threshold? We used five methods to test agreement for Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) ratings. CBCL scores were higher than TRF scores on most scales, but the informant differences varied in magnitude across the societies studied. Cross-informant correlations for problem scale scores varied moderately across societies studied and were significantly higher for Externalizing than Internalizing problems. Parents and teachers tended to rate the same items as low, medium, or high, but within-dyad item agreement varied widely in every society studied. In all societies studied, both parental noncorroboration of teacher-reported deviance and teacher noncorroboration of parent-reported deviance were common. Our findings underscore the importance of obtaining information from parents and teachers when evaluating and treating children, highlight the need to use multiple methods of quantifying cross-informant agreement, and provide comprehensive baselines for patterns of parent-teacher agreement across 21 societies.

Cross-informant agreement between parent-reported and adolescent self-reported problems in 25 societies.

We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) Do levels of parent-adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent-adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent-adolescent dyads within each society agree on the adolescent's deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR-CBCL discrepancy varied across societies. Cross-informant correlations for problem scale scores varied more across societies than across types of problems. Across societies, parents and adolescents tended to rate the same items as low, medium, or high, but within-dyad parent-adolescent item agreement varied widely in every society. In all societies, both parental noncorroboration of self-reported deviance and adolescent noncorroboration of parent-reported deviance were common. Results indicated many multicultural consistencies but also some important differences in parent-adolescent cross-informant agreement. Our findings provide valuable normative baselines against which to compare multicultural findings for clinical samples.

Exploratory factor analysis of African Self-Consciousness Scale scores.

This study replicates and extends prior studies of the dimensionality, convergent, and external validity of African Self-Consciousness Scale scores with appropriate exploratory factor analysis methods and a large gender balanced sample (N = 348). Viable one- and two-factor solutions were cross-validated. Both first factors overlapped significantly and were labeled "Embracing African Heritage." The second subscale of the two-factor solution was labeled "Refusal to Deny African Heritage." Only the structural validity of the first factor of the two-factor solution was fully consistent with prior findings. Partial evidence of convergent validity was found for all factors, and only the second factor of the two-factor solution received external validity support. Implications for usage of the African Self-Consciousness Scale and recommendations for further investigation are discussed.

Mental ability performance among adults with type 2 diabetes in primary care.

Aim and method The present university-based outpatient clinic, cross-sectional study assessed cognitive performance in a sample of 137 adults, with the primary objective of determining differences in cognitive performance as a function of gender and hypertension status in a type 2 diabetes cohort.Results Approximately 64% of the sample was 65 years old and younger, and 50 subjects had > 13 years of education. Global mental ability scores were relatively similar by age grouping, and higher-ordered cognitive functioning and reading literacy were strongly correlated, r (98) = 0.62, P < 0.01. Approximately 30% of the sample posted global mental ability scores in the slow learner range on tasks measuring attention, immediate memory and verbal reasoning. Males achieved higher cognitive functioning scores compared to females on multiple mental ability tasks. The presence of hypertension was associated with significantly worse cognitive performance compared to those subjects without hypertension, t = 2.11, P = 0.03. Approximately 57% of the hypertension group was classified as mild cognitive impaired.Conclusion While approximately half of the general population can be expected to demonstrate an average range of performance on cognitive ability measures, such an expectation could be inappropriately generalised to persons diagnosed with type 2 diabetes, even among those who were high school educated.

The generalizability of the Youth Self-Report syndrome structure in 23 societies.

As a basis for theories of psychopathology, clinical psychology and related disciplines need sound taxonomies that are generalizable across diverse populations. To test the generalizability of a statistically derived 8-syndrome taxonomic model for youth psychopathology, confirmatory factor analyses (CFAs) were performed on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) completed by 30,243 youths 11-18 years old from 23 societies. The 8-syndrome taxonomic model met criteria for good fit to the data from each society. This was consistent with findings for the parent-completed Child Behavior Checklist (Achenbach & Rescorla, 2001) and the teacher-completed Teacher's Report Form (Achenbach & Rescorla, 2001) from many societies. Separate CFAs by gender and age group supported the 8-syndrome model for boys and girls and for younger and older youths within individual societies. The findings provide initial support for the taxonomic generalizability of the 8-syndrome model across very diverse societies, both genders, and 2 age groups.

Epidemiological comparisons of problems and positive qualities reported by adolescents in 24 countries.

In this study, the authors compared ratings of behavioral and emotional problems and positive qualities on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) by adolescents in general population samples from 24 countries (N = 27,206). For problem scales, country effect sizes (ESs) ranged from 3% to 9%, whereas those for gender and age ranged from less than 1% to 2%. Scores were significantly higher for girls than for boys on Internalizing Problems and significantly higher for boys than for girls on Externalizing Problems. Bicountry correlations for mean problem item scores averaged .69. For Total Problems, 17 of 24 countries scored within one standard deviation of the overall mean of 35.3. In the 19 countries for which parent ratings were also available, the mean of 20.5 for parent ratings was far lower than the self-report mean of 34.0 in the same 19 countries (d = 2.5). Results indicate considerable consistency across 24 countries in adolescents' self-reported problems but less consistency for positive qualities.

Measuring social change preferences in African American adolescents: development of the Measure of Social Change for Adolescents (MOSC-A).

Studies addressing Black adolescents' social change strategies are nonexistent and might be associated with the absence of social change measures for Black adolescents. In an effort to begin addressing this concern, the 30-item Measure of Social Change for Adolescents (MOSC-A) was designed to measure Black adolescents' first- (i.e., within the system) and second- (outside of the system) order social change strategies. Factor analysis of responses that 226 Black adolescents gave to the MOSC-A revealed first- and second-order social change factors. Item response theory analyses revealed that 65% of the items on the former factor adequately discriminate across different trait levels, but those of the latter were less promising. Scaffolded on this study, future research might refine the MOSC-A's psychometric properties and improve its utility.

Comparisons of problems reported by youths from seven countries.

OBJECTIVE: This study compared ratings for self-reported behavioral and emotional problems in adolescents from seven countries. METHOD: Youth Self-Report scores were analyzed for 7,137 adolescents ages 11-18 years from general population samples from Australia, China, Israel, Jamaica, the Netherlands, Turkey, and the United States. RESULTS: Comparisons of problems scores yielded small to medium effect sizes for cross-cultural variations. Youths from China and Jamaica had the highest and youths from Israel and Turkey had the lowest mean total problems scores. With cross-cultural consistency, girls scored higher for internalizing and lower for externalizing than boys. Cross-cultural correlations were high among the mean item scores. CONCLUSIONS: Empirically based assessment provided a robust method for assessing and comparing adolescents' self-reported problems. Self-reports thus supplemented empirically based assessments of parent-reported problems and offered a cost-effective way of identifying problems for which adolescents from diverse cultural backgrounds may need help.

Emotions and psychopathology

Few psychological assessment instruments exist for Jamaicans. Studies that address the appropriateness of foreign instruments for Jamaicans are sparse and empirical focus on psychopathology and its aetiology in Jamaican adults is virtually nonexistent. The present study addressed these deficits via Confirmatory Factor Analyses (CFA) which revealed that factors on the Toronto Alexithymia Scale (TAS-20) and Brief Symptom Inventory (BSI) were not replicated for a Jamaican sample (N=352). Exploratory Factor Analyses (EFA) on the TAS-20 revealed one factor labelled Unawareness and Confusion Regarding Emotions (UCRE). Also, EFA yielded six BSI dimensions labelled Somatic Complaints, Paranoia, Hostility, Mild Depression/Dysthymia, Major Depression with Psychotic features, and Agoraphobia with Panic. Regression analyses on the Jamaican-based TAS-20 and BSI factors revealed a positive relationship between UCRE and each BSI factor and total BSI score. Mild Depression, Agoraphobia with Panic, Paranoia, Hostility, Mild Depression and Major Depression were higher for women and younger Jamaicans, respectively, but younger Jamaicans with higher UCRE scores had higher scores on Paranoia, Major Depression, and total score. The findings suggest that Jamaican mental health policy and programmes should focus on the difficulties some Jamaicans experience in recognising and expressing their emotions.(AU)

Behavioral and Emotional problems among adolescents of Jamaica and the United States: Parent, Teacher and self-reports for ages 12 to 18

Compares nonreferred adolescent samples for ages 12 to 18 from Jamaica and the United States via syndromes; syndrome groupings and total problem scores on the Child Behavioral Checklist (CBCL), Teacher's report form and Youth Self-report. Reporting of more problems by adolescents in both societies than their parents or teachers.(AU)

Behaviour and emotional problems of clinic referred children of the African diaspora

Several factors determine behaviour problem types children exhibit, and actions adults (eg, parents) subsequently take. Factors include children's sociocultural background and clinicians' professional training. Cross-national research on children of similar heritage (eg, the African Diaspora) living in different cultures can address sociocultural issues associated with child psychopathology, but few cross-cultural studies focus on children of African descent. This study begins addressing these issues by surveying clinic records of 696 African American and Jamaican children aged 4-18 years. Trained recorders reviewed clinic records and recorded youngsters' presenting problems. By matching youngsters' problem to the widely used Child Behavior Checklist (CBCL) items, recorders coded and summed problems according to eight CBCL syndromes, internalising, externalising problems, other CBCL-, and non-CBCL problems. Stepwise regression revealed that African American youngsters scored higher on the Somatization syndrome only, a child problem type the Jamaican culture seems to tolerate.(AU)

Self report ratings of psychopathology in Korean and Jamaican women

Women from different nations with different customs may express varying levels of psychological distress and present problems in forms their societies accept. We compared women from Korea and Jamaica where women's roles and behaviour differ, and may influence the types of symptoms they display. Korean culture supports women's dependence, submissiveness, and obedience toward male partners and discourages women from expressing feelings, a custom that causes women distress which is usually expressed as anxiety related disorders. Jamaican women comprise most Jamaica's work force and are described as independent, outwardly expressive, and unlike Korean women may externalize their psychological distress. We tested these hypotheses using the Brief Symptom Inventory (BSI), a multidimensional psychopathology measure, to survey Korean (N = 214) and Jamaican women (N = 282). Using age and nationality as predictors and total score and the nine BSI scales as criterion variables considered separately, multiple regression analyses reveal significantly higher scores on total problems and on all the paranoid scales scores on total problems and on all the paranoid scale scores for Korean than for Jamaica women. Large effect on the Somatization and Obsessive Complusive scales and a medium effect on the anxiety scale indicate that while Korean women generally expressed much more distress than Jamaica women, they are particularly vulnerable for the development of anxiety related problems(AU)

Identification of emotions and emotional confusion in Jamaican men vs women: do they predict severity and types of psychopathology?

In Jamaica, women comprise two-thirds of the workforce, but the society rigidly defines gender roles and behaviour for men versus women. Jamaican women are reportedly independent and outwardly express wide varieties of feelings. Jamaican men have greater difficulty acknowledging, labelling and expressing their emotions, a process labelled alexithymia. Therefore, Jamaican men may report higher levels of alexithymia. Since identification and expression of feelings are positively associated with psychological health, Jamaicans (especially men) with higher alexithymia scores should report higher levels of psychological distress than those with low alexithymia scores. These hypotheses were tested using the Toronto Alexithymia Scale II (TAS-II), and Brief Symptom Inventory (BSI), to survey 400 Jamaican men and women

Epidemiology of behavioral and emotional problems among children of Jamaica and the United States: parents reports for ages 6 to 11

Research on child behavior problems requires standardized methodology in order to compare parent-reported behavior problems of 360 Jamaican and 946 U.S. children aged 6 to 11. It revealed few differences in individual, total, internalizing (e.g., depression), and externalizing (e.g., fighting) problem scores as a function of nationality, gender, or age. Findings from this and other studies indicate the feasibility of a common methodology in cross-national studies of children's problems, but also the need for further refinement. (AU)

Further comparisons of teacher and parent ratings of behavior and emotional problems in Jamaican children

As a sequel to comparisons between parent and teacher reports on behavioral/emotional problems in clinic-referred Jamaican 6-11 year-old youngster were compared. Similar to clinic-refered findings,low to moderate correlations emerged for parent and teacher reports on nonreferred children. Correlations were also significantly higher for ratings of undercontrolled (eg., disobedience, stealing, fighting) than ratings of overcontrolled (eg., shyness, depression, fearfulness) behavior, suggesting that some findings may be robust across cultures and referral status. However, correlation coefficients varied across referral status for ratings of overcontrolled problems in boys. Overall, the findings suggest that the study of child behavior requires attention to the reporter of the behavior and the context in which such behavior occurs (AU)

Jamaican and American adult perspectives on child psychopathology: further exploration of the threshold model

Although several factors determine whether children receive psychological intervention, cultural determinants may be particularly influential. Cultural factors may influence adults' levels of concern over child psychopathology. This possibility was explored by comparing adult attitudes in two socioculturally different societies. Jamaican and American parents, teachers, and clinicians (total N=382) judged vignettes of two children, one with over controlled (e.g., fearfulness) and one with undercontrolled (e.g., fighting) problems. Regression analyses revealed that although years of education affected some adult ratings, culture had the most profound effect. (AU)

Teacher and parent ratings of behavior problems in Jamaican children and adolescents: convergence and divergence of views

In child assesment, mental health workers often collect behavioral information from parents and teachers. The literature, however, generally indicates low correlations between parent and teacher child problem ratings. One possible explanation is that parents and teachers, in home and school settings, respectively, have disparate opportunities to observe some child problems. Teachers and parents may have equally good opportunities to observe Undercontrolled problems (eg., fighting, lying, disobedience), but teachers may have fewer opportunities to observe overcontrolled problems (e.g., depression, withdrawal, shyness). We explored this possibility, examining parent and teacher reports of overcontrolled and undercontrolled problems in Jamaican children. As expected, when parents and teachers rated overcontrolled problems we generally found nonsignificant correlations and generally significant correlations when they rated Undercontrolled problems. We inferred that because undercontrolled problems are directed outwardly they may be more objectively and similarly observed. Conversely, and thus less concordant judgments (AU)