Search

This study examines the psychometric properties of the Autism Diagnostic Interview-Revised (ADI-R) in the context of DSM-5 in a sample of Chinese children. Using re-mapped ADI-R items and algorithms matched to DSM-5 criteria, and administering to children with autism spectrum disorder (ASD) with and without intellectual disability, attention-deficit hyperactivity disorder, and typically developing, it evidenced high sensitivity and specificity. However, similar to DSM-IV algorithm, the DSM-5 algorithms were better at classifying ASD among children with intellectual disability than among those without intellectual disability. With the DSM-5's recognition of the spectrum nature of ASD, the performance of the ADI-R can be improved by having finer gradations in the ADI-R scoring and adding more items on the restricted and repetitive behavior domain.

The Hong Kong Chinese version of the Autism-Spectrum Quotient-Child and Autism-Spectrum Quotient-Adolescent were examined for their psychometric properties and specificity on screening autism spectrum disorder against attention-deficit/hyperactivity disorder. This study recruited three groups of participants: typically developing children; children with autism spectrum disorder and children with attention-deficit/hyperactivity disorder. Both the Autism-Spectrum Quotient questionnaires demonstrated satisfactory psychometric properties in terms of internal consistency, test-retest reliability and area under receiver operating characteristics curve in discriminating the autism spectrum disorder group from the attention-deficit/hyperactivity disorder and typically developing groups, separately and jointly. The optimal cutoff scores for both the Autism-Spectrum Quotient questionnaires were identified to be 76, with satisfactory sensitivity and specificity, for differentiating the autism spectrum disorder group from the typically developing group and from the typically developing and attention-deficit/hyperactivity disorder groups combined. On the contrary, both Autism-Spectrum Quotient questionnaires could not effectively differentiate the attention-deficit/hyperactivity disorder group from the typically developing group, or in other words, they did not misclassify attention-deficit/hyperactivity disorder as autism spectrum disorder because of their phenotypic overlap in social difficulties. These findings supported that both the Autism-Spectrum Quotient questionnaires were not general measures of child and adolescent psychopathology, but could claim to be more specific measures of autism spectrum disorder, given their success in identifying the autism spectrum disorder group from the attention-deficit/hyperactivity disorder/typically developing groups, while failing to differentiate the latter two groups.

The Autism-Spectrum Quotient-Adult (AQ-Adult) is a screening tool for adults with autism spectrum disorder (ASD). The present study examined the psychometric properties of the Chinese self- and parent-report versions of the AQ-Adult in Hong Kong (AQ-Adult-HK). Participants included adults with ASD (n = 27) and community controls (n = 345). Parents of a subset of adults with ASD (n = 21) and controls (n = 87) also participated as informants. The parent-report version showed significantly stronger psychometric properties, including a larger area under receiver operating characteristic curve (AUC) and higher sensitivity/specificity, than those of the self-report version. The stronger psychometric properties of the former were related to its significantly higher ratings of ASD symptoms in the ASD adults.

Autism spectrum disorder (ASD) is a disorder with high levels of co-morbidities. The Developmental, Dimensional and Diagnostic Interview (3Di) is a relatively new instrument designed to provide dimensional as well as categorical assessment of autistic behaviours among children with normal intelligence. Its sound psychometric properties and relatively short administration time make it a versatile instrument. The 3Di was translated into Chinese (Cantonese) and its applicability among 194 clinic children was examined. Results found excellent reliability and validity, and achieved a sensitivity of 95% and specificity of 77%. It was able to capture the diagnosis of ASD among children presenting with attention deficit hyperactivity disorder. However, although the disorder of ASD is considered universal, the use of a western instrument in a Chinese context should also take note of cultural influences that may impact on the manifestation of its symptoms.

Objective: Unlike rating scales that focus on the severity of ADHD symptoms, the Strengths and Weaknesses of ADHD-Symptoms and Normal-Behaviors (SWAN) rating scale is phrased in neutral or positive terms for carers to compare the index child's behaviors with that of their peers. This study explores its psychometric properties when applied to Chinese children in Hong Kong. Method: Ratings from the Chinese SWAN scale collected from parents and teachers of a community sample of 3,722 6- to 12-year-old students recruited by stratified random sampling were compared with 247 clinic children with a diagnosis of ADHD. Reliability, validity, factor structure, and cutoff scores were calculated. Results: Favorable psychometrics and a two-factor structure identical to the original were reproduced. Cutoff scores were supported by satisfactory sensitivities and specificities. Conclusion: The SWAN scale is a reliable and valid instrument for the assessment of ADHD symptoms in Chinese children in Hong Kong. (Contains 4 tables.)

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. (Contains 5 tables and 1 figure.)

This study tested societal effects on caregiver/teacher ratings of behavioral/emotional problems for 10,521 preschoolers from 15 societies. Many societies had problem scale scores within a relatively narrow range, despite differences in language, culture, and other characteristics. The small age and gender effects were quite similar across societies. The rank orders of mean item ratings were similar across diverse societies. For 7,380 children from 13 societies, ratings were also obtained from a parent. In all 13 societies, mean Total Problems scores derived from parent ratings were significantly higher than mean Total Problems scores derived from caregiver/teacher ratings, although the size of the difference varied somewhat across societies. Mean cross-informant agreement for problem scale scores varied across societies. Societies were very similar with respect to which problem items, on average, received high versus low ratings from parents and caregivers/teachers. Within every society, cross-informant agreement for item ratings varied widely across children. In most respects, results were quite similar across 15 very diverse societies. (Contains 5 tables and 1 figure.)

Preschool children have long been a neglected population in the study of psychopathology. The Achenbach System of Empirically Based Assessment (ASEBA), which includes the Child Behavior Checklist/1.5-5 (CBCL/1.5-5) and the Caregiver-Teacher Report Form (C-TRF), constitutes the few available measures to assess preschoolers with an empirically derived taxonomy of preschool psychopathology. However, the utility of the measures and their taxonomy of preschool psychopathology to the Chinese is largely unknown and has not been studied. The present study aimed at testing the cross-cultural factorial validity of the CBCL/1.5-5 and C-TRF, as well as the applicability of the taxonomy of preschool psychopathology they embody, to Mainland Chinese preschoolers. Country effects between our Chinese sample and the original U.S. sample, gender differences, and cross-informant agreement between teachers and parents were also to be examined. A Chinese version of the CBCL/1.5-5 and C-TRF was completed by parents and teachers respectively on 876 preschoolers in Mainland China. Confirmatory factor analysis (CFA) confirmed the original, U.S.-derived second order, multi-factor model best fit the Chinese preschool data of the CBCL/1.5-5 and C-TRF. Rates of total behavior problems in Chinese preschoolers were largely similar to those in American preschoolers. Specifically, Chinese preschoolers scored higher on internalizing problems while American preschoolers scored higher on externalizing problems. Chinese preschool boys had significantly higher rates of externalizing problems than Chinese preschool girls. Cross-informant agreement between Chinese teachers and parents was relatively low compared to agreement in the original U.S. sample. Results support the generalizability of the taxonomic structure of preschool psychopathology derived in the U.S. to the Chinese, as well as the applicability of the Chinese version of the CBCL/1.5-5 and C-TRF.

International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1 1/2-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; "Diagnostic and Statistical Manual of Mental Disorders"-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0-198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes less than 1%). Across all pairs of societies, correlations between mean item ratings averaged 0.78, and correlations between internal consistency alphas for the scales averaged 0.92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies. (Contains 4 tables and 1 figure.)

Objective: To test the fit of a seven-syndrome model to ratings of preschoolers' problems by parents in very diverse societies. Method: Parents of 19,106 children 18 to 71 months of age from 23 societies in Asia, Australasia, Europe, the Middle East, and South America completed the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Confirmatory factor analyses were used to test the seven-syndrome model separately for each society. Results: The primary model fit index, the root mean square error of approximation (RMSEA), indicated acceptable to good fit for each society. Although a six-syndrome model combining the Emotionally Reactive and Anxious/Depressed syndromes also fit the data for nine societies, it fit less well than the seven-syndrome model for seven of the nine societies. Other fit indices yielded less consistent results than the RMSEA. Conclusions: The seven-syndrome model provides one way to capture patterns of children's problems that are manifested in ratings by parents from many societies. Clinicians working with preschoolers from these societies can thus assess and describe parents' ratings of behavioral, emotional, and social problems in terms of the seven syndromes. The results illustrate possibilities for culture-general taxonomic constructs of preschool psychopathology. Problems not captured by the CBCL/1.5-5 may form additional syndromes, and other syndrome models may also fit the data. (Contains 2 tables and 1 figure.)

Background: Psychometric properties of the Chinese version of CBCL, TRF, and YSR were understudied. This study aimed at examining their test-retest reliability and criterion validity. Methods: Three Chinese community and clinic samples were recruited in Hong Kong. The parents, teachers, and youths respectively completed the CBCL, TRF, and YSR. Results: The Chinese CBCL, TRF, and YSR were test-retest reliable and valid. However, there was score/case attenuation at retest. CBCL and TRF appeared to screen externalizing and ADHD problems better, while YSR screened internalizing problems better. Conclusions: Clinicians should be cautious about score/case attenuation at retest while using CBCL, TRF, and YSR to chart patients' progress. They should also recognize their different strengths in screening various disorders.

Surveyed Hong Kong high schoolers to test model stipulating motivational orientations as mediators between parenting styles and self-perceived academic competence: authoritarian parenting leading to extrinsic motivation, authoritative parenting to intrinsic motivation, and neglectful parenting to amotivation, and each motivation in turn related to self-perceived academic competence. Results largely supported model but with extra pathway from authoritarian parenting to amotivation. (EV)

The current study aimed at testing and developing alternative short versions of autism spectrum quotient (AQ‐10) (adult [self‐report], adult [parent‐report], adolescent, and child versions) for use in Hong Kong. First, the various versions of AQ‐10 developed in the United Kingdom (the AQ‐10‐UK) were applied to Hong Kong Chinese samples and demonstrated satisfactory discriminative power (AUCs 0.77–0.94). Second, the Hong Kong Chinese versions of AQ‐10 (AQ‐10‐HK) were developed, using the same methodology as in the original UK study. There were some changes in the choice of items and cut‐offs. The AQ‐10‐HK demonstrated slightly greater discriminative power (AUCs 0.88–0.97) to that of the AQ‐10‐UK, but the differences in AUCs were not statistically significant. Compared to the corresponding full‐length versions, both the UK and HK short forms did not seem to lose any significant discriminative power. Yet, the various versions of AQ, be they the full‐length or AQ‐10, appeared to consistently exhibit slightly smaller AUCs with the Hong Kong Chinese samples than with the UK samples. So, this study found both cross‐cultural similarities and differences. The AQ‐10‐HK was recommended for local practice to maximize the advantage gained. Yet, for international multi‐site research collaboration, involving the UK and HK, the original AQ‐10‐UK can be used for direct comparison of data. Lay Summary: The short autism‐spectrum quotient is a screening questionnaire on autistic symptoms. The Hong Kong version is only slightly better than the UK version so that both versions are in fact applicable in Hong Kong. Clinicians may opt for the Hong Kong version in local practice while the UK version may facilitate international comparison, for example, between UK and HK. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia (SCZ) is a heterogeneous psychiatric disorder, with significant contribution from genetic factors particularly for chronic cases with negative symptoms and cognitive deficits. To date, Genome Wide Association Studies (GWAS) and exome sequencing have associated SCZ with a number of single nucleotide polymorphisms (SNPs) and copy number variants (CNVs), but there is still missing heritability. Medium-sized structural variants (SVs) are difficult to detect using SNP arrays or second generation sequencing, and may account for part of the missing heritability of SCZ. Aims and objectives: To identify SVs associated with severe chronic SCZ across the whole genome. Study design: 10 multiplex families with probands suffering from chronic SCZ with negative symptoms and cognitive deficits were recruited, with all their affected members demonstrating uni-lineal inheritance. Control subjects comprised one affected member from the affected lineage, and unaffected members from each paternal and maternal lineage. Methods: Third generation sequencing was applied to peripheral blood samples from 10 probands and 5 unaffected controls. Bioinformatic tools were used to identify SVs from the long sequencing reads, with confirmation of findings in probands by short-read Illumina sequencing, Sanger sequencing and visual manual validation with Integrated Genome Browser. Results: In the 10 probands, we identified and validated 88 SVs (mostly in introns and medium-sized), within 79 genes, which were absent in the 5 unaffected control subjects. These 79 genes were enriched in 20 biological pathways which were related to brain development, neuronal migration, neurogenesis, neuronal/synaptic function, learning/memory, and hearing. These identified SVs also showed evidence for enrichment of genes that are highly expressed in the adolescent striatum. Conclusion: A substantial part of the missing heritability in SCZ may be explained by medium-sized SVs detectable only by third generation sequencing. We have identified a number of such SVs potentially conferring risk for SCZ, which implicate multiple brain-related genes and pathways. In addition to previously-identified pathways involved in SCZ such as neurodevelopment and neuronal/synaptic functioning, we also found novel evidence for enrichment in hearing-related pathways and genes expressed in the adolescent striatum. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness is a negative experience arising from a mismatch between perceived and actual social relationships. Several dimensions of loneliness have been suggested, namely intimate, relational and collective loneliness. Loneliness has been linked to poorer mental health, with its co-occurrence with depression, social anxiety, and paranoia most widely reported. While expressions of these symptoms are heterogeneous across individuals in the non-clinical population, it remains unclear how these symptoms co-occur with one another and with various dimensions of loneliness. It is also of interest how trait factors such as core schemas about self/others may moderate these relationships between loneliness and co-occurring symptoms. Methods: A demographically diverse sample of young adults was recruited from multiple sources. The validated sample consisted of 2,089 participants (68.4% female), who completed an online survey consisting of questionnaires assessing levels of multidimensional loneliness, depression, social anxiety, paranoia, core schemas, and demographic characteristics. Latent profile analysis (LPA) was used to identify distinct profiles of loneliness and the three symptoms. Positive and negative core schemas about self and others were modeled as predictors of these profiles. Results: Five distinct profiles were identified. Profile 1 had low levels across all symptoms and dimensions of loneliness (n = 1,273, 60.9%). Profiles 2-5 were elevated on dimensions of loneliness, and were heightened in depression (n = 189, 9.0%), social anxiety (n = 206, 9.9%), paranoia (n = 198, 9.5%), and all symptoms (n = 223, 10.7%), respectively. Relative to Profile 1, the other four profiles scored higher on negative-self (adjusted ORs = 1.36-1.49, ps < 0.001) and negative-other schemas (adjusted ORs = 1.24-1.44, ps < 0.001), and lower on positive-self (adjusted ORs = 0.82-0.85, ps < 0.001) and positive-other schemas (adjusted ORs = 0.81-0.90, ps < 0.001). Conclusion: More marked intimate, relational and collective loneliness were evident across profiles that had heightened depression, social anxiety and/or paranoia, suggesting that loneliness may serve as a general risk factor for these psychopathologies. Our findings shed light on the heterogeneity of the cooccurrence of loneliness and various mental health difficulties in non-clinical young adults. Core schemas are suggested to be putative psychological mechanisms underlying their co-occurrence and even development. [ABSTRACT FROM AUTHOR]