Skip to main content
SpringerLink
Log in

Assessing Functional Impairment in Youth: Development of the Adolescent Life Interference Scale for Internalizing Symptoms (ALIS-I)

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

This study described the psychometric properties of a self-report measure of functional impairment related to anxiety and depression in adolescents, the Adolescent Life Interference Scale for Internalizing symptoms (ALIS-I). A clinical sample of 266 adolescents and a community sample of 63 adolescents, aged 11 to 18 years (Mean = 14.7, SD = 1.71) completed the ALIS-I and additional measures assessing internalizing problems. Exploratory factor analyses indicated four distinct but correlated factors of life interference related to personal withdrawal/avoidance, peer problems, problems with study/work, and somatic symptoms. Reliability and retest reliability (8–12 weeks) of the total score were high and psychometric properties of the subscales were acceptable. The ALIS-I effectively discriminated between clinical and community control groups, and expected correlations were shown between ALIS-I subscales and other related symptom measures. The ALIS-I is a promising instrument for the assessment of functional impairment related to internalizing disorders in youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. A copy of the full measure can be freely downloaded from: https://mq.edu.au/ceh-resources

References

  1. Polanczyk GV et al (2015) Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365

    Article  PubMed  Google Scholar 

  2. Cummings CM, Caporino N, Kendall PC (2014) Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull 140(3):816–845

    Article  PubMed  Google Scholar 

  3. Rapee RM, Schniering CA, Hudson JL (2009) Anxiety disorders during childhood and adolescence: origins and treatment. Annu Rev Clin Psychol 5:311–341

    Article  PubMed  Google Scholar 

  4. Goodwin RD, Fergusson DM, Horwood L (2004) Early anxious/withdrawn behaviours predict later internalising disorders. J Child Psychol Psychiatry 45(4):874–883

    Article  PubMed  Google Scholar 

  5. Rapee RM et al (2019) Adolescent development and risk for the onset of social-emotional disorders: a review and conceptual model. Behav Res Ther 123:103501

    Article  PubMed  Google Scholar 

  6. Starr LR, Davila J (2008) Differentiating interpersonal correlates of depressive symptoms and social anxiety in adolescence: implications for models of comorbidity. J Clin Child Adolesc Psychol 37(2):337–349

    Article  PubMed  Google Scholar 

  7. Ollendick TH et al (2008) Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders. Clin Psychol Rev 28:1447–1471

    Article  PubMed  Google Scholar 

  8. Young JF, Mufson L, Davies M (2006) Impact of comorbid anxiety in an effectiveness study of interpersonal psychotherapy for depressed adolescents. J Am Acad Child Adolesc Psychiatry 45(8):904–912

    Article  PubMed  Google Scholar 

  9. Gotlib IH, Hammen CL (2008) Handbook of depression. Guilford Press, New York

    Google Scholar 

  10. Schniering CA, Hudson JL, Rapee RM (2000) Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clin Psychol Rev 20(4):453–478

    Article  PubMed  Google Scholar 

  11. Angold A et al (1999) Impaired but undiagnosed. J Am Acad Child Adolesc Psychiatry 38(2):129–137

    Article  PubMed  Google Scholar 

  12. Creswell C et al (2021) Research review: recommendations for reporting on treatment trials for child and adolescent anxiety disorders: an international consensus statement. J Child Psychol Psychiatry 62(3):255–269

    Article  PubMed  Google Scholar 

  13. Rapee RM et al (2012) Conceptualising functional impairment in children and adolescents. J Child Psychol Psychiatry 53:454–468

    Article  PubMed  Google Scholar 

  14. Hoagwood K et al (1996) Outcomes of mental health care for children and adolescents: I. A comprehensive conceptual model. J Am Acad Child Adolesc Psychiatry 35:1055–1063

    Article  PubMed  Google Scholar 

  15. Garber J, Weersing V (2010) Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clin Psychol Sci Pract 17(4):293–306

    Article  Google Scholar 

  16. Seiffge-Krenke I, Klessinger N (2000) Long-term effects of avoidant coping on adolescents’ depressive symptoms. J Youth Adolesc 29:617–630

    Article  Google Scholar 

  17. Pickles A et al (2001) Child psychiatric symptoms and psychosocial impairment: relationship and prognostic significance. Br J Psychiatry 179:230–235

    Article  PubMed  Google Scholar 

  18. Bird HR (1999) The assessment of functional impairment. In: Shaffer D, Lucas CP, Richters JE (eds) Diagnostic assessment in child and adolescent psychopathology. Guilford Press, New York

    Google Scholar 

  19. Bird HR et al (2000) How specific is specific impairment? J Am Acad Child Adolesc Psychiatry 39:1182–1189

    Article  PubMed  Google Scholar 

  20. Bates MP (2001) The child and adolescent functional assessment scale (CAFAS): review and current status. Clin Child Fam Psychol Rev 4:63–84

    Article  PubMed  Google Scholar 

  21. Winters NC, Collett BR, Myers RM (2005) Ten- year review of rating scales, VII: scales assessing functional impairment. J Am Acad Child Adolesc Psychiatry 44:309–338

    Article  PubMed  Google Scholar 

  22. Shaffer D et al (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40(11):1228–1231

    Article  PubMed  Google Scholar 

  23. Bird HR et al (2005) The Brief Impairment Scale (BIS): a multidimensional scale of functional impairment for children and adolescents. J Am Acad Child Adolesc Psychiatry 44:699–707

    Article  PubMed  Google Scholar 

  24. Sparrow SS, Balla DA, Cicchetti DV (1984) Vineland adaptive behavior scales: interview edition, survey form manual. American Guidance Service, Circle Pines

    Google Scholar 

  25. Ratcliffe J et al (2012) An assessment of the construct validity of the CHU9D in the Australian adolescent general population. Qual Life Res 21:717–725

    Article  PubMed  Google Scholar 

  26. Hodges K, Wong MM (1996) Psychometric characteristics of a multidimensional measure to assess impairment: the Child and Adolescent Functional Assessment Scale. J Child Fam Stud 5:445–467

    Article  Google Scholar 

  27. Francis SE, Ebesutani C, Chorpita BF (2012) Differences in levels of functional impairment and rates of serious emotional disturbance between youth with internalizing and externalizing disorders when using the CAFAS or GAF to assess functional impairment. J Emot Behav Disord 20:226–240

    Article  Google Scholar 

  28. Angold A, Costello EJ (2000) The Child and Adolescent Psychiatric Assessment (CAPA). J Am Acad Child Adolesc Psychiatry 39:39–48

    Article  PubMed  Google Scholar 

  29. Schwab-Stone M et al (1996) Criterion vailidity of the NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC 2.3). J Am Acad Child Adolesc Psychiatry 35:878–888

    Article  PubMed  Google Scholar 

  30. Silverman WK, Albano AM (1996) The anxiety disorders interview schedule for children-IV (child and parent versions). Psychological Corporation, San Antonio

    Google Scholar 

  31. Shaffer D et al (1996) The NIMH diagnostic interview schedule for children version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA study. J Am Acad Child Adolesc Psychiatry 35(7):865–877

    Article  PubMed  Google Scholar 

  32. Whiteside SP (2009) Adapting the Sheehan Disability Scale to assess child and adolescent impairment related to childhood anxiety disorders. J Clin Child Adolesc Psychol 38:721–730

    Article  PubMed  Google Scholar 

  33. Langley AK et al (2004) Impairment in childhood anxiety disorders: preliminary examination of the Child Anxiety Impact Scale-Parent Version. J Child Adolesc Psychopharmacol 14:105–114

    Article  PubMed  Google Scholar 

  34. Langley AK et al (2014) The child anxiety impact scale: examining parent- and child-reported impairment in child anxiety disorders. J Clin Child Adolesc Psychol 43(4):579–591

    Article  PubMed  Google Scholar 

  35. Lyneham HJ et al (2013) Psychometric properties of the Child Anxiety Life Interference Scale (CALIS). J Anxiety Disord 27(7):711–719

    Article  PubMed  Google Scholar 

  36. Gilbertson TJ et al (2017) Psychometric properties of the child anxiety life interference scale: preschool version. J Anxiety Disord 52:62–71

    Article  PubMed  Google Scholar 

  37. Foddy W (1993) Constructing questions for interviews and questionnaires. Cambridge University Press, Cambridge

    Book  Google Scholar 

  38. Silverman WK, Saavedra LM, Pina AA (2001) Test-retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40(8):937–943

    Article  PubMed  Google Scholar 

  39. Hudson JL et al (2014) The impact of brief parental anxiety management on child anxiety treatment outcomes: a controlled trial. J Clin Child Adolesc Psychol 43(3):370–380

    Article  PubMed  Google Scholar 

  40. Lyneham HJ, Abbott MJ, Rapee RM (2007) Inter-rater reliability of the anxiety disorders interview schedule for DSM-IV: child and parent version. J Am Acad Child Adolesc Psychiatry 46(6):731–736

    Article  PubMed  Google Scholar 

  41. Nauta MH et al (2004) Development of a parent report measure of children’s anxiety: psychometric properties and comparison with child report in a clinic and normal sample. Behav Res Ther 42:813–839

    Article  PubMed  Google Scholar 

  42. Spence SH (1998) A measure of anxiety symptoms among children. Behav Res Ther 36(5):545–566

    Article  PubMed  Google Scholar 

  43. Radloff LS (1977) The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  44. Mojarred Y, Lennings CJ (2002) Examination of the Centre for Epidemiological Studies Depression Scale (CES-D) in an adolescent mental health sample. J Appl Health Behav 4:1–6

    Google Scholar 

  45. Watson D, Clark LE, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS Scales. J Pers Soc Psychol 54:1063–1070

    Article  PubMed  Google Scholar 

  46. Lonigan CJ, Phillips BM, Hooe ES (2003) Relations of positive and negative affectivity to anxiety and depression in children: evidence from a latent variable longitudinal study. J Consult Clin Psychol 71(3):465–481

    Article  PubMed  Google Scholar 

  47. Wuthrich VM et al (2012) A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety. J Am Acad Child Adolesc Psychiatry 51(3):261–270

    Article  PubMed  Google Scholar 

  48. Schniering CA, Rapee RM (2020) Evaluation of a transdiagnostic treatment for adolescents with comorbid anxiety and depression. J Affect Disord Rep 2:100026

    Article  Google Scholar 

  49. Rapee RM et al (2006) The cool kids® child and adolescent anxiety program therapist manual. Centre for Emotional Health, Macquarie University, , Sydney

    Google Scholar 

  50. Kazdin AE, Weisz JR (1998) Identifying and developing empirically supported child and adolescent treatments. J Consult Clin Psychol 66:19–36

    Article  PubMed  Google Scholar 

  51. Clarke GN et al (1999) Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. J Am Acad Child Adolesc Psychiatry 38:272–279

    Article  PubMed  Google Scholar 

  52. Ehrenreich-May J et al (2018) The unified protocols for the transdiagnostic treatment of emotional disorders in children and adolescents: therapist guide. Oxford University Press, New York

    Google Scholar 

  53. Ehrenreich-May J et al (2017) An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. J Anxiety Disord 46:46–55

    Article  PubMed  Google Scholar 

  54. Queen AH, Ehrenreich-May J, Hershorin ER (2012) Preliminary validation of a screening tool for adolescent panic disorder in pediatric primary care clinics. Child Psychiatry Hum Dev 43:171–183

    Article  PubMed  Google Scholar 

  55. Hayes AF, Coutts JJ (2020) Use omega rather than Cronbach’s alpha for estimating reliability. But…. Commun Methods Meas 14(1):1–24

    Article  Google Scholar 

  56. Enders CK (2011) Analyzing longitudinal data with missing values. Rehabil Psychol 56:267–288

    Article  PubMed  Google Scholar 

  57. Storch EA et al (2010) Predictors of functional impairment in pediatric obsessive-compulsive disorder. J Anxiety Disord 24(2):275–283

    Article  PubMed  Google Scholar 

  58. Somerville LH (2013) The teenage brain: sensitivity to social information. Curr Dir Psychol Sci 22:121–127

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia

    Carolyn A. Schniering, Miriam K. Forbes, Ronald M. Rapee & Viviana M. Wuthrich

  2. Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA

    Carolyn A. Schniering & Jill Ehrenreich-May

  3. Department of Psychology, Tufts University, 490 Boston Avenue, Medford, MA, USA

    Alexander H. Queen

Authors
  1. Carolyn A. Schniering
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miriam K. Forbes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ronald M. Rapee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Viviana M. Wuthrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alexander H. Queen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jill Ehrenreich-May
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Carolyn A. Schniering or Ronald M. Rapee.

Ethics declarations

Conflict of interest

The authors report no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schniering, C.A., Forbes, M.K., Rapee, R.M. et al. Assessing Functional Impairment in Youth: Development of the Adolescent Life Interference Scale for Internalizing Symptoms (ALIS-I). Child Psychiatry Hum Dev 54, 508–519 (2023). https://doi.org/10.1007/s10578-021-01241-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-021-01241-3

Keywords

Search

Navigation