Abstract
The present study investigated the ability of the General Behavior Inventory (GBI) to discriminate between diagnostic groups using youth self-report. One hundred and ninety-seven youths ages 10–17 years presenting at a midwestern urban outpatient clinic specializing in mood disorders completed the GBI as part of the intake process. Diagnoses were determined by a structured clinical interview (K-SADS) administered by either a child and adolescent psychiatrist or a research assistant trained to a high level of interrater reliability (κ > .85). Games–Howell post hoc tests showed that the diagnostic groups significantly differed on the GBI's 2 subscales, Depression and Hypomanic–Biphasic. Logistic regression demonstrated that the scales discriminated between bipolar and disruptive behavior disorders, unipolar and bipolar depression, and mood and disruptive behavior disorders or no diagnosis. Receiver Operating Characteristic (ROC) curves further indicated the good diagnostic efficiency of the scales. Results indicate that the GBI's subscales might aid in making traditionally difficult differential diagnoses, such as between bipolar disorder and Attention Deficit Hyperactivity Disorder (ADHD) and between unipolar and bipolar depression.
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References
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18. Burlington: University of Vermont.
Baldessarini, R. J., & Tondo, L. (2000). Treatment of bipolar disorder. Clinical Reviews and Updates in Neurology and Psychiatry, 2, 9-12.
Biederman, J. (1995). Developmental subtypes of juvenile bipolar disorder. Harvard Review of Psychiatry, 3, 227-230.
Biederman, J. (1998). Resolved: Mania is mistaken for ADHD in prebubertal children. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 1091-1093.
Biederman, J., Russell, R., Soriano, J., Wozniak, J., & Faraone, S. V. (1998). Clinical features of children with both ADHD and mania: Does ascertainment source make a difference? Journal of Affective Disorders, 51, 101-112.
Biederman, J., Wozniak, J., Kiely, K., Ablon, S., Faraone, S., Mick, E., et al. (1995). CBCL clinical scales discriminate prepubertal children with structured interview-derived diagnosis of mania from those with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 464-471.
Bowring, M. A., & Kovacs, M. (1992). Difficulties in diagnosing manic disorders among children. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 611-614.
Brown, R. T., & Sawyer, M. G. (1998). Medications for school-age children: Effects on learning and behavior. New York: Guilford Press.
Carlson, G. A. (1998). Mania and ADHD: Comorbidity or confusion. Journal of Affective Disorders, 51, 177-187.
Chen, W. J., Faraone, S. V., Biederman, J., & Tsuang, M. (1994). Diagnostic accuracy of the Child Behavior Checklist Scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis. Journal of Consulting and Clinical Psychology, 62, 1017-1025.
Clark, D. A., & Bolton, D. (1985). An investigation of two self-report measures of obsessional phenomena in obsessive–compulsive adolescents: Research note. Journal of Child Psychology and Psychiatry and Allied Disciplines, 26, 429-437.
Depue, R. A. (1987). General Behavior Inventory (manual). Minneapolis: University of Minnesota.
Depue, R. A., Krauss, S., Spoont, M. R., & Arbisi, P. (1989). General Behavior Inventory identification of unipolar and bipolar affective conditions in a nonclinical university population. Journal of Abnormal Psychology, 98, 117-126.
Depue, R. A., Slater, J. F., Wolfstetter-Kausch, H., Klein, D., Goplerud, E., & Farr, D. (1981). A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: A conceptual framework and five validation studies. Journal of Abnormal Psychology Monograph, 90, 381-487.
Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4, 272-299.
Findling, R. L., Youngstrom, E. A., Danielson, C. K., DelPorto, D., Papish David, R., Townsend, L., & Calabrese, J. R. (2002). Clinical decision-making using the General Behavior Inventory in juvenile bipolarity. Bipolar Disorders, 4, 34-42.
Fine, S., Moretti, M., Haley, G., & Marriage, K. (1985). Affective disorders in children and adolescents: The dysthymic disorder dilemma. Canadian Journal of Psychiatry, 30, 173-177.
Geller, B., Warner, K., Williams, M., & Zimerman, B. (1998). Prepubertal and young adolescent bipolarity versus ADHD: Assessment and validity using the WASH-U-KSADS, CBCL and TRF. Journal of Affective Disorders, 51, 93-100.
Geller, B., Warner, K., Williams, M., Zimerman, B., Frazier, Z., Beringer, L., et al. (1998). Prepubertal and early adolescent bipolarity differentiate from ADHD by manic symptoms, grandiose delusions, ultra-rapid or ultradian cycling. Journal of Affective Disorders, 51, 81-91.
Giedd, J. N. (2000). Bipolar disorder and attention-deficith/hyperactivity disorder in children and adolescents. Journal of Clinical Psychiatry, 61, 31-34.
Grom-Marnat, G. (1999). Handbook of psychological assessment (3rd ed.). New York: Wiley.
Herjanic, B., Herjanic, M., Brown, F., & Wheatt, T. (1975). Are children reliable reporters? Journal of Abnormal Child Psychology, 3, 41-48.
Horn, J. L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30, 179-185.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980-988.
Klein, D. N., Depue, R. A., & Slater, J. F. (1986). Inventory identification of cyclothymia IX. Validation in offspring of bipolar I patients. Archives of General Psychiatry, 43, 441-445.
Klein, D. N., Dickstein, S., Taylor, E. B., & Harding, K. (1989). Identifying chronic affective disorders in outpatients: Validation of the General Behavior Inventory. Journal of Consulting and Clinical Psychology, 57, 106-111.
Kovacs, M. (1987). Diagnosis of depressive disorders in children: An interim appraisal of the pertinent DSM-III categories. In G. L. Tischler (Ed.), Diagnosis and classification in psychiatry: A critical appraisal of DSM-III (pp. 369-383). New York: Cambridge University Press.
Kraemer, H. C. (2000). Statistical analysis to settle ethical issues? Archives of General Psychiatry, 57, 327-328.
Loeber, R., Green, S. M., & Lahey, B. B. (1990). Mental health professionals' perception of the utility of children, mothers, and teachers as informants on childhood psychopathology. Journal of Clinical Child Psychology, 19, 136-143.
Mallon, J. C., Klein, D. N., Bornstein, R. F., & Slater, J. F. (1986). Discriminant validity of the General Behavior Inventory: An outpatient study. Journal of Personality Assessment, 50, 568-577.
McFall, R. M., & Treat, T. A. (1999). Quantifying the information value of clinical assessment with signal detection theory. Annual Review of Psychology, 50, 215-241.
Pedhazur, E., & Schmelkin, L. P. (1991). Measurement, design, and analysis: An integrated approach. Hillsdale, NJ: Erlbaum.
Richters, J. E. (1992). Depressed mothers as informants about their children: A critical review of the evidence for distortion. Psychological Bulletin, 112, 485-499.
Starfield, B., Powe, N. R., Weiner, J. R., Stuart, M., Steinwachs, D., Scholle, S. H., et al. (1994). Costs vs. quality in different types of primary care settings. JAMA, 272, 1903-1908.
Steinhausen, H., & Metzke, C. W. (2000). Adolescent self-rated depressive symptoms in a Swiss epidemiological study. Journal of Youth and Adolescence, 29, 427-440.
Velicer, W. F. (1976). Determining the number of components from the matrix of partial correlations. Psychometrika, 41, 321-327.
Velicer, W. F., Eaton, C. A., & Fava, J. L. (2000). Construct explication through factor or component analysis. A review and evaluation of alternative procedures for determining the number of factors or components. In R. O. Goffin & E. Helmes (Eds.), Problems and solutions in human assessment: A festschrift to Douglas Jackson at seventy (pp. 41-71). Hillsdale, NJ: Erlbaum.
Weinberger, D. A. (1996). Distorted self-perceptions: Divergent self-reports as statistical outliers in the multimethod assessment of children's social–emotional adjustment. Journal of Personality Assessment, 66, 126-143.
Weller, E. B., Weller, R. A., & Fristad, M. A. (1995). Bipolar disorder in children: Misdiagnosis, underdiagnosis, and future directions. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 709-714.
Winokur, G., Coryel, W., Keller, M., Endicott, J., & Akishal, H. (1993). A prospective follow-up of patients with bipolar and primary unipolar affective disorder. Archives of General Psychiatry, 50, 457-465.
Witt, J., Cavell, T., Heffer, R., Carey, M., & Martens, B. (1988). Child self-report: Interviewing techniques and rating scales. In E. Shapiro & T. Kratochwill (Eds.), Behavioral assessment in schools: Conceptual foundations and practical applications (pp. 384-454). New York: Guilford Press.
Youngstrom, E. A., Findling, R. L., Danielson, C. K., & Calabrese, J. (2001). Discriminant validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory. Psychological Assessment, 13, 267-276.
Youngstrom, E. A., Izard, C., & Ackerman, B. (1999). Dysphoria-related bias in maternal ratings of children. Journal of Consulting and Clinical Psychology, 67, 1-12.
Youngstrom, E. A., Loeber, R., & Stouthamer-Loeber, M. (2000). Patterns and correlates of agreement between parent, teacher, and male youth behavior ratings. Journal of Consulting and Clinical Psychology, 68, 1038-1050.
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Danielson, C.K., Youngstrom, E.A., Findling, R.L. et al. Discriminative Validity of the General Behavior Inventory Using Youth Report. J Abnorm Child Psychol 31, 29–39 (2003). https://doi.org/10.1023/A:1021717231272
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DOI: https://doi.org/10.1023/A:1021717231272