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Preschoolers' contribution to their diagnosis of depression and anxiety: uses and limitations of young child self-report of symptoms.

Luby JL, Belden A, Sullivan J, Spitznagel E

Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid, Campus Box 8134, St. Louis, MO 63110, USA. lubyj@psychiatry.wustl.edu

BACKGROUND: The assessment of psychopathology in preschool aged children has traditionally relied exclusively on adult informants as children under 6 years-of-age have been widely regarded as developmentally unable to serve as valid reporters of their own mental state. Based on the finding of a valid preschool depressive syndrome, methods to obtain self-report of symptoms of depression and related anxiety directly from the child are now needed. METHODS: The Berkeley Puppet Interview (BPI), a novel measure of psychopathology designed for the young child informant, was administered to N = 110 preschool study subjects aged 4.0-5.6 who participated in a comprehensive assessment of preschool depression. Parents filled out the Child Behavioral Checklists (CBCL) and the diagnosis was derived using parent report on the Diagnostic Interview Schedule for children, version IV (DISC-IV-YC) at baseline and 6 months later. RESULTS: Findings suggest that young children may serve as useful reporters of several core and basic symptoms of depression and anxiety based on significant correlations with a variety of parent report measures administered concurrently and 6 months later. However, no significant correlations were found between preschool reports of more complex or abstract symptoms. CONCLUSION: These findings taken together suggest that the young child can validly self-report on some key aspects of depression and anxiety and that self-report of young children should be sought in these domains. Findings also suggested that these self-reports are limited to the core and basic symptoms of these disorders and that direct age appropriate approaches may not be useful beyond that domain.

Published 12 October 2007 in Child Psychiatry Hum Dev, 38(4): 321-38.
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