Comparing the psychometric properties of multiple teacher report instruments as predictors of bipolar disorder in children and adolescents

Abstract

The psychometric properties of four teacher report measures and their utility for accurate diagnosis of pediatric bipolar spectrum disorders (BPSDs) were examined. Participants were 191 youth (65% male; 62% African-American; 23% diagnosed with a BPSD), age 5-18 (M=10.16, SD=3.27) years, 70% recruited from a community mental health center and 30% recruited from a mood disorders clinic. Teachers "who knew the child best" were asked to complete the Achenbach Teacher Report Form (TRF) as well as teacher versions of the General Behavior Inventory (T-GBI), the Child Mania Rating Scale (CMRS-T), and the Young Mania Rating Scale (T-YMRS). Teacher response rates and missing data varied significantly depending on the age of the child. Exploratory factor analysis identified stable and interpretable factors; however, receiver operating characteristic (ROC) and logistic regression analyses showed that teacher report measures were not able to discriminate BPSD cases from non-BPSD cases, or from attention deficit hyperactivity disorder (ADHD) cases. Teacher report appears to be insufficiently specific or sensitive to BPSD for clinical diagnostic use, although teacher scales might have research utility.

Diagnostic Efficiency of the Child and Adolescent Symptom Inventory (CASI-4R) Depression Subscale for Identifying Youth Mood Disorders

“…In contrast, 42 of the participants who met criteria for a narrow mood diagnosis and 418 who did not meet criteria had a completed CASI-4R teacher form (460 total). The lower numbers of completed teacher forms are the result of not all teachers returning the form, and this rate of nonresponse is similar to other studies not taking place in a school (Youngstrom, Joseph, & Greene, 2008). Participants without teacher data did not differ in age, sex, number of diagnoses at baseline, or CASI-4R caregiver scores ( p s > .08).…”

Paradigm Shift: Preliminary Clinical Categorization of Ultrahigh Risk for Childhood Bipolar Disorder to Facilitate Studies on Prevention

“…This approach also converges with the data that parental reports on the symptoms necessary for a diagnosis of childhood-onset bipolar illness are more reliable and valid than those from teachers or the young children themselves, [30][31][32] and repeated parental report of symptoms is helpful in making a bipolar diagnosis. 33 Greater reliance on parental evaluations would minimize costs and allow the development of Web-based comparative effectiveness trials.…”

Comparing the CASI-4R and the PGBI-10 M for Differentiating Bipolar Spectrum Disorders from Other Outpatient Diagnoses in Youth

“…Perhaps, similar to Tourette’s Disorder, the school situation has a suppressing effect on manic symptoms that are more unrestrained at home. The poor discriminative performance of teacher report about manic symptoms has been a consistent finding across multiple measures and samples (Youngstrom et al, 2015; Youngstrom, Joseph, & Greene, 2008). At the same time, it is worthwhile for the clinician to inquire in cases where the parent and teacher report diverge extemely: Disagreement can signal situationally specific problems, and cases where parent and teacher agree about the presence of manic symptoms tend to be substantially more impaired (Carlson & Youngstrom, 2003).…”