Psychosocial assessments for young people: a systematic review examining acceptability, disclosure and engagement, and predictive utility

Abstract

Adolescence and young adulthood are often turbulent periods in a person’s life. There are high rates of accidental deaths, suicide, mental health concerns, substance use, and sexual experimentation. Health care professionals need to conduct holistic assessments of clients in these developmental life stages to identify psychosocial risks and provide targeted early intervention and implement prevention strategies. The most useful psychosocial assessments for most health care professionals are those that can provide a complete picture of the young person’s life and circumstances. This article identifies psychosocial assessment instruments that can be used as an initial assessment and engagement tool with the general population of young people presenting for health care. We review the psychometric properties of each of the instruments, determining what type of instrument is most acceptable to young people, whether any can increase disclosure and improve engagement between young people and health professionals, and whether they have predictive utility. The search strategy complied with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 89 published articles were identified, covering 31 different assessment instruments. Results indicated that those that were self-administered were most acceptable to young people, although it is unclear whether pen-and-paper or computer formats were preferred. Most psychosocial assessments can improve rates of disclosure and enhance engagement between young people and health professionals; however, worryingly, we found evidence that clinicians did not always respond to some of the most serious identified risks. Only for one instrument was there any mention of predictive utility. Future research should employ longitudinal approaches to determine the predictive utility of psychosocial assessments and focus on whether the use of new technologies can improve rates of disclosure.

Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare

“…Although this entirely verbal assessment is widely utilized, young people are generally more accepting of psychosocial assessment tools that are initially self-administered in a questionnaire format [11]. This preference for self-administered tools exists because they provide young people with increased control over the help-seeking and treatment process by allowing them to identify the areas they most want to focus on and to structure their thoughts prior to the face-to-face clinical interview [12] [13].…”

Healthcare transition in pediatric liver transplantation: The perspectives of pediatric and adult healthcare professionals

“…It is recommended that HCPs providing regular follow-up implement the use of routine psychosocial screening tools in clinical practice to identify additional support needs, personalize care, and engage with young people. 37,38 Such tools also provide a framework with which to discuss psychological, social, and behavioral concerns (for example, HEADSSS 39 and the transition-specific version, THRxEADSS 40 ), and they provide a way to identify and support protective resilient behaviors as well as address problematic behaviors, and in so doing ensure good long-term outcomes. When one such tool was evaluated in adolescents in a general surgical setting, unforeseen mental health issues were identified and addressed.…”

Pathways to romantic relational aggression through adolescent peer aggression and heavy episodic drinking

“…Self-administered assessments tend to produce the highest rates of disclosure, particularly for behavior that is socially undesirable or sensitive in nature (Aquilino, 1994;Bradford & Rickwood, 2012), and thus we employed self-report instruments to examine the study constructs. Utilizing path analytic models with a large community-based sample of Canadian adolescents, we predicted (i) that aggression toward peers (both relational and physical) would be relatively stable during early adolescence; (ii) that early peer aggression would predict romantic relational aggression during emerging adulthood; (iii) that early aggression toward peers would predict heavy episodic drinking during mid-adolescence; (iv) that concurrent heavy episodic drinking would mediate the link between peer aggression and romantic relational aggression; (v) that this mediation effect would hold even controlling for earlier levels of alcohol use; and (vi) that the magnitude of these associations would be stronger for females than males, but would not differ by the age of the participants (12-18 years old at T1; 18-25 years old at T4).…”

“…Utilizing path analytic models with a large community-based sample of Canadian adolescents, we predicted (i) that aggression toward peers (both relational and physical) would be relatively stable during early adolescence; (ii) that early peer aggression would predict romantic relational aggression during emerging adulthood; (iii) that early aggression toward peers would predict heavy episodic drinking during mid-adolescence; (iv) that concurrent heavy episodic drinking would mediate the link between peer aggression and romantic relational aggression; (v) that this mediation effect would hold even controlling for earlier levels of alcohol use; and (vi) that the magnitude of these associations would be stronger for females than males, but would not differ by the age of the participants (12-18 years old at T1; 18-25 years old at T4). Self-administered assessments tend to produce the highest rates of disclosure, particularly for behavior that is socially undesirable or sensitive in nature (Aquilino, 1994;Bradford & Rickwood, 2012), and thus we employed self-report instruments to examine the study constructs.…”