Toward a Dimensional Assessment of Externalizing Disorders in Children: Reliability and Validity of a Semi-Structured Parent Interview

Ann-Kathrin Thöne; Anja Görtz-Dorten; Paula Altenberger; Christina Dose; Nina Geldermann; Christopher Hautmann; Lea Teresa Jendreizik; Anne-Katrin Treier; Elena von Wirth; Tobias Banaschewski; Daniel Brandeis; Sabina Millenet; Sarah Hohmann; Katja Becker; Johanna Ketter; Johannes Hebebrand; Jasmin Wenning; Martin Holtmann; Tanja Legenbauer; Michael Huss; Marcel Romanos; Thomas Jans; Julia Geissler; Luise Poustka; Henrik Uebel-von Sandersleben; Tobias Renner; Ute Dürrwächter; Manfred Döpfner

doi:10.3389/fpsyg.2020.01840

Toward a Dimensional Assessment of Externalizing Disorders in Children: Reliability and Validity of a Semi-Structured Parent Interview

Front Psychol. 2020 Jul 24:11:1840. doi: 10.3389/fpsyg.2020.01840. eCollection 2020.

Authors

Ann-Kathrin Thöne¹, Anja Görtz-Dorten^{1

2}, Paula Altenberger¹, Christina Dose¹, Nina Geldermann¹, Christopher Hautmann¹, Lea Teresa Jendreizik¹, Anne-Katrin Treier¹, Elena von Wirth¹, Tobias Banaschewski³, Daniel Brandeis^{3

4

5

6}, Sabina Millenet³, Sarah Hohmann³, Katja Becker^{7

8}, Johanna Ketter⁷, Johannes Hebebrand⁹, Jasmin Wenning⁹, Martin Holtmann¹⁰, Tanja Legenbauer¹⁰, Michael Huss¹¹, Marcel Romanos¹², Thomas Jans¹², Julia Geissler¹², Luise Poustka¹³, Henrik Uebel-von Sandersleben¹³, Tobias Renner¹⁴, Ute Dürrwächter¹⁴, Manfred Döpfner^{1

2}

Affiliations

¹ School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
² Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
³ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁴ Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
⁵ Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
⁶ Neuroscience Center Zurich, University and ETH Zürich, Zurich, Switzerland.
⁷ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg, Marburg, Germany.
⁸ Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig University Giessen, Marburg, Germany.
⁹ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
¹⁰ LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany.
¹¹ Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
¹² Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.
¹³ Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
¹⁴ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Tübingen University Hospital, Tübingen, Germany.

Abstract

Objective: This study assesses the reliability and validity of the DSM-5-based, semi-structured Clinical Parent Interview for Externalizing Disorders in Children and Adolescents (ILF-EXTERNAL).

Method: Participant data were drawn from the ongoing ESCAschool intervention study. The ILF-EXTERNAL was evaluated in a clinical sample of 474 children and adolescents (aged 6-12 years, 92 females) with symptoms of attention-deficit/hyperactivity disorder (ADHD). To obtain interrater reliability, the one-way random-effects, absolute agreement models of the intraclass correlation (ICC) for single ICC(1,1) and average measurements ICC(1,3) were computed between the interviewers and two independent raters for 45 randomly selected interviews involving ten interviewers. Overall agreement on DSM-5 diagnoses was assessed using Fleiss' kappa. Further analyses evaluated internal consistencies, item-total correlations as well as correlations between symptom severity and the degree of functional impairment. Additionally, parents completed the German version of the Child Behavior Checklist (CBCL) and two DSM-5-based parent questionnaires for the assessment of ADHD symptoms and symptoms of disruptive behavior disorders (FBB-ADHS; FBB-SSV), which were used to evaluate convergent and divergent validity.

Results: ICC coefficients demonstrated very good to excellent interrater reliability on the item and scale level of the ILF-EXTERNAL [scale level: ICC(1,1) = 0.83-0.95; ICC(1,3) = 0.94-0.98]. Overall kappa agreement on DSM-5 diagnoses was substantial to almost perfect for most disorders (0.38 ≤ κ ≤ 0.94). With some exceptions, internal consistencies (0.60 ≤ α ≤ 0.86) and item-total correlations (0.21 ≤ r _it ≤ 0.71) were generally satisfactory to good. Furthermore, higher symptom severity was associated with a higher degree of functional impairment. The evaluation of convergent validity revealed positive results regarding clinical judgment and parent ratings (FBB-ADHS; FBB-SSV). Correlations between the ILF-EXTERNAL scales and the CBCL Externalizing Problems were moderate to high. Finally, the ILF-EXTERNAL scales were significantly more strongly associated with the CBCL Externalizing Problems than with the Internalizing Problems, indicating divergent validity.

Conclusion: In clinically referred, school-age children, the ILF-EXTERNAL demonstrates sound psychometric properties. The ILF-EXTERNAL is a promising clinical interview and contributes to high-quality diagnostics of externalizing disorders in children and adolescents.

Keywords: ADHD; ODD; externalizing disorders; intraclass correlation coefficient; reliability; structured interview; validity.

Copyright © 2020 Thöne, Görtz-Dorten, Altenberger, Dose, Geldermann, Hautmann, Jendreizik, Treier, von Wirth, Banaschewski, Brandeis, Millenet, Hohmann, Becker, Ketter, Hebebrand, Wenning, Holtmann, Legenbauer, Huss, Romanos, Jans, Geissler, Poustka, Uebel-von Sandersleben, Renner, Dürrwächter and Döpfner.