Where’s the need? the use of specialist mental health services in adolescence and young
adulthood
Raven, Dennis
DOI:10.33612/diss.116938522
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Publication date: 2020
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Raven, D. (2020). Where’s the need? the use of specialist mental health services in adolescence and young adulthood. University of Groningen. https://doi.org/10.33612/diss.116938522
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A pp en dix T ab le A 2. 1. H az ar d r ati o e sti m at es f ro m c ox r eg re ss io n a na ly se s o f T 1 Y SR D SM -IV p ro bl em b eh av io r o n a ge o f o ns et o f D SM -IV d iso rd er s af te r T1 b y cl ass a, b A ny m oo d di sor de r A ny a nx ie ty di sor de r A ny b eh av ior di sor de r# A ny s ub st an ce de pe nde nc e H R 95 % C I H R 95 % C I H R 95 % C I H R 95 % C I YS R D SM -I V p ro bl em b eh av io r c, d Aff ec tive ( re f = n or m al r an ge ) 1. 76 ** (1 .12 -2 .7 6) 1. 70 ~ (0 .6 4-3 .0 0) 0. 45 (0 .16 -1 .2 7) 1. 95 * (1 .11 -3 .4 3) An xi et y ( re f = n or m al r an ge ) 1. 78 ~ (0 .9 9-3. 19 ) 0. 13 (0 .11 -1 .63 ) 0. 86 (0 .19 -3 .9 9) 0. 84 (0 .3 6-1 .9 8) An xi et y * T im e 1. 41 * (1. 03 -1 .9 5) So m at ic ( re f = n or m al r an ge ) 1. 03 (0 .7 6-1 .3 9) 1. 36 ~ (0 .9 6-1.9 5) 1.15 (0 .7 2-1. 85) 1. 27 (0 .8 4-1 .9 4) At te nt io na l ( re f = n or m al r an ge ) 0.7 3 (0 .3 6-1 .4 9) 0. 80 (0 .33 -1 .9 4) 0. 23 (0 .0 3-1 .6 9) 1. 56 (0. 77 -3 .17 ) O pp os iti on al ( re f = n or m al r an ge ) 0. 91 (0 .4 4-1 .8 9) 1. 40 (0 .5 7-3. 45 ) 2. 59 * (1. 01 -6 .6 2) 1. 59 (0 .7 5-3 .3 5) Co nd uc t ( re f = n or m al r an ge ) 0.9 9 (0 .5 9-1.6 4) 0. 58 (0 .2 8-1.2 0) 2. 75 ** (1. 39 -5 .4 4) 1. 78 * (1 .0 2-3.0 9) M od el c harac te ris tic s n 14 81 12 50 13 76 15 20 N um be r o f o ns et s 221 14 5 85 10 7 M od el im pr ove m en t ( ch i-s q; d f) 19 .7 ** 6 22. 0 ** 7 21. 6 ** * 6 40 .1 ** * 6 YS R = Y ou th S el f R ep or t; H R = H az ar d r at io ; C I = C on fid en ce in te rv al ; c hi -s q = Ch i s qu ar ed ; d f = D eg re es o f f re ed om . a D SM -IV h ie ra rc hy r ul es a pp lie d w he re a pp lic ab le . b A ll D SM -IV d iso rd er s w ith a n o ns et o n o r b ef or e T 1 ( ag e= 11 ) w er e e xc lu de d. c Y SR D SM -IV p ro bl em b eh av io r m ea su re d a s d um m y v ar ia bl es in di ca tin g s ub -c lin ic al o r c lin ic al l eve ls o f p ro bl em b eh av io r ( re f = n or m al r an ge ) d Y SR D SM -IV p ro bl em b eh av io r e nt er ed a s t im e in de pe nd en t c ov ar ia te s. I f t he p ro po rt io na l h az ar ds a ss um pt io n w as v io la te d in te ra ct io ns w ith t im e c en te re d o n a ge 1 1 (m ea n a ge a t T 1) w er e a dd ed . # B eh av io r d iso rd er s d o n ot in clu de A D H D b ec au se t he y w er e e xc lu de d d ue t o t he ir o ns et p rio r t o b as elin e ~ p< 0. 10 * p< 0. 05 * * p< 0. 01 * ** p< 0. 001
A pp endi x T ab le A 2. 2. H az ar d r ati o e sti m at es f ro m c ox r eg re ss io n a na ly se s o f T 1 C BC L D SM -IV p ro bl em b eh av io r o n a ge o f o ns et o f D SM -IV d iso rd er s a ft er T1 b y cl ass a, b A ny m oo d di sor de r A ny a nx ie ty di sor de r A ny b eh av ior di sor de r# A ny s ub st an ce de pe nde nc e H R 95 % C I H R 95 % C I H R 95 % C I H R 95 % C I CB CL D SM -I V p ro bl em b eh av io r c, d Aff ec tive ( re f = n or m al r an ge ) 1. 46 * (1 .0 1-2. 12 ) 1. 61 * (1 .0 2-2 .5 5) 29. 9 * (1 .3 8-64 7.7 ) 1. 29 (0. 77 -2 .17 ) Aff ec tive * T im e 0. 49 * (0. 27 -0. 91 ) An xi et y ( re f = n or m al r an ge ) 1.1 6 (0 .76 -1 .76 ) 1.15 (0 .6 6-2 .0 0) 0. 85 (0 .3 9-1. 86 ) 21 .12 ~ (0 .9 9-44 8. 85) An xi et y * T im e 0. 70 ~ (0 .48-1. 01 ) So m at ic ( re f = n or m al r an ge ) 0.9 4 (0 .6 6-1 .3 4) 0. 80 (0 .5 0-1 .2 7) 1.19 (0 .6 9-2 .0 5) 1.1 6 (0 .7 2-1. 88) At te nt io na l ( re f = n or m al r an ge ) 1. 28 (0 .8 0-2 .0 4) 0.9 5 (0 .5 0-1 .8 2) 1. 08 (0 .4 9-2 .3 5) 1. 01 (0 .5 2-1 .9 4) O pp os iti on al ( re f = n or m al r an ge ) 0.9 6 (0 .5 6-1.6 5) 0. 88 (0 .4 2-1. 85) 1. 27 (0 .5 8-2. 80 ) 1.17 (0 .5 9-2 .3 4) Co nd uc t ( re f = n or m al r an ge ) 0.9 8 (0 .6 1-1.5 9) 0.9 5 (0 .5 1-1. 80 ) 2. 45 * (1 .31 -4 .6 0) 1. 70 ~ (0 .9 5-3. 06 ) M od el c harac te ris tic s n 14 37 1210 13 37 14 73 N um be r o f o ns et s 211 14 1 83 10 4 M od el im pr ove m en t ( ch i-s q; d f) 9. 8 6 5.9 6 20 .1 ** 7 15 .1 * 7 CB CL = Ch ild B eh av io r Ch ec k L is t; H R = H az ar d r at io ; C I = C on fid en ce in te rv al ; c hi -s q = Ch i s qu ar ed ; d f = D eg re es o f f re ed om . a D SM -IV h ie ra rc hy r ul es a pp lie d w he re a pp lic ab le . b A ll D SM -IV d iso rd er s w ith a n o ns et o n o r b ef or e T 1 ( ag e= 11 ) w er e e xc lu de d. c C BC L D SM -IV p ro bl em b eh av io r m ea su re d a s d um m y v ar ia bl es in di ca tin g s ub -c lin ic al o r c lin ic al l eve ls o f p ro bl em b eh av io r ( re f = n or m al r an ge ) d C BC L D SM -IV p ro bl em b eh av io r e nt er ed a s t im e in de pe nd en t c ov ar ia te s. I f t he p ro po rt io na l h az ar ds a ss um pt io n w as v io la te d in te ra ct io ns w ith t im e c en te re d o n a ge 1 1 (m ea n a ge a t T 1) w er e a dd ed . # B eh av io r d iso rd er s d o n ot in clu de A D H D b ec au se t he y w er e e xc lu de d d ue t o t he ir o ns et p rio r t o b as elin e ~ p< 0. 10 * p< 0. 05 * * p< 0. 01 * ** p< 0. 001
A pp en dix T ab le A 2. 3. O dd s r ati os f ro m b in ar y l og isti c r eg re ss io n a na ly se s o f T 1 Y SR D SM -IV p ro bl em b eh av io r o n D SM -IV d iso rd er s i n th e p as t 1 2 m on th s by cl ass (n =1 ,5 46 ) a A ny m oo d di sor de r A ny a nx ie ty di sor de r A ny b eh av ior di sor de r A ny s ub st an ce de pe nde nc e OR 95 % C I OR 95 % C I OR 95 % C I OR 95 % C I YS R D SM -I V p ro bl em b eh av io r c Aff ec tive ( re f = n or m al r an ge ) 1.1 8 (0 .6 5-2. 13 ) 1. 88 ** (1 .2 0-2 .9 5) 1. 77 ~ (0 .9 7-3. 22 ) 1. 71 (0 .8 5-3 .4 4) An xi et y ( re f = n or m al r an ge ) 2.7 2 ** (1 .3 2-5. 61) 1. 56 (0 .8 2-2 .9 7) 0. 91 (0 .35 -2 .3 4) 1. 03 (0 .3 7-2 .8 7) So m at ic ( re f = n or m al r an ge ) 1. 05 (0 .7 2-1 .5 4) 0.9 9 (0 .7 3-1 .3 3) 1. 39 (0 .9 0-2. 13 ) 1. 47 (0 .8 9-2 .4 4) At te nt io na l ( re f = n or m al r an ge ) 1. 04 (0 .4 7-2 .31 ) 1. 50 (0 .8 2-2. 76 ) 1. 80 (0 .83 -3 .9 0) 2. 29 * (1. 01 -5 .2 2) O pp os iti on al ( re f = n or m al r an ge ) 1. 56 (0 .7 0-3 .4 8) 1.1 0 (0 .5 4-2 .2 5) 0.7 2 (0 .28 -1 .8 5) 1. 34 (0 .51 -3 .51 ) Co nd uc t ( re f = n or m al r an ge ) 1.17 (0 .6 4-2. 15 ) 0. 80 (0 .4 7-1 .3 5) 3. 52 ** * (2 .0 4-6.0 6) 1. 90 ~ (0. 96 -3 .77 ) M od el c harac te ris tic s -2 L og L ik eli ho od 10 03 .7 14 64 .7 75 7.4 58 8. 4 N ag el ke rk e R s qua re 0. 02 2 0. 02 0 0. 065 0. 04 6 M od el im pr ove m en t ( ch i-s q; d f) 16 .3 * 6 18 .9 ** 6 41 .2 ** * 6 23 .7 ** 6 YS R = Y ou th S el f R ep or t; O R = O dd s r at io ; C I = C on fid en ce in te rv al ; c hi -s q = Ch i s qu ar ed ; d f = D eg re es o f f re ed om . a D SM -IV h ie ra rc hy r ul es a pp lie d w he re a pp lic ab le . b Y SR D SM -IV p ro bl em b eh av io r m ea su re d a s d um m y v ar ia bl es in di ca tin g s ub -c lin ic al o r c lin ic al l eve ls o f p ro bl em b eh av io r ( re f = n or m al r an ge ) ~ p< 0. 10 * p< 0. 05 * * p< 0. 01 * ** p< 0. 001
A pp en di x T ab le A 2. 4. O dd s r ati os f ro m b in ar y l og isti c r eg re ss io n a na ly se s o f T 1 C BC L D SM -IV p ro bl em b eh av io r o n D SM -IV d iso rd er s i n t he p as t 1 2 m on th s by cl ass (n =1 ,4 83 ) a A ny m oo d di sor de r A ny a nx ie ty di sor de r A ny b eh av ior di sor de r A ny s ub st an ce de pe nde nc e OR 95 % C I OR 95 % C I OR 95 % C I OR 95 % C I CB CL D SM -I V p ro bl em b eh av io r c Aff ec tive ( re f = n or m al r an ge ) 1. 37 (0 .8 5-2. 21) 1. 70 ** (1 .18 -2 .4 5) 0. 69 (0 .3 8-1.2 7) 1. 39 (0 .7 3-2 .6 4) An xi et y ( re f = n or m al r an ge ) 1. 23 (0 .7 2-2 .0 9) 1. 34 (0 .8 9-2 .0 2) 1. 77 ~ (0 .9 9-3. 19 ) 0. 87 (0 .4 0-1 .9 0) So m at ic ( re f = n or m al r an ge ) 1. 06 (0 .6 8-1. 66) 0.9 4 (0 .6 7-1 .3 4) 1.12 (0 .6 6-1 .8 9) 1. 45 (0 .8 2-2. 56 ) At te nt io na l ( re f = n or m al r an ge ) 1. 48 (0 .8 3-2 .6 2) 1. 47 (0 .9 3-2 .3 2) 3. 83 ** * (2 .17 -6 .7 5) 0. 54 (0 .2 1-1. 42 ) O pp os iti on al ( re f = n or m al r an ge ) 1. 24 (0 .6 5-2. 38 ) 0. 85 (0 .4 9-1. 46 ) 1. 45 (0 .74 -2 .8 8) 1. 28 (0 .5 3-3. 12 ) Co nd uc t ( re f = n or m al r an ge ) 0. 92 (0 .5 0-1.7 1) 0.9 5 (0 .5 9-1.5 4) 1. 30 (0 .6 9-2. 46) 1. 65 (0. 77 -3 .5 1) M od el c harac te ris tic s -2 L og L ik eli ho od 92 6. 5 13 83 .9 68 4. 6 57 5.1 N ag el ke rk e R s qua re 0. 014 0. 02 2 0. 07 3 0. 014 M od el im pr ove m en t ( ch i-s q; d f) 9. 7 6 20 .5 ** 6 42 .5 ** * 6 6.9 6 CB CL = Ch ild B eh av io r c he ck L is t; O R = O dd s r at io ; C I = C on fid en ce in te rv al ; c hi -s q = Ch i s qu ar ed ; d f = D eg re es o f f re ed om . a D SM -IV h ie ra rc hy r ul es a pp lie d w he re a pp lic ab le . b C BC L D SM -IV p ro bl em b eh av io r m ea su re d a s d um m y v ar ia bl es in di ca tin g s ub -c lin ic al o r c lin ic al l eve ls o f p ro bl em b eh av io r ( re f = n or m al r an ge ) ~ p< 0. 10 * p< 0. 05 * * p< 0. 01 * ** p< 0. 001
Appendix Table A3.1. Sample characteristics
PCRNNA CIDIB SampleC
% (SE) % (SE)) % (SE)
Male (ref: female) 48.4 (1.2) 46.0 (1.3) 45.5 (3.5)
Lower educated at T4 (ref: intermediate or high) 7.3 (0.7) 7.9 (0.7) 14.0 (2.5)
Low IQ at T1 (ref: ≥85) 15.6 (0.9) 13.7 (0.9) 21.0 (2.9)
Lower educated parents at T1 (ref: intermediate or high) 22.4 (1.0) 19.7 (1.0) 24.0 (3.1)
High parental psychopathology at T1 (ref: lowest 75%) 19.2 (1.0) 18.1 (1.0) 29.3 (3.3)
High YSR/ASR total problems T1-T4 (ref: 3 or 4 × lowest 75%) 21.4 (1.0) 22.7 (1.1) 46.5 (3.5) High CBCL total problems T1-T3 (ref: 2 or 3 × lowest 75%) 11.5 (0.8) 10.2 (0.8) 33.3 (3.4)
High TCP total problems T1-T3 (ref: 2 or 3 × lowest 75%) 3.8 (0.5) 3.3 (0.5) 10.5 (2.2)
High parental stress T1; T3 (ref: 1 or 2 × lowest 75%) 10.6 (0.8) 9.5 (0.7) 27.9 (3.2)
Poor school performance T1-T3 (ref: 2 or 3 × highest 75%) 14.1 (0.9) 12.5 (0.8) 18.6 (2.8)
Poor physical health T1-T3 (ref: 2 or 3 × highest 75%) 18.0 (0.9) 17.7 (1.0) 11.5 (2.3)
PCRNN = Psychiatric Case Register North Netherlands; CIDI = Composite International Diagnostic Interview; YSR = Youth self-report; ASR = Adult self-report; CBCL = Child behavior checklist; TCP = Teacher checklist of psychopathology
A Based on all TRAILS population cohort participants with consent to match with the PCRNN (n=1698) B Based on all TRAILS population cohort participants who completed the CIDI (n=1584)
C Sample of cases who met all inclusion criteria (see Figure 3.1; n=200)
The representativeness of the sample was examined using descriptive statistics of socioeconomic variables and various types of problem indicator, as shown in Appendix Table A3.1. The data are from the first four assessment waves of TRAILS. The waves ran from March 2001 to July 2002 (T1; N=2230, response rate=76.0%; mean age=11.1 years; SD=0.6 years; 50.8% girls), from September 2003 to December 2004 (T2; n=2149; response rate=96.4%; mean age=13.6 years; SD=0.5 years; 51.0% girls), from September 2005 to August 2007 (T3; n=1816; response rate=81.6%; mean age=16.3 years; SD=0.7 years; 52.3% girls), and from October 2008 to September 2010 (T4; n=1881; response rate=84.3%; mean age=19.1 years; SD=0.6 years; 52.3% girls).
The sample was described using the socioeconomic variables sex (male; reference: female), low IQ (≤84; reference: ≥85) (Silverstein 1975), low parental educational attainment (none through lower secondary; reference: higher secondary through tertiary) (de Winter et
al. 2005), low socioeconomic position (lowest 25%; reference: highest 75%) (Amone-P’Olak et al. 2010), and severe parental psychopathology (highest 25%; reference: lowest 75%)
(Ormel et al. 2005) as assessed at T1, and low educational attainment of the adolescent (primary through lower secondary; reference: higher secondary through tertiary) (Veldman
et al. 2014) assessed at T4. Emotional and behavioral problems were reported by the
adolescents (T1-T4) (Achenbach & Rescorla 2001, 2003), their parents (T1-T3) (Achenbach & Rescorla 2001), and their teachers (T1-T3) (de Winter et al. 2005). Other measures were high parental stress (T1, T3) (Abidin 1990), poor school performance (T1-T3) (de Winter et
al. 2005), and poor physical health (T1-T3). Continuous measures assessed at multiple wave
were combined into one. Respondents who scored in the top 25% of problem levels or parental stress (or bottom 25% of school performance or physical health) at least twice were categorized in the high problem/stress group (or poor performance/health group).
The study sample (n=200) was compared to the total sample of CIDI participants (n=1584) and the total sample of participants who gave consent for linking the TRAILS database to the PCRNN (n=1698). The sample with consent for matching to the PCRNN was largely overlapping with (n=1387), and very similar to the sample of CIDI participants. The sample used to analyze diagnostic agreement (n=200) was characterized by a poorer socioeconomic background and higher levels of psychopathology than the sample with consent for matching to the PCRNN (n=1698) and the sample of CIDI participants (n=1584).
A pp en dix T ab le A 3. 2. R at es o f d iso rd er f ro m th e P sy ch ia tr ic C as e R eg ist er N or th N eth er la nd s th at w er e n ot a va ila bl e i n th e C ID I b y d iso rd er a nd d iso rd er cl as se s f ro m th e C om po sit e I nt er na tio na l D ia gn os tic I nt er vi ew A ll ca se s Sc hi zo ph re ni a (2 95) Pe rv as iv e de ve lo pme nt al di sor de rs (2 99 ) Pe rso nalit y di sor de rs (3 01) Sp ec ial sy mp to ms or sy ndro m es N O S ( 30 7) A dj us tm ent re ac tio n (3 09 ) D is tu rba nc e of e m ot io ns sp ec ifi c t o ch ild . a nd ad ol . ( 313 ) Sp eci fic de la ys i n de ve lo pme nt (3 15 ) M ild m en ta l re tar da tio n (3 17 ) n n ( %) n ( %) n ( %) n ( %) n ( %) n ( %) n ( %) n ( %) N o d isor de rs 49 0 (0 .0 ) 8 ( 16 .3 ) 2 ( 4. 1) 3 ( 6. 1) 1 ( 2) 1 ( 2) 0 (0 .0 ) 2 ( 4. 1) Bi po la r di so rd er 5 0 (0 .0 ) 2 (4 0) 1 (2 0) 0 (0 .0 ) 0 (0 .0 ) 1 (2 0) 0 (0 .0 ) 1 (2 0) M aj or de pr es siv e d isor de r 76 0 (0 .0 ) 8 ( 10 .5 ) 11 ( 14. 5) 8 ( 10 .5 ) 1 ( 1. 3) 11 ( 14. 5) 2 ( 2. 6) 0 (0 .0 ) D ys thy m ia 11 0 (0 .0 ) 1 ( 9.1) 3 ( 27. 3) 2 ( 18 .2 ) 0 (0 .0 ) 2 ( 18 .2 ) 0 (0 .0 ) 0 (0 .0 ) An y m oo d d iso rd er 82 0 (0 .0 ) 10 ( 12. 2) 12 ( 14. 6) 8 (9 .8 ) 1 ( 1. 2) 12 ( 14. 6) 2 ( 2. 4) 1 ( 1. 2) Se pa ra tio n a nx ie ty di so rd er 12 0 (0 .0 ) 0 (0 .0 ) 1 ( 8. 3) 1 ( 8. 3) 0 (0 .0 ) 3 (2 5) 0 (0 .0 ) 0 (0 .0 ) Ad ul t s ep ar at io n a nx ie ty di sor de r 13 1 ( 7.7 ) 1 ( 7.7 ) 3 ( 23. 1) 0 (0 .0 ) 0 (0 .0 ) 4 ( 30 .8) 0 (0 .0 ) 0 (0 .0 ) Agor ap hobi a ( wi th ou t p an ic di sor de r) 6 0 (0 .0 ) 3 (5 0) 1 ( 16 .7 ) 1 ( 16 .7 ) 0 (0 .0 ) 1 ( 16 .7 ) 0 (0 .0 ) 0 (0 .0 ) G en er ali ze d a nx ie ty d iso rd er 11 0 (0 .0 ) 3 ( 27. 3) 0 (0 .0 ) 2 ( 18 .2 ) 0 (0 .0 ) 1 ( 9.1) 0 (0 .0 ) 0 (0 .0 ) O bs es siv e-com pu lsi ve d isor de r 22 1 ( 4. 5) 4 ( 18 .2 ) 2 ( 9.1) 1 ( 4. 5) 0 (0 .0 ) 4 ( 18 .2 ) 1 ( 4. 5) 0 (0 .0 ) Pa ni c d iso rd er 8 1 ( 12. 5) 0 (0 .0 ) 1 ( 12. 5) 0 (0 .0 ) 0 (0 .0 ) 2 (2 5) 1 ( 12. 5) 1 ( 12. 5) So cia l p ho bia 39 0 (0 .0 ) 8 (2 0. 5) 9 ( 23. 1) 2 ( 5. 1) 0 (0 .0 ) 6 ( 15 .4 ) 0 (0 .0 ) 0 (0 .0 ) Sp ec ifi c p ho bia 34 0 (0 .0 ) 4 ( 11 .8 ) 3 ( 8. 8) 3 ( 8. 8) 0 (0 .0 ) 5 ( 14. 7) 0 (0 .0 ) 0 (0 .0 ) An y a nx ie ty d iso rd er 94 2 ( 2. 1) 11 (11 .7 ) 13 (13 .8 ) 6 ( 6. 4) 0 (0 .0 ) 16 (17 ) 1 ( 1.1) 1 ( 1.1) At te nt ion de fic it d isor de r 26 0 (0 .0 ) 5 ( 19 .2 ) 1 ( 3. 8) 0 (0 .0 ) 0 (0 .0 ) 1 ( 3. 8) 1 ( 3. 8) 1 ( 3. 8)
A ll ca se s Sc hi zo ph re ni a (2 95) Pe rv as iv e de ve lo pme nt al di sor de rs (2 99 ) Pe rso nalit y di sor de rs (3 01) Sp ec ial sy mp to ms or sy ndro m es N O S ( 30 7) A dj us tm ent re ac tio n (3 09 ) D is tu rba nc e of e m ot io ns sp ec ifi c t o ch ild . a nd ad ol . ( 313 ) Sp eci fic de la ys i n de ve lo pme nt (3 15 ) M ild m en ta l re tar da tio n (3 17 ) n n ( %) n ( %) n ( %) n ( %) n ( %) n ( %) n ( %) n ( %) O pp os iti on al de fia nt d isor de r 40 1 ( 2. 5) 3 ( 7.5 ) 2 (5 ) 2 (5 ) 1 ( 2. 5) 5 ( 12. 5) 1 ( 2. 5) 0 (0 .0 ) Cond uc t d isor de r 34 0 (0 .0 ) 2 ( 5.9 ) 3 ( 8. 8) 1 ( 2. 9) 1 ( 2. 9) 6 ( 17. 6) 1 ( 2. 9) 0 (0 .0 ) An y b eh av ior d isor de r 66 1 ( 1. 5) 8 ( 12. 1) 3 ( 4. 5) 3 ( 4. 5) 1 ( 1. 5) 8 ( 12. 1) 2 ( 3) 1 ( 1. 5) Al co ho l de pe nde nc e 16 0 (0 .0 ) 3 ( 18 .8 ) 3 ( 18 .8 ) 1 ( 6. 3) 0 (0 .0 ) 2 ( 12. 5) 0 (0 .0 ) 0 (0 .0 ) D rug de pe nde nc e 16 1 ( 6. 3) 1 ( 6. 3) 3 ( 18 .8 ) 0 (0 .0 ) 1 ( 6. 3) 4 (2 5) 0 (0 .0 ) 0 (0 .0 ) An y s ub st anc e de pe nde nc e 28 1 ( 3. 6) 3 ( 10 .7 ) 5 ( 17. 9) 1 ( 3. 6) 1 ( 3. 6) 5 ( 17. 9) 0 (0 .0 ) 0 (0 .0 ) n 20 0 2 28 16 13 3 20 3 4 PC RN N = P sy ch ia tr ic C as e R eg is te r N or th N et he rla nd s; C ID I = C om po sit e I nt er na tio na l D ia gn os tic I nt er vi ew A pp endi x Ta bl e A 3. 2 (C on ti nue d) . R at es o f d iso rd er f ro m th e P sy ch ia tr ic C as e R eg ist er N or th N eth er la nd s th at w er e n ot a va ila bl e i n th e C ID I b y d iso rd er an d d iso rd er c la ss es f ro m th e C om po sit e I nt er na tio na l D ia gn os tic I nt er vi ew
A pp en dix T ab le A 4. 1. C ox re gre ss io n a na ly se s p re di ct in g tim e-to -t reat m en t a w ith a ny h ea lth c ar e p ro fe ss io na l b fo r D SM -IV d iso rd er s b y d iso rd er c la ss a nd an y d iso rd er f or a do le sc en ts w ith ou t a ny d iso rd er o ns et b ef or e 2 00 0 A ny he al th c ar e p ro fe ss io nal b M oo d di sor de rs A nx ie ty di sor de rs Be ha vi or di sor de rs Su bs ta nc e de pe nde nc e A ny di sor de r H R ( 95% CI) H R ( 95% CI) H R ( 95% CI) H R ( 95% CI) H R ( 95% CI) M al e ( re f= fem al e) 0. 81 (0. 5-1. 31 ) 0. 65 (0. 34 -1 .2 5) 1. 33 ( 0. 47 -3. 80 ) 0.7 1 ( 0. 17 -2 .95 ) 0.7 2 ( 0. 50 -1 .0 3) Et hni c m in or ity (r ef = m aj or ity ) 1. 28 (0 .6 7-2. 42 ) 0. 72 ( 0. 26 -2. 01 ) 1. 05 (0 .14 -7 .6 6) – h 1.1 4 ( 0. 68 -1. 92 ) Lo w IQ (re f= hi gh ) 1. 60 ( 0. 72 -3. 57 ) 3. 56 * ( 1.1 8-10 .7 8) 0. 72 (0 .12 -4 .18 ) 4. 51 (0 .5 2-39 .4 6) 1. 63 (0 .8 3-3. 20 ) M id dl e I Q (r ef = hig h) 0. 94 (0. 49 -1 .8 ) 1.9 0 ( 0. 74 -4 .9 1) 0. 40 (0. 10 -1 .5 2) 0. 58 ( 0. 10 -3. 27 ) 1. 21 ( 0. 70 -2. 09 ) Lo w p are nt al S EP (re f= hi gh ) 1.1 4 ( 0. 61 -2 .13 ) 0. 79 (0 .3 5-1. 76 ) 0. 83 ( 0. 23 -2. 99 ) 0. 22 (0 .0 2-2. 86 ) 1.1 7 ( 0. 73 -1. 89 ) M id dl e p ar en ta l S EP ( re f= hi gh ) 1. 32 ( 0. 81 -2. 15 ) 1. 00 (0 .5 3-1. 91 ) 0. 31 (0. 07 -1 .2 9) 0. 94 ( 0. 21 -4. 17 ) 1.1 1 ( 0. 76 -1. 64 ) 0 o r 1 b io lo gi ca l p ar en ts ( re f= bo th ) 1. 06 (0 .6 7-1. 69 ) 0. 89 (0. 46 -1 .7 ) 0. 81 ( 0. 23 -2. 78 ) 0. 28 (0 .0 5-1. 61 ) 1. 08 (0 .7 6-1. 55 ) Se ve re d iso rd er ( re f= m ild ) c 1. 98 ** * ( 1. 33 -2 .9 6) 1.1 5 ( 0. 60 -2 .19 ) 2. 45 (0 .82 -7 .2 9) – c 1. 03 (0 .7 1-1. 50 ) Ag e a t o ns et 1 -5 ( re f= 16 -2 0) – e – e – e – e – e Ag e a t o ns et 6 -1 0 ( re f= 16 -2 0) 0. 49 (0. 19 -1 .2 4) 0. 28 * ( 0. 10 -0. 81 ) 0. 53 (0 .13 -2 .12 ) – i 0. 31 ** * ( 0. 18 -0. 56 ) Ag e a t o ns et 1 1-15 ( re f= 16 -2 0) 0.7 8 ( 0. 50 -1 .2 2) 0. 58 (0. 27 -1 .2 5) – g 3. 21 (0 .8 7-11 .8 6) 0. 53 ** (0. 35 -0. 81 ) Co -m orbi d m oo d d isor de r ( re f= no ) d – f 3. 53 ** * ( 2. 07 -6 .0 2) 1. 87 (0 .6 0-5. 86 ) 5. 87 * ( 1. 34 -2 5. 78 ) 2. 74 ** * ( 1. 86 -4. 04 ) Co -m orbi d a nx ie ty d isor de r ( re f= no ) d 1.1 2 ( 0. 73 -1. 72 ) – f – h 2. 27 (0 .6 2-8. 33 ) 1.1 7 ( 0. 78 -1. 73 ) Co -m orbi d b eh av ior d isor de r ( re f= no ) d 1. 04 ( 0. 51 -2. 12 ) 1. 91 ( 0. 84 -4. 31 ) – f 1. 02 (0 .17 -5 .97 ) 2. 02 ** ( 1.1 9-3. 42 ) Co -m orbi d s ub st anc e de pe nde nc e ( re f= no ) d 1. 82 (0 .9 1-3. 63 ) 0. 72 (0 .2 3-2. 26 ) 1. 76 ( 0. 30 -1 0. 52 ) – f 1. 35 ( 0. 73 -2. 49 ) Ch i-s qua re 25. 9 ( 13 )* 56 .3 (1 3) ** * 11 .1 (11 ) 15 .6 (1 0) 86 .2 (1 4) ** * n ev en ts 10 8 63 22 12 16 3 n ce ns or ed 63 12 8 30 57 201 n to ta l 17 1 19 1 52 69 36 4 D SM -IV = D ia gn os tic a nd S ta tis tic al M an ua l o f M en ta l D iso rd er s, f ou rt h e di tio n; H R = H az ar d r at io ; 9 5% CI = 9 5% c on fid en ce in te rv al ; I Q = in te lli ge nc e q uo tie nt ; S EP = s oc io -ec on om ic p os iti on a T im e-to -t re at m en t f or d iso rd er s w ith in iti al t re at m en t c on ta ct a ft er in iti al s ym pt om s a nd b ef or e t he y ea r o f o ns et o f t he r es pe ct ive f ul l-b lo w n d iso rd er s et t o 0 . b L ife tim e t re at m en t c on ta ct a nd a ge o f in iti al t re at m en t c on ta ct f or a ny h ea lth c ar e p ro fe ss io na l b as ed o n t he C om po sit e I nt er na tio na l D ia gn os tic I nt er vi ew . c A ll s ubs ta nc e d ep en den ce d ia gn os es w er e c on sid er ed s ev er e. d T im e-de pen den t c ov ar ia te . e N o c as es , b ec au se a do le sc en ts w ith a ny d iso rd er o ns et b ef or e 2 00 0 w er e e xc lu de d. f Di sor de r c la ss is th e de pe nde nt v ari ab le . g C om bin ed w ith a ge o f o ns et 1 6-20 y ea rs ( re fe re nc e c at eg or y) d ue t o in su ffi ci en t c as es in t he r ef er en ce c at eg or y. h C ov ar ia te e xc lu de d d ue t o in su ffi ci en t c as es . i C om bin ed w ith a ge o f o ns et 1 1-15 y ea rs d ue t o in su ffi ci en t c as es . * p< .0 5 * * p< .0 1 * ** p< .0 01
A pp en dix T ab le A 4. 2. C ox re gre ss io n a na ly se s p re di ct in g t im e-to -t reat m en t a w ith a ny h ea lth c ar e p ro fe ss io na l b fo r an y s ymp to m b y di so rd er cl ass an d an y di so rd er A ny he al th c ar e p ro fe ss io nal b M oo d di sor de rs A nx ie ty di sor de rs Be ha vi or di sor de rs Su bs ta nc e de pe nde nc e A ny di sor de r H R ( 95% CI) H R ( 95% CI) H R ( 95% CI) H R ( 95% CI) H R ( 95% CI) M al e ( re f= fem al e) 0. 82 (0. 58 -1 .17 ) 0. 80 (0. 58 -1 .11 ) 1. 07 (0 .7 0-1. 64 ) 0. 89 (0. 49 -1 .5 9) 0. 88 (0. 69 -1 .13 ) Et hni c m in or ity (r ef = m aj or ity ) 1. 02 (0 .6 4-1. 64 ) 0. 62 (0. 34 -1 .12 ) 0.7 2 ( 0. 30 -1 .7 2) – h 0. 90 (0 .5 9-1. 36 ) Lo w IQ (re f= hi gh ) 1. 33 (0 .7 2-2. 46 ) 1.1 1 ( 0. 63 -1. 99 ) 1.1 8 ( 0. 46 -2. 98 ) 0. 70 (0. 25 -1 .9 3) 1. 37 ( 0. 85 -2. 21 ) M id dl e I Q (r ef = hig h) 1. 07 (0 .6 5-1. 77 ) 1. 29 ( 0. 80 -2. 08 ) 1. 52 ( 0. 67 -3. 41 ) 0. 83 (0. 37 -1 .8 8) 1. 31 (0 .8 8-1. 93 ) Lo w p are nt al S EP (re f= hi gh ) 1. 32 ( 0. 84 -2. 09 ) 1.1 8 ( 0. 76 -1. 82 ) 1. 22 ( 0. 68 -2. 19 ) 1. 65 ( 0. 81 -3. 36 ) 1. 27 (0 .9 1-1. 77 ) M id dl e p ar en ta l S EP ( re f= hi gh ) 1. 36 (0 .9 3-1. 98 ) 1. 20 (0 .8 3-1. 72 ) 0. 84 (0 .4 9-1.4 5) 1. 23 (0 .63 -2 .4 0) 1.1 8 ( 0. 90 -1. 57 ) 0 o r 1 b io lo gi ca l p ar en ts ( re f= bo th ) 1. 00 (0 .7 3-1. 38 ) 1. 41 * ( 1. 04 -1. 91 ) 1. 23 (0 .7 8-1. 93 ) 1. 53 ( 0. 86 -2. 72 ) 1. 28 * ( 1. 00 -1. 62 ) Se ve re d iso rd er ( re f= m ild ) c 1. 61 ** (1. 20 -2 .17 ) 1. 51 * ( 1. 07 -2 .14 ) 1. 38 ( 0. 90 -2. 13 ) – c 1. 57 ** * ( 1. 22 -2 .0 3) Ag e a t o ns et 1 -5 ( re f= 16 -2 0) – e 0. 22 ** * ( 0. 11 -0. 44 ) 0. 54 * ( 0. 29 -0. 97 ) – i 0. 20 ** * ( 0. 12 -0. 32 ) Ag e a t o ns et 6 -1 0 ( re f= 16 -2 0) 0. 40 ** (0. 22 -0. 73 ) 0. 35 ** (0. 18 -0. 68 ) 0. 42 ** (0. 23 -0. 74 ) – j 0. 26 ** * ( 0. 17 -0. 42 ) Ag e a t o ns et 1 1-15 ( re f= 16 -2 0) 0. 80 (0. 58 -1 .13 ) 0. 59 (0. 32 -1 .0 9) – g 1. 00 (0 .5 5-1. 85 ) 0. 58 ** (0. 39 -0. 87 ) Co -m orbi d m oo d d isor de r ( re f= no ) d – f 4. 97 ** * ( 3. 65 -6 .7 9) 2. 94 ** * ( 1. 81 -4. 78 ) 2. 58 ** ( 1. 45 -4. 59 ) 3. 09 ** * ( 2. 35 -4. 06 ) Co -m orbi d a nx ie ty d isor de r ( re f= no ) d 1.1 8 ( 0. 87 -1. 61 ) – f 1. 59 * ( 1. 05 -2 .4 1) 1. 48 ( 0. 84 -2. 62 ) 1. 09 (0 .8 3-1. 42 ) Co -m orbi d b eh av ior d isor de r ( re f= no ) d 1. 23 (0 .8 4-1. 79 ) 2. 17 ** * ( 1. 53 -3. 06 ) – f 1. 90 * ( 1. 08 -3 .3 5) 1. 49 ** (1. 11 -2 .0 1) Co -m orbi d s ub st anc e de pe nde nc e ( re f= no ) d 1. 68 ( 0. 99 -2. 87 ) 1. 32 ( 0. 73 -2. 40 ) 1. 37 ( 0. 56 -3. 35 ) – f 1. 06 (0 .6 5-1. 73 ) Ch i-s qua re 36 .7 ( 13 )* ** 31 0. 3 ( 14 )* ** 62. 0 ( 13 )* ** 29 .4 (10 )* * 27 6. 2 ( 15 )* ** n ev en ts 19 0 19 9 99 56 31 4 n ce ns or ed 78 23 4 69 53 347 n to ta l 26 8 43 3 16 8 10 9 66 1 D SM -IV = D ia gn os tic a nd S ta tis tic al M an ua l o f M en ta l D iso rd er s, f ou rt h e di tio n; H R = H az ar d r at io ; 9 5% CI = 9 5% c on fid en ce in te rv al ; I Q = in te lli ge nc e q uo tie nt ; S EP = s oc io -ec on om ic p os iti on a T im e-to -t re at m en t f or d iso rd er s w ith in iti al t re at m en t c on ta ct a ft er in iti al s ym pt om s a nd b ef or e t he y ea r o f o ns et o f t he r es pe ct ive f ul l-b lo w n d iso rd er s et t o 0 . b L ife tim e t re at m en t c on ta ct a nd a ge o f in iti al t re at m en t c on ta ct f or a ny h ea lth c ar e p ro fe ss io na l b as ed o n t he C om po sit e I nt er na tio na l D ia gn os tic I nt er vi ew . c A ll s ubs ta nc e d ep en den ce d ia gn os es w er e c on sid er ed s ev er e. d T im e-de pen den t c ov ar ia te . e C om bin ed w ith a ge o f o ns et 6 -1 0 y ea rs d ue t o in su ffi ci en t c as es . f Di sor de r c la ss is th e de pe nde nt v ari ab le . g C om bin ed w ith a ge o f o ns et 1 6-20 y ea rs ( re fe re nc e c at eg or y) d ue t o in su ffi ci en t c as es in t he r ef er en ce c at eg or y. h C ov ar ia te e xc lu de d d ue t o in su ffi ci en t c as es . i C om bin ed w ith a ge o f o ns et 1 1-15 y ea rs d ue t o in su ffi ci en t c as es . * p< .0 5 * * p< .0 1 * ** p< .0 01
Appendix Table A5.1. Descriptive statistics of study variables for three groups of participants: those without case register data, those who did not meet the inclusion criteria, and those who were included in the study.
No register data (1)a Excluded participants (2)b Included participants (3)c Group differences (p<.05)d Mean (SD) or % Mean (SD) or % Mean (SD) or % Sociodemographic covariates Male 51.9 64.1 46.5 1,2,3 Separated parents 32.5 54.7 29.0 1,3
Parental internalizing problems (Z score) 0.55 (0.83) 0.79 (0.86) 0.53 (0.77) 1,3
Parental externalizing problems (Z score) 0.20 (0.51) 0.34 (0.61) 0.10 (0.35) 1,2,3
Parental SEP (Z score) -0.28 (0.80) -0.25 (0.76) 0.06 (0.78) 2,3
Variables used for imputation (assessed at age 11)
Ethnic minority 16.7 7.6 8.6 1,2
Attending special education 8.1 20.0 2.9 1,2,3
Intelligence 93.16 (14.80) 95.72 (16.18) 98.95 (14.61) 2,3 Antisocial behavior 0.36 (0.41) 0.40 (0.41) 0.29 (0.31) 2,3 Family functioning 1.80 (0.37) 1.87 (0.35) 1.75 (0.35) 1,2,3 Social behavior 14.00 (12.21) 25.41 (15.87) 10.75 (9.15) 1,2,3 Affiliation 3.85 (0.59) 3.76 (0.63) 3.90 (0.54) 3 Fear 2.47 (0.77) 2.56 (0.73) 2.39 (0.71) 2,3 Surgency 3.27 (0.98) 3.21 (1.02) 3.34 (0.89) Shyness 2.54 (0.90) 2.44 (0.96) 2.51 (0.87) Effortful control 3.16 (0.66) 2.80 (0.73) 3.30 (0.67) 1,2,3 Academic performance 3.37 (0.93) 3.28 (0.95) 3.76 (0.84) 2,3 Specialist care
Parent-reported specialist care before 2000 12.5 100.0 – 1
Moved out of the region between T1 and 2012 8.2 8.2 8.3
Years between 2000 and specialist care – 3.03 (3.14) 6.52 (3.21) 3
Self-reported problems (YSR/ASR)
Internalizing age 11 0.36 (0.26) 0.39 (0.26) 0.36 (0.23) Internalizing age 13 0.32 (0.25) 0.37 (0.25) 0.33 (0.24) 1,3 Internalizing age 16 0.29 (0.24) 0.40 (0.29) 0.31 (0.24) 1,3 Internalizing age 19 0.24 (0.25) 0.34 (0.29) 0.24 (0.24) 1,3 Externalizing age 11 0.27 (0.20) 0.31 (0.21) 0.27 (0.19) 1,3 Externalizing age 13 0.29 (0.22) 0.31 (0.19) 0.28 (0.19) 3 Externalizing age 16 0.32 (0.20) 0.38 (0.23) 0.31 (0.21) 1,3 Externalizing age 19 0.22 (0.21) 0.32 (0.24) 0.22 (0.20) 1,3 Parent-reported problems (CBCL) Internalizing age 11 0.24 (0.19) 0.35 (0.24) 0.23 (0.19) 1,3 Internalizing age 13 0.21 (0.18) 0.30 (0.22) 0.18 (0.18) 1,2,3 Internalizing age 16 0.20 (0.19) 0.30 (0.23) 0.18 (0.18) 1,3 Externalizing age 11 0.26 (0.21) 0.40 (0.27) 0.22 (0.18) 1,2,3 Externalizing age 13 0.20 (0.20) 0.30 (0.26) 0.15 (0.16) 1,2,3
No register data (1)a Excluded participants (2)b Included participants (3)c Group differences (p<.05)d Mean (SD) or % Mean (SD) or % Mean (SD) or % Externalizing age 16 0.22 (0.23) 0.30 (0.27) 0.15 (0.17) 1,2,3 Teacher-reported problems (TCP) Internalizing age 11 0.40 (0.41) 0.49 (0.42) 0.28 (0.34) 1,2,3 Internalizing age 13 0.45 (0.43) 0.56 (0.49) 0.38 (0.39) 1,2,3 Internalizing age 16 0.49 (0.43) 0.55 (0.39) 0.40 (0.40) 3 Externalizing age 11 0.29 (0.44) 0.40 (0.49) 0.17 (0.33) 1,2,3 Externalizing age 13 0.28 (0.47) 0.36 (0.52) 0.21 (0.40) 2,3 Externalizing age 16 0.42 (0.57) 0.37 (0.50) 0.18 (0.35) 2,3
aRespondents could not be included due to missing consent (n=239), refusal to give consent (n=293), no unique match (n=2) or missing records (n=48).
bRespondents were excluded if parents reported secondary care before 2000 (n=170).
cn=1478.
d1: groups 1 and 2 differ; 2: groups 1 and 3 differ; 3 groups 2 and 3 differ.
eAge 11 represents T1 represents age 11 (mean age 11.1; SD=0.6; age range 10-12 years). fAge 13 represents T2 (mean age 13.6; SD=0.5; age range 12-15 years).
gAge 16 represents T3 (mean age 16.3; SD=0.7; age range 15-17 years). hAge 19 represents T4 (mean age 19.1; SD=0.6; age range 18-20 years).
Abbreviations: ASR=Adult Sell-Report; CBCL=Child Behavior Checklist; SD=standard deviation; SEP=socio-economic position; TCP=Teacher Checklist of Psychopathology; YSR=Youth Self-Report.
Appendix Table A5.1 (Continued). Descriptive statistics of study variables for three groups of participants: those without case register data, those who did not meet the inclusion criteria, and those who were included in the study.
Appendix Table A5.2. Number and percentage of cases with missing values by variable in the raw data.
Cases with missing values
n (%)
Sociodemographic covariates
Male 0 (0.0)
Separated parents 0 (0.0)
Parental internalizing problems (Z score) 71 (3.2)
Parental externalizing problems (Z score) 65 (2.9)
Lowest 25% parental SEP 42 (1.9)
Middle 50% parental SEP 42 (1.9)
Highest 25% parental SEP 42 (1.9)
Self-reported problems (YSR/ASR)
T1 Internalizing 59 (2.6) T2 Internalizing 155 (7.0) T3 Internalizing 588 (26.4) T4 Internalizing 539 (24.2) T1 Externalizing 42 (1.9) T2 Externalizing 138 (6.2) T3 Externalizing 569 (25.5) T4 Externalizing 538 (24.1) Parent-reported problems (CBCL) T1 Internalizing 185 (8.3) T2 Internalizing 328 (14.7) T3 Internalizing 734 (32.9) T1 Externalizing 175 (7.8) T2 Externalizing 305 (13.7) T3 Externalizing 723 (32.4) Teacher-reported problems (TCP) T1 Internalizing 306 (13.7) T2 Internalizing 704 (31.6) T3 Internalizing 1308 (58.7) T1 Externalizing 305 (13.7) T2 Externalizing 693 (31.1) T3 Externalizing 1301 (58.3)
Abbreviations: ASR=Adult Sell-Report; CBCL=Child Behavior Checklist; SEP=socio-economic position; TCP=Teacher Checklist of Psychopathology; YSR=Youth Self-Report.
A pp en di x T ab le A 5. 3. C ox r eg re ss io n a na ly se s p re di cti ng th e eff ec ts o f s ta nd ar di ze d s el f-, p ar en t-, a nd t ea ch er -r ep or te d i nt er na liz in g a nd e xt er na liz in g pr ob le m s o n i ni tia l s pe ci al ist m en ta l h ea lth c ar e u se f ro m l at e c hi ld ho od ( m ea n a ge 9 .4 y ea rs , S D = 0. 6) a th ro ug h e ar ly a du lth oo d ( m ea n a ge 2 1.4 y ea rs , S D = 0. 6) b, fo r s el f-, p ar en t-, a nd t ea ch er -re po rt ed p ro bl em s s ep ar at el y ( le ft th re e c ol um ns ), a nd f or i nt er na liz in g a nd e xt er na liz in g p ro bl em s s ep ar at el y ( rig ht t w o c ol um ns ). Se lf -re por te d prob le m s Pa re nt -re por te d prob le m s Te ac he r-re por te d prob le m s In te rn ali zing prob le m s Ex te rn ali zing prob le m s H R ( 95 % ) P H R ( 95 % ) P H R ( 95 % ) P H R ( 95 % ) P H R ( 95 % ) P So cio de m og rap hic c ov aria te s M al e 2. 88 ( 1. 60 -5 .19 ) < .0 01 2. 91 (1 .6 3-5 .2 0) <. 00 1 3. 06 ( 1. 71 -5 .4 7) < .0 01 3. 09 ( 1. 73 -5 .5 2) < .0 01 2. 78 ( 1. 55 -4. 97 ) < .0 01 M al e × t im e c 0. 84 (0. 77 -0. 92 ) < .0 01 0. 82 (0. 75 -0. 89 ) < .0 01 0. 81 (0. 74 -0. 89 ) < .0 01 0. 84 (0. 77 -0. 92 ) < .0 01 0. 81 (0. 75 -0. 89 ) < .0 01 Se pa ra te d pa re nt s c 1. 56 ( 1. 20 -2. 02 ) < .0 01 1. 50 (1. 15 -1. 95 ) . 00 3 1. 65 ( 1. 27 -2. 14 ) < .0 01 1. 51 (1 .16 -1. 96 ) . 00 2 1. 46 (1. 12 -1. 91 ) . 00 5 Pa re nt al in te rn ali zin g p ro bl em s ( Z s co re ) 1. 26 (1 .13 -1. 40 ) < .0 01 1.1 7 ( 1. 05 -1. 31 ) . 00 5 1. 23 (1. 11 -1. 38 ) < .0 01 1.1 7 ( 1. 05 -1. 31 ) . 00 5 1. 23 (1. 10 -1. 37 ) < .0 01 Pa re nt al e xt er na liz in g p ro bl em s ( Z s co re ) 1. 03 (0 .9 4-1.1 4) .4 82 1. 03 (0 .9 3-1.1 3) .5 81 1. 03 (0 .9 3-1.1 3) .6 10 1. 05 ( 0. 95 -1 .16 ) . 330 1. 00 (0 .9 1-1.1 0) .9 59 Low p ar en tal S EP 1. 81 ( 1. 25 -2. 63 ) . 00 2 1. 65 ( 1.1 3-2. 40 ) . 01 0 1. 54 ( 1. 05 -2. 25 ) . 02 8 1. 62 ( 1.1 1-2. 36 ) . 01 3 1. 62 ( 1.1 1-2. 38 ) . 01 2 M id dl e p ar en ta l S EP 1. 48 ( 1. 07 -2. 05 ) . 01 9 1. 43 (1. 03 -1. 98 ) . 03 2 1. 41 (1. 02 -1. 96 ) . 03 9 1. 45 ( 1. 05 -2. 01 ) . 02 5 1. 43 (1. 03 -1. 98 ) . 03 3 Ag e 1 8-2 1 c 0. 51 (0. 26 -0. 99 ) . 04 5 0. 47 (0. 24 -0. 92 ) . 02 8 0. 44 (0. 23 -0. 86 ) . 01 7 0. 46 (0. 23 -0. 91 ) . 02 5 0. 48 (0. 25 -0. 94 ) . 03 1 Se lf-rep or te d p ro bl em s ( YS R/ A SR ) In te rn ali zin g a ge 1 1 à S pe ci ali st c ar e a ge 1 1-13 d 0. 97 (0 .7 1-1. 31 ) . 828 1. 09 (0 .8 2-1. 44 ) . 56 3 In te rn ali zin g a ge 1 3 à S pe ci ali st c ar e a ge 1 3-16 e 1. 35 (1. 10 -1. 67 ) . 00 4 1.1 3 ( 0. 90 -1 .4 1) . 30 8 In te rn ali zi ng a ge 1 6 à S pe ci ali st c ar e a ge 1 6-19 f 1. 68 ( 1. 37 -2. 07 ) < .0 01 1. 54 (1. 24 -1. 91 ) < .0 01 In te rn ali zi ng a ge 1 9 à S pe ci ali st c ar e a ge 1 9-21 g 1. 48 ( 1. 09 -2. 02 ) . 01 3 1. 82 ( 1. 46 -2. 28 ) < .0 01 Ex te rn ali zin g a ge 1 1 à S pe ci ali st c ar e a ge 1 1-13 d 1. 29 (0 .9 7-1. 71 ) . 07 5 1.1 3 ( 0. 87 -1. 47 ) . 35 3 Ex te rn ali zin g a ge 1 3 à S pe ci ali st c ar e a ge 1 3-16 e 1. 38 (1. 12 -1. 71 ) . 00 3 1. 26 (1 .0 1-1. 59 ) . 04 4 Ex te rn ali zin g a ge 1 6 à S pe ci ali st c ar e a ge 1 6-19 f 1. 22 (0 .9 7-1. 53 ) . 08 9 1. 21 (0 .9 6-1. 52 ) . 10 7 Ex te rn ali zin g a ge 1 9 à S pe ci ali st c ar e a ge 1 9-21 g 1. 38 (0 .9 9-1. 93 ) . 05 8 1. 83 ( 1. 44 -2. 33 ) < .0 01 Pa ren t-rep or te d p ro bl em s ( CB CL ) In te rn ali zi ng a ge 1 1 à S pe ci ali st c ar e a ge 1 1-13 d 0. 82 (0 .6 0-1.1 3) .2 28 0. 89 (0 .6 7-1.1 8) .4 28 In te rn ali zi ng a ge 1 3 à S pe ci ali st c ar e a ge 1 3-16 e 1. 62 (1. 33 -1. 97 ) < .0 01 1. 54 (1 .2 6-1. 87 ) < .0 01 In te rn ali zin g a ge 1 6 à S pe ci ali st c ar e a ge 1 6-19 f 1. 39 (1. 06 -1. 83 ) . 01 9 1. 38 (1. 10 -1. 73 ) . 00 6
Se lf -re por te d prob le m s Pa re nt -re por te d prob le m s Te ac he r-re por te d prob le m s In te rn ali zing prob le m s Ex te rn ali zing prob le m s H R ( 95 % ) P H R ( 95 % ) P H R ( 95 % ) P H R ( 95 % ) P H R ( 95 % ) P Ex te rn ali zin g a ge 1 1 à S pe ci ali st c ar e a ge 1 1-13 d 1. 48 (1 .14 -1. 92 ) . 00 4 1.18 (0 .9 2-1. 51 ) . 20 3 Ex te rn ali zin g a ge 1 3 à S pe ci ali st c ar e a ge 1 3-16 e 1. 21 (0 .9 8-1. 49 ) . 07 1 1. 37 (1. 14 -1. 64 ) < .0 01 Ex te rn ali zin g a ge 1 6 à S pe ci ali st c ar e a ge 1 6-19 f 1. 35 (1. 04 -1. 75 ) . 02 6 1. 52 (1 .2 1-1. 92 ) < .0 01 Tea che r-re por te d p rob le m s ( TC P) In te rn ali zi ng a ge 1 1 à S pe ci ali st c ar e a ge 1 1-13 d 1. 46 (1. 15 -1. 85 ) . 00 2 1. 59 ( 1. 26 -2. 01 ) < .0 01 In te rn ali zin g a ge 1 3 à S pe ci ali st c ar e a ge 1 3-16 e 1. 65 (1. 37 -1. 99 ) < .0 01 1. 37 (1. 10 -1. 70 ) . 00 5 In te rn ali zi ng a ge 1 6 à S pe ci ali st c ar e a ge 1 6-19 f 1. 45 (1. 17 -1. 79 ) < .0 01 1. 26 (0 .9 9-1. 60 ) . 06 3 Ex te rn ali zin g a ge 1 1 à S pe ci ali st c ar e a ge 1 1-13 d 1. 23 (1. 00 -1. 51 ) . 05 3 1. 26 (1 .0 2-1. 56 ) . 03 3 Ex te rn ali zin g a ge 1 3 à S pe ci ali st c ar e a ge 1 3-16 e 1. 24 (1. 04 -1. 49 ) . 01 6 1.1 1 ( 0. 90 -1. 35 ) . 33 4 Ex te rn ali zin g a ge 1 6 à S pe ci ali st c ar e a ge 1 6-19 f 1. 23 (0 .9 9-1. 52 ) . 06 4 1. 03 ( 0. 81 -1 .30 ) . 80 5 aSp ec ia lis t c ar e p rio r t o a ge 1 1 n ot p re di ct ed b y p ro bl em b eh av io r. bSp ec ia lis t c ar e a ft er a ge 1 6 n ot p re di ct ed b y p ar en t- a nd t ea ch er r ep or te d p ro bl em b eh av io r. cTi m e-de pe nde nt pr ed ic tor s. dAg e 1 1 r ep re se nt s T 1 ( m ea n a ge 1 1.1 ; S D = 0. 6; a ge r an ge 1 0-12 y ea rs ). eAg e 1 3 r ep re se nt s T 2 ( m ea n a ge 1 3. 6; S D = 0. 5; a ge r an ge 1 2-15 y ea rs ). fAg e 1 6 r ep re se nt s T 3 ( m ea n a ge 1 6. 3; S D = 0. 7; a ge r an ge 1 5-17 y ea rs ). gAg e 1 9 r ep re se nt s T 4 ( m ea n a ge 1 9.1 ; S D = 0. 6; a ge r an ge 1 8-20 y ea rs ). Ab br ev ia tio ns : A SR =A du lt S el l-R ep or t; C BC L= Ch ild B eh av io r Ch ec kli st ; C I= co nfi de nc e in te rv al ; H R= H az ar d R at io ; S D = st an da rd d ev ia tio n; S EP = so ci o-ec on om ic p os iti on ; TC P= Te ac he r Ch ec kli st o f P sy ch op at ho lo gy ; Y SR =Y ou th S el f-R ep or t. A pp endi x T ab le A 5. 3 ( Con ti nue d) . C ox r eg re ss io n a na ly se s p re di cti ng th e eff ec ts o f s ta nd ar di ze d s el f-, p ar en t-, a nd t ea ch er -r ep or te d i nt er na liz in g a nd ex te rn al iz in g p ro bl em s o n i ni tia l s pe ci al ist m en ta l h ea lth c ar e u se f ro m l at e c hi ld ho od ( m ea n a ge 9 .4 y ea rs , S D = 0. 6) a th ro ug h e ar ly a du lth oo d ( m ea n a ge 2 1. 4 ye ar s, S D = 0.6 ) b, f or s el f-, p ar en t-, a nd t ea ch er -r ep or te d p ro bl em s s ep ar at el y ( le ft th re e c ol um ns ), a nd f or i nt er na liz in g a nd e xt er na liz in g p ro bl em s s ep ar at el y (ri gh t t wo c ol umn s).
Appendix Table A5.4. Cox regression analyses including children with parent-reported secondary care before 2000, predicting the effects of standardized self-, parent-, and teacher-reported internalizing and externalizing problems on initial specialist mental health care use from late childhood (mean age 9.4 years, SD=0.6)a through early adulthood (mean age 21.4 years,
SD=0.6)b, unadjusted (left column) and adjusted for both sociodemographic covariates and (other)
internalizing and externalizing problems at the same time point (right column). Unadjusted
effects
Effects adjusted for sociodemographic covariates and (other) internalizing and externalizing problems at
the same time point HR (95% CI) HR (95% CI) Sociodemographic covariates
Male 3.63 (2.39-5.50) <.001 2.64 (1.46-4.76) .001
Male × timec 0.80 (0.75-0.85) <.001 0.85 (0.78-0.93) <.001
Separated parentsc 2.12 (1.73-2.60) <.001 1.44 (1.10-1.88) .008
Parental internalizing problems (Z score) 1.32 (1.19-1.46) <.001 1.19 (1.06-1.33) .002 Parental externalizing problems (Z score) 1.18 (1.09-1.27) <.001 1.03 (0.93-1.14) .578
Low parental SEP 2.41 (1.77-3.29) <.001 1.48 (1.01-2.19) .045
Middle parental SEP 1.78 (1.35-2.37) <.001 1.40 (1.01-1.95) .043
Age 18-21c 0.54 (0.29-0.99) .047 0.49 (0.25-0.96) .039
Self-reported problem behavior (YSR/ASR; Z score)
Internalizing age 11 à Specialist care age 11-13d 1.10 (0.87-1.38) .433 1.00 (0.71-1.40) .983 Internalizing age 13 à Specialist care age 13-16e 1.52 (1.28-1.79) <.001 1.05 (0.81-1.36) .714 Internalizing age 16 à Specialist care age 16-19f 1.82 (1.53-2.16) <.001 1.63 (1.26-2.11) <.001 Internalizing age 19 à Specialist care age 19-21g 1.96 (1.59-2.43) <.001 1.52 (1.10-2.09) .011 Externalizing age 11 à Specialist care age 11-13d 1.32 (1.08-1.63) .008 1.19 (0.86-1.64) .299 Externalizing age 13 à Specialist care age 13-16e 1.63 (1.39-1.90) <.001 1.27 (0.98-1.65) .075 Externalizing age 16 à Specialist care age 16-19f 1.51 (1.26-1.80) <.001 1.00 (0.75-1.33) .990 Externalizing age 19 à Specialist care age 19-21g 1.75 (1.38-2.20) <.001 1.40 (0.99-1.99) .055
Parent-reported problem behavior (CBCL; Z score)
Internalizing age 11 à Specialist care age 11-13d 1.26 (1.02-1.56) .033 0.75 (0.53-1.08) .122 Internalizing age 13 à Specialist care age 13-16e 1.82 (1.59-2.09) <.001 1.50 (1.13-1.97) .004 Internalizing age 16 à Specialist care age 16-19f 1.89 (1.59-2.26) <.001 1.06 (0.73-1.52) .773 Externalizing age 11 à Specialist care age 11-13d 1.79 (1.51-2.13) <.001 1.35 (0.96-1.90) .089 Externalizing age 13 à Specialist care age 13-16e 1.75 (1.52-2.02) <.001 1.06 (0.79-1.44) .689 Externalizing age 16 à Specialist care age 16-19f 1.82 (1.54-2.16) <.001 1.46 (0.98-2.17) .064
Teacher-reported problem behavior (TCP; Z score)
Internalizing age 11 à Specialist care age 11-13d 1.62 (1.34-1.95) <.001 1.60 (1.23-2.08) <.001 Internalizing age 13 à Specialist care age 13-16e 1.72 (1.46-2.02) <.001 1.37 (1.09-1.73) .008 Internalizing age 16 à Specialist care age 16-19f 1.54 (1.26-1.89) <.001 1.27 (0.98-1.64) .074 Externalizing age 11 à Specialist care age 11-13d 1.55 (1.32-1.81) <.001 1.10 (0.85-1.43) .459 Externalizing age 13 à Specialist care age 13-16e 1.45 (1.24-1.68) <.001 1.14 (0.92-1.42) .228 Externalizing age 16 à Specialist care age 16-19f 1.31 (1.07-1.61) .009 1.10 (0.82-1.48) .511 aSpecialist care prior to age 11 not predicted by problem behavior.
bSpecialist care after age 16 not predicted by parent- and teacher reported problem behavior. cTime-dependent predictors.
dAge 11 represents T1 (mean age 11.1; SD=0.6; age range 10-12 years). eAge 13 represents T2 (mean age 13.6; SD=0.5; age range 12-15 years). fAge 16 represents T3 (mean age 16.3; SD=0.7; age range 15-17 years). gAge 19 represents T4 (mean age 19.1; SD=0.6; age range 18-20 years).
Appendix Table A5.5. Cox regression analyses predicting the effects of standardized self-, parent-, and teacher-reported attention problems, internalizing and externalizing problems on initial specialist mental health care use from late childhood (mean age 9.4 years, SD=0.6)a through
early adulthood (mean age 21.4 years, SD=0.6)b, with attention problems only adjusted for
sociodemographic covariates (left column) and problem scores adjusted for sociodemographic covariates, attention problems, and (other) internalizing and externalizing problems at the same time point (right column).
Attention problems adjusted for sociodemographic covariates Attention problems adjusted for internalizing
and externalizing problems, and sociodemographic covariates HR (95% CI) P HR (95% CI) P Sociodemographic covariates Male 2.64 (1.48-4.71) .001 2.55 (1.41-4.62) .002 Male × timec 0.81 (0.74-0.89) <.001 0.85 (0.77-0.92) <.001 Separated parentsc 1.48 (1.14-1.92) .003 1.41 (1.08-1.85) .011
Parental internalizing problems (Z score) 1.21 (1.09-1.35) <.001 1.19 (1.06-1.33) .003
Parental externalizing problems (Z score) 1.01 (0.92-1.12) .789 1.03 (0.93-1.14) .584
Low parental SEP 1.68 (1.15-2.44) .007 1.47 (1.00-2.16) .049
Middle parental SEP 1.40 (1.01-1.94) .043 1.37 (0.99-1.91) .059
Age 18-21c 0.46 (0.24-0.91) .024 0.49 (0.25-0.96) .038
Self- (YSR/ASR), parent- (CBCL), and teacher-reported (TCP) attention problems
YSR attention age 11 -> Specialist care age 11-13d 1.17 (0.89-1.54) .266 1.14 (0.80-1.64) .472 YSR attention age 13 -> Specialist care age 13-16e 1.17 (0.92-1.49) .192 0.93 (0.67-1.29) .655 YSR attention age 16 -> Specialist care age 16-19f 1.56 (1.22-1.99) <.001 1.28 (0.91-1.81) .153 ASR attention age 19 -> Specialist care age 19-21g 1.76 (1.31-2.36) <.001 0.97 (0.61-1.55) .913 CBCL attention age 11 -> Specialist care age 11-13 d 1.32 (0.99-1.75) .057 1.30 (0.92-1.84) .137 CBCL attention age 13 -> Specialist care age 13-16 e 1.46 (1.18-1.81) <.001 1.07 (0.78-1.45) .681 CBCL attention age 16 -> Specialist care age 16-19 f 1.47 (1.16-1.85) .001 1.22 (0.86-1.74) .259 TCP attention age 11 -> Specialist care age 11-13 d 1.25 (0.94-1.65) .123 1.02 (0.72-1.45) .903 TCP attention age 13 -> Specialist care age 13-16 e 1.28 (1.01-1.62) .045 1.10 (0.82-1.47) .519 TCP attention age 16 -> Specialist care age 16-19 f 1.11 (0.85-1.45) .452 1.00 (0.71-1.40) .996
Self-reported problems (YSR/ASR)
Internalizing age 11 à Specialist care age 11-13d 0.95 (0.65-1.37) .769
Internalizing age 13 à Specialist care age 13-16e 1.07 (0.79-1.46) .649
Internalizing age 16 à Specialist care age 16-19f 1.48 (1.12-1.97) .007
Internalizing age 19 à Specialist care age 19-21g 1.49 (1.06-2.10) .021
Externalizing age 11 à Specialist care age 11-13d 1.13 (0.81-1.58) .463
Externalizing age 13 à Specialist care age 13-16e 1.28 (0.96-1.71) .093
Externalizing age 16 à Specialist care age 16-19f 0.91 (0.66-1.24) .543
Externalizing age 19 à Specialist care age 19-21g 1.43 (0.97-2.11) .074
Parent-reported problem behavior (CBCL; Z score)
Internalizing age 11 à Specialist care age 11-13d 0.73 (0.52-1.03) .076
Attention problems adjusted for sociodemographic covariates Attention problems adjusted for internalizing
and externalizing problems, and sociodemographic
covariates HR (95% CI) P HR (95% CI) P
Internalizing age 16 à Specialist care age 16-19f 1.05 (0.75-1.46) .781
Externalizing age 11 à Specialist care age 11-13d 1.22 (0.87-1.72) .255
Externalizing age 13 à Specialist care age 13-16e 1.03 (0.77-1.39) .847
Externalizing age 16 à Specialist care age 16-19f 1.23 (0.84-1.79) .283
Teacher-reported problem behavior (TCP; Z score)
Internalizing age 11 à Specialist care age 11-13d 1.55 (1.19-2.02) .001
Internalizing age 13 à Specialist care age 13-16e 1.30 (1.00-1.68) .048
Internalizing age 16 à Specialist care age 16-19f 1.25 (0.97-1.61) .079
Externalizing age 11 à Specialist care age 11-13d 1.03 (0.78-1.36) .842
Externalizing age 13 à Specialist care age 13-16e 1.13 (0.89-1.43) .322
Externalizing age 16 à Specialist care age 16-19f 1.10 (0.81-1.48) .537
aSpecialist care prior to age 11 not predicted by problem behavior.
bSpecialist care after age 16 not predicted by parent- and teacher reported problem behavior. cTime-dependent predictors.
dAge 11 represents T1 (mean age 11.1; SD=0.6; age range 10-12 years). eAge 13 represents T2 (mean age 13.6; SD=0.5; age range 12-15 years). fAge 16 represents T3 (mean age 16.3; SD=0.7; age range 15-17 years). gAge 19 represents T4 (mean age 19.1; SD=0.6; age range 18-20 years).
Abbreviations: ASR=Adult Sell-Report; CBCL=Child Behavior Checklist; CI=confidence interval; HR=Hazard Ratio; SD=standard deviation; SEP=socio-economic position; TCP=Teacher Checklist of Psychopathology; YSR=Youth Self-Report.
Appendix Table A5.5 (Continued). Cox regression analyses predicting the effects of standardized self-, parent-, and teacher-reported attention problems, internalizing and externalizing problems on initial specialist mental health care use from late childhood (mean age 9.4 years, SD=0.6)a
through early adulthood (mean age 21.4 years, SD=0.6)b, with attention problems only adjusted
for sociodemographic covariates (left column) and problem scores adjusted for sociodemographic covariates, attention problems, and (other) internalizing and externalizing problems at the same time point (right column).
Appendix Table 7.1. Pooled regression coefficients estimating the effects of amount of treatment on post treatment social well-being including additional control variables
Social well-being
b (S.E.) 95% CI Beta
Constant 3.43 (0.07) *** (3.30-3.56) 0.00
1-3 weighted treatment contacts (ref=none) 0.10 (0.20) (-0.30-0.49) 0.03
4-8 weighted treatment contacts (ref=none) -0.08 (0.20) (-0.47-0.31) -0.04
9-17 weighted treatment contacts (ref=none) -0.09 (0.18) (-0.44-0.26) -0.04
18+ weighted treatment contacts (ref=none) -0.27 (0.16) ~ (-0.59-0.05) -0.10
T2: Total problemsA 0.41 (0.09) *** (0.23-0.58) 0.45
T2-T1 Symptom change scoreA -0.14 (0.06) * (-0.26--0.03) -0.14
Sex (ref=female) 0.10 (0.09) (-0.08-0.29) 0.06
Age in years at T3A 0.06 (0.06) (-0.06-0.19) 0.07
WISC IntelligenceA 0.00 (0.00) (-0.01-0.00) -0.12
Socio-economic statusA 0.07 (0.06) (-0.05-0.20) 0.09
Familial loading internalizing problemsA -0.08 (0.06) (-0.19-0.03) -0.09
Familial loading externalizing problemsA 0.11 (0.10) (-0.09-0.31) 0.11
EATQ-R AffiliationA 0.30 (0.09) ** (0.12-0.49) 0.22
EATQ-R FearA 0.06 (0.08) (-0.10-0.22) 0.07
EATQ-R FrustrationA 0.13 (0.10) (-0.06-0.33) 0.09
EATQ-R SurgencyA -0.02 (0.05) (-0.12-0.08) -0.05
EATQ-R ShynessA -0.04 (0.05) (-0.13-0.06) -0.07
EATQ-R Depressed moodA 0.08 (0.07) (-0.07-0.22) 0.05
EATQ-R Effortful controlA 0.10 (0.07) (-0.05-0.24) 0.07
EATQ-R AggressionA 0.04 (0.09) (-0.15-0.22) 0.05
T1-T3 Stressful life eventsA -0.01 (0.01) (-0.03-0.02) -0.07
S.E. = standard error; CI = confidence interval; WISC = Wechsler Intelligence Scale for Children; EATQ-R = Early Adolescent Temperament Questionnaire Revised
A centered
Appendix Table 7.2. Pooled regression coefficients estimating the effects of amount of treatment on post treatment social behavior including additional control variables
Social behavior (CSBQ)
b (S.E.) 95% CI Beta
Constant 13.15 (1.17) *** (10.85-15.46) 0.00
1-3 weighted treatment contacts (ref=none) 10.80 (4.21) * (2.46-19.15) 0.14
4-8 weighted treatment contacts (ref=none) 6.79 (4.34) (-1.89-15.47) 0.08
9-17 weighted treatment contacts (ref=none) 10.73 (3.08) *** (4.63-16.83) 0.19
18+ weighted treatment contacts (ref=none) 5.24 (3.84) (-2.47-12.95) 0.11
T2: Total problemsA 0.43 (0.10) *** (0.22-0.64) 0.58
T2-T1 Symptom change scoreA -0.10 (0.11) (-0.32-0.13) -0.14
Sex (ref=female) -0.50 (1.75) (-3.95-2.96) -0.05
Age in years at T3A -0.34 (1.27) (-2.86-2.18) 0.03
WISC IntelligenceA -0.08 (0.06) (-0.21-0.05) -0.07
Socio-economic statusA 3.07 (1.08) ** (0.95-5.20) 0.10
Familial loading internalizing problemsA -0.44 (1.13) (-2.67-1.80) -0.02
Familial loading externalizing problemsA 1.23 (2.30) (-3.36-5.83) 0.03
EATQ-R AffiliationA -1.45 (2.03) (-5.49-2.58) -0.01
EATQ-R FearA -0.58 (1.37) (-3.30-2.14) -0.03
EATQ-R FrustrationA -0.47 (1.82) (-4.07-3.13) 0.03
EATQ-R SurgencyA 0.20 (0.91) (-1.60-2.00) -0.01
EATQ-R ShynessA 0.23 (0.81) (-1.36-1.82) -0.03
EATQ-R Depressed moodA 0.18 (1.64) (-3.09-3.45) -0.04
EATQ-R Effortful controlA 0.08 (1.33) (-2.54-2.70) 0.03
EATQ-R AggressionA 1.20 (1.82) (-2.40-4.81) 0.08
T1-T3 Stressful life eventsA -0.23 (0.26) (-0.76-0.29) -0.09
CSBQ = Child Social Behavior Questionnaire; S.E. = standard error; CI = confidence interval; WISC = Wechsler Intelligence Scale for Children; EATQ-R = Early Adolescent Temperament Questionnaire Revised
A centered
Appendix Table 7.3. Pooled regression coefficients estimating the effects of amount of treatment on post treatment family functioning including additional control variables
Family functioning (FAD) b (S.E.) 95% CI Beta
Constant 1.73 (0.05) *** (1.63-1.83) 0.00
1-3 weighted treatment contacts (ref=none) 0.42 (0.16) ** (0.11-0.74) 0.16
4-8 weighted treatment contacts (ref=none) 0.06 (0.17) (-0.27-0.39) 0.04
9-17 weighted treatment contacts (ref=none) 0.11 (0.11) (-0.11-0.33) 0.08
18+ weighted treatment contacts (ref=none) 0.26 (0.16) (-0.06-0.57) 0.15
T2: Total problemsA 0.53 (0.10) *** (0.35-0.72) 0.56
T2-T1 Symptom change scoreA -0.17 (0.11) (-0.39-0.04) -0.22
Sex (ref=female) -0.02 (0.08) (-0.17-0.14) -0.09
Age in years at T3A -0.05 (0.05) (-0.14-0.04) -0.05
WISC IntelligenceA 0.00 (0.00) (0.00-0.01) 0.10
Socio-economic statusA 0.00 (0.05) (-0.09-0.09) -0.08
Familial loading internalizing problemsA 0.01 (0.04) (-0.07-0.09) 0.04
Familial loading externalizing problemsA 0.00 (0.09) (-0.18-0.17) -0.06
EATQ-R AffiliationA 0.02 (0.07) (-0.12-0.16) 0.00
EATQ-R FearA 0.02 (0.06) (-0.10-0.14) 0.08
EATQ-R FrustrationA 0.00 (0.07) (-0.13-0.14) 0.05
EATQ-R SurgencyA 0.04 (0.04) (-0.03-0.11) 0.04
EATQ-R ShynessA 0.01 (0.04) (-0.06-0.08) 0.03
EATQ-R Depressed moodA 0.08 (0.07) (-0.06-0.21) 0.05
EATQ-R Effortful controlA -0.06 (0.06) (-0.18-0.05) -0.01
EATQ-R AggressionA -0.05 (0.07) (-0.19-0.09) -0.06
T1-T3 Stressful life eventsA -0.01 (0.01) (-0.03-0.01) -0.05
FAD = Family Assessment Device; S.E. = standard error; CI = confidence interval; WISC = Wechsler Intelligence Scale for Children; EATQ-R = Early Adolescent Temperament Questionnaire Revised A centered
Appendix Table 7.4. Pooled regression coefficients estimating the effects of amount of treatment on post treatment academic performance including additional control variables
Academic performance b (S.E.) 95% CI Beta
Constant 3.04 (0.17) *** (2.70-3.37) 0.00
1-3 weighted treatment contacts (ref=none) -0.25 (0.45) (-1.14-0.64) -0.09
4-8 weighted treatment contacts (ref=none) -0.04 (0.36) (-0.75-0.66) -0.01
9-17 weighted treatment contacts (ref=none) 0.04 (0.31) (-0.58-0.66) 0.01
18+ weighted treatment contacts (ref=none) -0.11 (0.45) (-1.01-0.80) 0.06
T2: Total problemsA 0.12 (0.15) (-0.17-0.41) 0.17
T2-T1 Symptom change scoreA -0.02 (0.14) (-0.31-0.27) -0.07
Sex (ref=female) 0.01 (0.21) (-0.41-0.44) -0.11
Age in years at T3A -0.02 (0.19) (-0.40-0.36) 0.06
WISC IntelligenceA 0.00 (0.01) (-0.02-0.02) 0.06
Socio-economic statusA -0.02 (0.15) (-0.32-0.27) -0.07
Familial loading internalizing problemsA -0.02 (0.12) (-0.27-0.23) -0.02
Familial loading externalizing problemsA -0.06 (0.25) (-0.56-0.43) -0.09
EATQ-R AffiliationA 0.05 (0.18) (-0.30-0.40) 0.02
EATQ-R FearA -0.03 (0.17) (-0.37-0.32) -0.03
EATQ-R FrustrationA 0.09 (0.21) (-0.32-0.51) 0.13
EATQ-R SurgencyA -0.01 (0.11) (-0.24-0.21) -0.04
EATQ-R ShynessA 0.06 (0.10) (-0.13-0.25) 0.03
EATQ-R Depressed moodA 0.09 (0.17) (-0.25-0.43) 0.03
EATQ-R Effortful controlA 0.09 (0.24) (-0.39-0.58) 0.02
EATQ-R AggressionA -0.17 (0.22) (-0.61-0.28) -0.15
T1-T3 Stressful life eventsA -0.01 (0.03) (-0.07-0.05) -0.02
S.E. = standard error; CI = confidence interval; WISC = Wechsler Intelligence Scale for Children; EATQ-R = Early Adolescent Temperament Questionnaire Revised
A centered
A pp en di x T ab le 7 .5 . P oo le d u ns ta nd ar di ze d r eg re ss io n c oeffi ci en ts e sti m ati ng th e eff ec ts o f u nw ei gh te d a m ou nt o f t re at m en t o n p os t t re at m en t t ot al pr ob le m s co re s i nc lud in g add iti on al c on tr ol v ari ab le s Ch ild s el f-re por t ( YS R) Pa re nt re por t ( CB CL ) Te ac he r re por t ( TC P) b ( S. E. ) 95% C I b ( S. E. ) 95% C I b ( S. E. ) 95% C I Co ns ta nt 0. 48 (0. 02 )* ** (0. 44 -0. 52 ) 0. 27 (0. 02 )* ** (0. 23 -0. 30 ) 0. 42 (0 .0 6) ** * (0. 30 -0. 54 ) 1-3 u nw ei ght ed tr ea tm ent c ont ac ts (r ef = no ne ) B 0. 12 (0. 07 )~ (0. 00 -0. 25 ) 0. 23 (0. 07 )* * (0. 09 -0. 37 ) 0. 43 (0. 18 )* (0. 08 -0. 79 ) 4-8 u nw ei ght ed tr ea tm ent c ont ac ts (r ef = no ne ) B 0. 12 (0 .0 6) * (0. 00 -0. 24 ) 0. 16 (0. 07 )* (0. 02 -0. 29 ) 0.1 1 ( 0.1 7) (-0. 22 -0. 45 ) 9-17 u nw ei ght ed tr ea tm ent c ont ac ts (r ef = no ne ) B 0. 06 (0. 05 ) (-0. 04 -0. 16 ) 0. 14 (0. 05 )* * (0. 04 -0. 24 ) 0. 24 (0. 14 )~ (-0. 04 -0. 52 ) 18 + u nw ei ght ed tr ea tm ent c ont ac ts (r ef = no ne ) B 0. 12 (0. 05 )* (0. 02 -0. 22 ) 0. 21 (0. 05 )* ** (0. 10 -0. 31 ) 0.1 0 ( 0.1 9) (-0. 29 -0. 49 ) T2: T ot al p ro bl em s A 0. 53 (0. 08 )* ** (0. 37 -0. 70 ) 0. 45 (0. 14 )* * (0. 16 -0. 73 ) 0.1 5 ( 0.1 6) (-0. 16 -0. 47 ) T2 -T 1 S ym pt om c ha nge s cor e A -0. 13 (0. 07 )~ (-0. 26 -0. 00 ) -0 .18 (0 .14 ) (-0. 46 -0. 10 ) -0 .14 (0 .18 ) (-0. 51 -0. 23 ) Se x ( re f= fem al e) -0. 11 (0. 03 )* ** (-0. 17 --0. 05 ) -0 .0 3 ( 0. 03 ) (-0. 09 -0. 03 ) 0. 04 (0. 08 ) (-0. 13 -0. 20 ) Ag e in y ea rs a t T 3 A -0. 03 (0. 02 ) (-0. 07 -0. 01 ) 0. 01 (0. 02 ) (-0. 03 -0. 05 ) 0. 01 (0. 07 ) (-0 .13 -0 .16 ) W IS C I nte lli ge nc e A 0. 00 (0. 00 ) (0. 00 -0. 00 ) 0. 00 (0. 00 ) (0. 00 -0. 00 ) 0. 00 (0. 00 ) (-0. 01 -0. 00 ) So ci o-ec on om ic st at us A 0. 00 (0. 02 ) (-0 .04-0. 04 ) 0. 02 (0 .02 ) (-0. 02 -0. 06 ) -0. 02 (0. 07 ) (-0 .16 -0 .12 ) Fa m ili al l oa din g in te rn ali zin g p ro bl em s A -0 .02 (0 .02 ) (-0. 05 -0. 02 ) -0 .02 (0 .02 ) (-0. 05 -0. 02 ) 0. 00 (0. 05 ) (-0 .11 -0 .11 ) Fa m ili al l oa din g e xt er na liz in g p ro bl em s A 0. 02 (0. 03 ) (-0. 05 -0. 09 ) -0. 02 (0. 03 ) (-0. 08 -0. 05 ) 0. 00 (0. 12 ) (-0 .24 -0 .24 ) EA TQ -R A ffili at io n A -0. 01 (0. 03 ) (-0. 08 -0. 05 ) 0. 01 (0. 03 ) (-0. 05 -0. 06 ) -0. 02 (0. 08 ) (-0 .19 -0 .15 ) EA TQ -R Fea r A 0. 01 (0. 02 ) (-0. 03 -0. 05 ) 0. 00 (0. 02 ) (-0. 04 -0. 05 ) -0. 01 (0. 08 ) (-0 .17 -0 .15 ) EA TQ -R F ru st ra tio n A 0. 04 (0. 03 ) (-0. 02 -0. 09 ) -0. 05 (0. 03 ) (-0. 11 -0. 01 ) -0 .07 (0 .07 ) (-0. 21 -0. 07 ) EA TQ -R S ur ge nc y A 0. 02 (0 .02 ) (-0. 01 -0. 05 ) 0. 01 (0. 02 ) (-0. 02 -0. 04 ) -0. 01 (0. 04 ) (-0 .10-0 .0 8) EA TQ -R Sh yn es s A 0. 00 (0. 01 ) (-0 .0 3-0. 03 ) 0. 01 (0. 02 ) (-0. 03 -0. 04 ) -0. 01 (0. 04 ) (-0 .10-0 .0 7) EA TQ -R D ep re ss ed m ood A -0. 03 (0. 02 ) (-0. 07 -0. 02 ) -0. 01 (0. 03 ) (-0. 07 -0. 04 ) -0. 01 (0. 08 ) (-0 .17 -0 .16 ) EA TQ -R E ffo rt fu l c on tr ol A -0. 01 (0. 02 ) (-0. 06 -0. 03 ) 0. 00 (0. 02 ) (-0. 05 -0. 04 ) -0. 01 (0. 09 ) (-0 .19 -0 .16 ) EA TQ -R A gg res sio n A -0. 01 (0. 03 ) (-0. 07 -0. 05 ) 0. 06 (0. 03 )* (0. 01 -0. 12 ) 0. 07 (0. 09 ) (-0. 11 -0. 25 ) T1 -T 3 S tr es sf ul li fe e ve nt s A 0. 00 (0. 00 ) (-0 .01 -0 .01 ) 0. 00 (0. 00 ) (-0. 01 -0. 00 ) 0. 02 (0. 01 ) (-0. 01 -0. 05 ) YS R = Y ou th S el f-R ep or t; C BC L = Ch ild B eh av io r Ch ec kli st ; T CP = T ea ch er ’s Ch ec kli st o f P sy ch op at ho lo gy ; S .E . = s ta nd ar d e rr or ; C I = c on fid en ce in te rv al ; W IS C = W ec hs le r In te lli ge nc e S ca le f or Ch ild re n; E AT Q -R = E ar ly A do le sc en t T em pe ra m en t Q ue st io nn ai re R ev ise d A c en ter ed B a mb ul at or y, da y c ar e a nd in pa tie nt tr ea tm en t c on ta ct s al l w ei gh te d e qual ly (= 1) ~ p< 0. 10 * p< 0. 05 * * p< 0. 01 * ** p< 0. 001
