Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients’ needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients’ behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants’ reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for “best practices” in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns.

https://papers.ssrn.com/sol3/Delivery.cfm?abstractid=2632484

The Validity of the Multi-Informant Approach to Assessing Child and Adolescent Mental Health

In neuropsychological assessment, and many areas of research, it is common for the same test to be administered on more than one occasion to measure change. Measured changes are presumed to reflect true changes in the construct being measured by the test; for example, cognitive changes due to processes such as aging, advancing neurological disease, or treatment interventions. However, practice effects, defined as score increases due to factors such as memory for specific test items, learned strategies, or test sophistication, complicate the interpretation of change. This review presents meta-analyses of nearly 1600 individual effect sizes representing changes in mean-level performance on tests commonly used to assess core domains of neuropsychological function, with the goal of quantitatively summarizing the magnitude of practice effects on such tests. The use of alternate forms, the ages of participants, clinical diagnoses of study participants, and length of the test-retest interval were associated with the magnitude of change in many cases. These findings have important implications for the practice of clinical neuropsychology, as well as for research applications, and highlight the need for practice effects to be taken into account in interpreting change across time with multiple measurements.

Scoring higher the second time around: meta-analyses of practice effects in neuropsychological assessment.

The individual alpha frequency (IAF) of the human EEG reflects systemic properties of the brain, is highly heritable, and relates to cognitive functioning. Not much is known about the modifiability of IAF by cognitive interventions. We report analyses of resting EEG from a large-scale training study in which healthy younger (20‐31 years, N = 30) and older (65‐80 years, N = 28) adults practiced 12 cognitive tasks for ~100 1-h sessions. EEG was recorded before and after the cognitive training intervention. In both age groups, IAF (and, in a control analysis, alpha amplitude) did not change, despite large gains in cognitive performance.As within-session reliability and test-retest stability were high for both age groups, imprecise measurements cannot account for the findings. In sum, IAF is highly stable in healthy adults up to 80 years, not easily modifiable by cognitive interventions alone, and thus qualifies as a stable neurophysiological trait marker.

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Peak individual alpha frequency qualifies as a stable neurophysiological trait marker in healthy younger and older adults

https://escholarship.org/content/qt21b4d1h1/qt21b4d1h1.pdf?t=qajz06

Adolescent neurobiological susceptibility to social context.

Anorexia nervosa (AN) is a serious psychiatric disorder with a high rate of relapse. The goal of this study was to identify predictors of relapse in adult AN using a prospective, longitudinal design. Participants were 100 AN patients who had successfully completed specialized inpatient/day treatment, were weight-restored to a body mass index (BMI) of at least 20 for a minimum of 2 weeks, and reported less than one binge-purge (BP) episode over the previous 28 days at the end of treatment. Predictor variables included baseline demographic and clinical features, behavioral and psychological changes during treatment, residual psychopathology at post-treatment, and motivation to recover. Results indicated that 41% of participants relapsed during the 1-year follow-up period. The highest risk period for relapse was between 4 and 9 months post-treatment. Predictors of relapse included: the BP subtype of AN, severity of checking behaviors at pre-treatment, decrease in motivation to recover during treatment, and lower motivation to recover at post-treatment. These findings suggest that individuals with the BP subtype of AN are particularly susceptible to relapse. Increasing and maintaining motivation to recover during acute treatment may have an important impact on long-term outcome.

Heyman Tom

Papers

Test-retest reliability.