Margaret J. Briggs-Gowan

Bio: Margaret J. Briggs-Gowan is an academic researcher from University of Connecticut. The author has contributed to research in topics: Poison control & Anxiety. The author has an hindex of 45, co-authored 107 publications receiving 8139 citations. Previous affiliations of Margaret J. Briggs-Gowan include Northwestern University & Yale University.

The Infant–Toddler Social and Emotional Assessment (ITSEA): Factor Structure, Reliability, and Validity

Abstract: In this paper the refinement and psychometric properties of the Infant-Toddler Social and Emotional Assessment (ITSEA) are described. Results from a sociodemographically diverse birth cohort sample of 1,235 parents of children between the ages of 12 and 36 months are presented. Confirmatory factor analyses supported the hypothesized Internalizing, Externalizing, Regulatory, and Competence domains as well as the 17 individual scales that comprise the ITSEA. Findings for 3 additional indices useful in identifying significant psychopathology are presented. Subgroup analyses revealed structural invariance and expected mean level differences across both child sex and 6-month age bands. Child sex differences emerged for some problem and most competence scales, with boys rated as higher on Activity/Impulsivity and girls rated higher on Anxiety and most Competence scales. All competence scores increased across age groups. Problem behaviors showed a more mixed developmental pattern. Test-retest and interrater reliability were acceptable. Associations between the ITSEA and independent evaluator ratings and parental ratings of child behavior problems, temperament, and parental distress support the validity of the instrument.

Maternal depression and comorbidity: predicting early parenting, attachment security, and toddler social-emotional problems and competencies.

Abstract: Objective To examine relations between maternal depression (in pure and comorbid forms) and mother–infant interactions, infant attachment, and toddler social-emotional problems and competencies. A second objective was to explore sex differences. Method Sixty-nine mother–infant dyads were followed from pregnancy to 30 months postpartum. Depression was measured at multiple times with self-report and interview assessments. Play was assessed at 4 months and attachment status at 14 months postpartum. At 30 months, mothers completed the Child Behavior Checklist and Infant-Toddler Social and Emotional Assessment. Results Lifetime maternal depression predicted less optimal mother–infant interactions and insecure infant attachment. However, this “depression effect” was accounted for by mothers with comorbid diagnoses, who had less optimal interactions, and infants with higher rates of insecurity than either mothers with depression only or mothers with no psychopathology. Prenatal and postpartum depressive symptoms were associated with problem behaviors and lower competencies for boys. In contrast, quality of early interactions predicted problem behaviors in girls. Conclusions It is important to examine the context of maternal depression with respect to additional psychopathology and environmental risks. Maternal depression in the presence of other psychopathology confers risk to the mother–child dyad. Consistent with previous work, risk pathways appear to differ for boys and girls. Early identification and prevention efforts are warranted.

The Brief Infant-Toddler Social and Emotional Assessment: Screening for Social-Emotional Problems and Delays in Competence

Abstract: Objective To examine the reliability and validity of the 42-item Brief Infant-Toddler Social and Emotional Assessment (BITSEA), a screener for social-emotional/behavioral problems and delays in competence. Method Parents in a representative healthy birth cohort of 1,237 infants aged 12 to 36 months completed the Infant-Toddler Social and Emotional Assessment (ITSEA)/BITSEA, the Child Behavior Checklist (CBCL)/1.5-5, the MacArthur Communication Developmental Inventory vocabulary checklist, and worry questions. In a subsample, independent evaluators rated infant-toddler behavior. Results Test-retest reliability was excellent and interrater agreement (mother/father and parent/child-care provider) was good. Supporting validity, BITSEA problems correlated with concurrent evaluator problem ratings and CBCL/1.5-5 scores and also predicted CBCL/1.5-5 and ITSEA problem scores one year later. BITSEA measures of competence correlated with concurrent observed competence and predicted later ITSEA competence measures. Supporting discriminant validity, only 23% of high BITSEA problem scorers had delayed vocabulary. Moreover, the combined BITSEA problem/ competence cutpoints identified 85% of subclinical/clinical CBCL/1.5-5 scores, while maintaining acceptable specificity (75%). Conclusions Findings support the BITSEA as a screener for social-emotional/behavioral problems and delays in social-emotional competence.

Assessment of young children's social-emotional development and psychopathology: recent advances and recommendations for practice.

Abstract: In this paper we have tried to document some of the recent advances in the conceptualization and assessment of early-emerging social-emotional and behavior problems, competencies, and psychopathology. Considerable evidence documents that young children evidence significant psychopathology (cf., Del Carmen & Carter, in press; Emde, 1999; Zeanah, 2001; Zeanah et al., 1997). Given the range of new assessment measures that have become available over the past 10 years, the field of young child mental health is poised for dramatic gains in knowledge. It is critical to conduct large-scale, longitudinal, epidemiological studies to inform our understanding of the course of psychopathological conditions within the context of a normative developmental framework. Multi-method, multi-informant assessment approaches are more essential in early childhood due to young children's inability to provide self-reports and the embedded nature of children's development in their caregiving contexts. Screening large representative samples affords the opportunity to ascertain unbiased clinically informative sub-samples for methodologically intensive sub-studies. These sub-studies can address the child's cognitive and linguistic developmental capacities as well as utilize observational methods to examine the relational context. This approach provides an opportunity to merge dimensional and diagnostic assessments and will yield critical information for disentangling continuities and discontinuities in normative and atypical development. The assessment methodology currently exists to routinely screen very young children for social-emotional and behavior problems as well as delays in the acquisition of competencies in pediatric settings as well as in early intervention programs. Yet, despite the likely long-term benefits and cost-saving potential of early identification and intervention services, short-term cost and knowledge barriers currently limit widespread implementation. Discussions with pediatricians suggest that one of the greatest barriers to screening is the limited availability of mental health referral sources. Indeed, very few children who are rated by parents as having elevated social-emotional and behavior problems are receiving any behavioral health services (Horwitz et al., in press). Unmet mental health needs exist among non-referred children in the community as well as among children receiving early intervention services for developmental concerns. Documenting the mental health needs of young children may promote training of professionals who have the competence to treat young children and their families. Moreover, the availability of social-emotional and behavior problem assessment tools should increase studies that focus on the clinical efficacy and effectiveness of prevention and early intervention programs designed to promote positive mental health. Finally, although significant progress is occurring in the arena of young child diagnosis, a strong case can be made for intervening when young children are exhibiting elevations in problem behaviors or delays in the acquisition of competence. This is particularly true when children are also experiencing exposure to multiple contextual risk factors. It is therefore important to advocate for changes to systems that require child diagnosis as a gateway to intervention. As we learn more about the precursors or prodromal manifestations of clinical psychopathology we will be able to examine the efficacy of earlier targeted preventive intervention approaches.

Discrepancies among mother, child, and teacher reports: examining the contributions of maternal depression and anxiety

Abstract: The relationship between maternal affective symptomatology and discrepancies in maternal reports of child symptoms, relative to teacher and child reports, was evaluated in a community sample of 188 children ages 9-12 years. Mothers, teachers, and children were administered a structured interview about child psychopathology. In general, mothers reported more child behavior problems than children and teachers regardless of maternal symptomatology. However, maternal affective symptoms were associated with discrepancies between mothers' and daughters' reports and between mothers' and teachers' reports of girls' externalizing symptoms. Furthermore, mothers who reported high levels of both anxiety and depressive symptomatology tended to report a large number of symptoms that were not confirmed by either their daughters or teachers. Findings are discussed as possible evidence of the role of maternal affective symptomatology in both actual increases in child symptomatology and maternal reporting distortions. Although maternal depressive and anxiety symptoms shared variance in reporting discrepancies, only anxiety explained unique variance. Consistent with previous studies, cross-informant agreement was modest to moderate (r = .16 to .50) and all informants reported more behavior problems in boys than in girls.

Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents

Abstract: Background The literature on the prevalence of mental disorders affecting children and adolescents has expanded significantly over the last three decades around the world. Despite the field having matured significantly, there has been no meta-analysis to calculate a worldwide-pooled prevalence and to empirically assess the sources of heterogeneity of estimates. Methods We conducted a systematic review of the literature searching in PubMed, PsycINFO, and EMBASE for prevalence studies of mental disorders investigating probabilistic community samples of children and adolescents with standardized assessments methods that derive diagnoses according to the DSM or ICD. Meta-analytical techniques were used to estimate the prevalence rates of any mental disorder and individual diagnostic groups. A meta-regression analysis was performed to estimate the effect of population and sample characteristics, study methods, assessment procedures, and case definition in determining the heterogeneity of estimates. Results We included 41 studies conducted in 27 countries from every world region. The worldwide-pooled prevalence of mental disorders was 13.4% (CI 95% 11.3–15.9). The worldwide prevalence of any anxiety disorder was 6.5% (CI 95% 4.7–9.1), any depressive disorder was 2.6% (CI 95% 1.7–3.9), attention-deficit hyperactivity disorder was 3.4% (CI 95% 2.6–4.5), and any disruptive disorder was 5.7% (CI 95% 4.0–8.1). Significant heterogeneity was detected for all pooled estimates. The multivariate metaregression analyses indicated that sample representativeness, sample frame, and diagnostic interview were significant moderators of prevalence estimates. Estimates did not vary as a function of geographic location of studies and year of data collection. The multivariate model explained 88.89% of prevalence heterogeneity, but residual heterogeneity was still significant. Additional meta-analysis detected significant pooled difference in prevalence rates according to requirement of funcional impairment for the diagnosis of mental disorders. Conclusions Our findings suggest that mental disorders affect a significant number of children and adolescents worldwide. The pooled prevalence estimates and the identification of sources of heterogeneity have important implications to service, training, and research planning around the world.

Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study.

Abstract: Discrepancies often exist among different informants' (e.g., parents, children, teachers) ratings of child psychopathology. Informant discrepancies have an impact on the assessment, classification, and treatment of childhood psychopathology. Empirical work has identified informant characteristics that may influence informant discrepancies. Limitations of previous work include inconsistent measurement of informant discrepancies and, perhaps most importantly, the absence of a theoretical framework to guide research. In this article, the authors present a theoretical framework (the Attribution Bias Context Model) to guide research and theory examining informant discrepancies in the clinic setting. Needed directions for future research and theory include theoretically driven attention to conceptualizing informant discrepancies across informant pairs (e.g., parent-teacher, mother-father, parent-child, teacher-child) as well as developing experimental approaches to decrease informant discrepancies in the clinic setting.

Maternal Depression and Child Psychopathology: A Meta-Analytic Review

Abstract: Although the association between maternal depression and adverse child outcomes is well established, the strength of the association, the breadth or specificity of the outcomes, and the role of moderators are not known This information is essential to inform not only models of risk but also the design of preventive interventions by helping to identify subgroups at greater risk than others and to elucidate potential mechanisms as targets of interventions A meta-analysis of 193 studies was conducted to examine the strength of the association between mothers’ depression and children’s behavioral problems or emotional functioning Maternal depression was significantly related to higher levels of internalizing, externalizing, and general psychopathology and negative affect/behavior and to lower levels of positive affect/behavior, with all associations small in magnitude These associations were significantly moderated by theoretically and methodologically relevant variables, with patterns of moderation found to vary somewhat with each child outcome Results are interpreted in terms of implications for theoretical models that move beyond main effects models in order to more accurately identify which children of depressed mothers are more or less at risk for specific outcomes

Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities

Abstract: This report builds on a highly valued predecessor, the 1994 Institute of Medicine (IOM) report entitled Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. That report provided the basis for understanding prevention science, elucidating its then-existing research base, and contemplating where it should go in the future. This report documents that an increasing number of mental, emotional, and behavioral problems in young people are in fact preventable. The proverbial ounce of prevention will indeed be worth a pound of cure: effectively applying the evidence-based prevention interventions at hand could potentially save billions of dollars in associated costs by avoiding or tempering these disorders in many individuals. Furthermore, devoting significantly greater resources to research on even more effective prevention and promotion efforts, and then reliably implementing the findings of such research, could substantially diminish the human and economic toll.

Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology.

Abstract: We review recent research on the presentation, nosology and epidemiology of behavioral and emotional psychiatric disorders in preschool children (children ages 2 through 5 years old), focusing on the five most common groups of childhood psychiatric disorders: attention deficit hyperactivity disorders, oppositional defiant and conduct disorders, anxiety disorders, and depressive disorders. We review the various approaches to classifying behavioral and emotional dysregulation in preschoolers and determining the boundaries between normative variation and clinically significant presentations. While highlighting the limitations of the current DSM-IV diagnostic criteria for identifying preschool psychopathology and reviewing alternative diagnostic approaches, we also present evidence supporting the reliability and validity of developmentally appropriate criteria for diagnosing psychiatric disorders in children as young as two years old. Despite the relative lack of research on preschool psychopathology compared with studies of the epidemiology of psychiatric disorders in older children, the current evidence now shows quite convincingly that the rates of the common child psychiatric disorders and the patterns of comorbidity among them in preschoolers are similar to those seen in later childhood. We review the implications of these conclusions for research on the etiology, nosology, and development of early onset of psychiatric disorders, and for targeted treatment, early intervention and prevention with young children.