Skip to main content

Advertisement

SpringerLink
Log in

Factor Structure of Parent- and Adolescent-Perceived Functional Impairment

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

Impairment of adaptive functioning is a critical criterion in the diagnostic process for mental disorders, as well as clinicians’ preferred target when treating clients. At the same time, clinical research with youth overemphasizes mental health symptoms and undervalues measures of adaptive functioning. Moreover, there is a dearth of comprehensive assessments of functioning that are practical and validated for use with both youth and parents in clinical outpatient settings. The current study addresses these issues by examining the factor structure of both youth and parent versions of a measure of functional impairment. This study used an archival dataset of adolescents aged 11–19 years (87% Caucasian, 50% female) receiving services at a semi-rural community mental health clinic in Northwest Ohio. To determine the factor structure of functional impairment, exploratory and confirmatory factor analyses were conducted separately on youth and parent versions of the Ohio Scales Functioning Scale. Prior to analyses, the final sample of 1080 adolescents was randomly split in half in order to perform principal axis factoring on one half and confirmatory factor analysis on the other half. Overall, youth and parent Functioning Scales tapped into five domains encompassing youths’ school, social-emotional, recreation, self-care, and responsible behavior. However, there were slight differences in the item compositions of some domains, suggesting that youth and parents view certain behaviors as indicators of different aspects of functioning. Results support that youth adaptive functioning is a multi-dimensional construct, and the Ohio Scales may offer a more comprehensive assessment of functional impairment than other measures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Achenbach, T. M. (1991). Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. Burlington, VT: Department of Psychiatry, University of Vermont.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Becker, K. D., Chorpita, B. F., & Daleiden, E. L. (2011). Improvement in symptoms versus functioning: How do our best treatments measure up? Administration and Policy in Mental Health and Mental Health Services Research, 38, 440–458.

    Article  PubMed  Google Scholar 

  • Bickman, L., Rosof-Williams, J., Salzer, M. S., Summerfelt, W. T., Noser, K., Wilson, S. J., & Karver, M. S. (2000). What information do clinicians value for monitoring adolescent client progress and outcomes? Professional Psychology: Research and Practice, 31, 70–74.

    Article  Google Scholar 

  • Bird, H. R., Canino, G. J., Davies, M., Ramírez, R., Chávez, L., Duarte, C., & Shen, S. (2005). The Brief Impairment Scale (BIS): A multidimensional scale of functional impairment for children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 699–707.

    Article  Google Scholar 

  • Bird, H. R., Davies, M., Fisher, P., Narrow, W. E., Jensen, P. S., Hoven, C., & Dulcan, M. K. (2000). How specific is specific impairment? Journal of the American Academy of Child & Adolescent Psychiatry, 39, 1182–1189.

    Article  Google Scholar 

  • Bird, H. R., Shaffer, D., Fisher, P., & Gould, M. S. (1993). The Columbia Impairment Scale (CIS): Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3, 167–176.

    Google Scholar 

  • California Department of Health Care Services (2013). Performance outcomes system plan for Medi-Cal specialty mental health services for children & youth. http://www.dhcs.ca.gov/formsandpubs/Documents/Legislative%20Reports/Mental%20Health/SMHS_Perf_Outcomes_System-Plan11-01-13.pdf.

  • Canino, G. (2016). The role of measuring functional impairment in assessing serious emotional disturbance in children. http://sites.nationalacademies.org/cs/groups/dbassesite/documents/webpage/dbasse_171793.pdf.

  • Capaldi, D. M., & Stoolmiller, M. (1999). Co-occurrence of conduct problems and depressive symptoms in early adolescent boys: III. Prediction to young-adult adjustment. Development and Psychopathology, 11, 59–84.

    Article  PubMed  Google Scholar 

  • Carlston, D. L., & Ogles, B. M. (2009). Age, gender, and ethnicity effects on parent–child discrepancy using identical item measures. Journal of Child and Family Studies, 18, 125–135.

    Article  Google Scholar 

  • Chen, X., Rubin, K. H., & Li, D. (1997). Relation between academic achievement and social adjustment: Evidence from Chinese children. Developmental Psychology, 33, 518–525. https://doi.org/10.1037/0012-1649.33.3.518.

    Article  PubMed  Google Scholar 

  • Conger, R. D., Wallace, L. E., Sun, Y., Simons, R. L., McLoyd, V. C., & Brody, G. H. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179–193.

    Article  PubMed  Google Scholar 

  • Copeland, W. E., Shanahan, L., Erkanli, A., Costello, E. J., & Angold, A. (2013). Indirect comorbidity in childhood and adolescence. Frontiers in Psychiatry, 4(144), 1–8.

    Google Scholar 

  • Costello, E. J., He, J., Sampson, N. A., Kessler, R. C., & Merikangas, K. R. (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey–Adolescent. Psychiatric Services, 65, 359–366.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., Alfano, C. A., & Beidel, D. C. (2011). Are clinicians’ assessments of improvements in children’s functioning “global”? Journal of Clinical Child & Adolescent Psychology, 40, 281–294.

    Article  Google Scholar 

  • De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. A. G., Burgers, D. E., & Rabinowitz, J. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141, 858–900.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ezpeleta, L., Keeler, G., Erkanli, A., Costello, E. J., & Angold, A. (2001). Epidemiology of psychiatric disability in childhood and adolescence. Journal of Child Psychology and Psychiatry, 42, 901–914.

    Article  PubMed  Google Scholar 

  • Fabiano, G. A., Pelham, W. E. Jr., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., Chronis, A. M., & Burrows-MacLean, L. (2006). A practical measure of impairment: Psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child & Adolescent Psychology, 35, 369–385.

    Article  Google Scholar 

  • Fergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1993). The effect of maternal depression on maternal ratings of child behavior. Journal of Abnormal Child Psychology, 21, 245–269.

    Article  PubMed  Google Scholar 

  • Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.

    Article  Google Scholar 

  • Goldstein, S. & Naglieri, J. A. (Eds.) (2016). Assessing impairment. Boston, MA: Springer.

    Google Scholar 

  • Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.

    Article  PubMed  Google Scholar 

  • Hawaii Department of Health (2014). Child and adolescent mental health strategic plan 2015–2018 and biennial review of progress made on the 2011–2014 strategic plan. http://health.hawaii.gov/camhd/files/2013/04/CAMHD-Strategic-Plan-2015-2018.pdf.

  • Hodges, K., Doucette-Gates, A., & Liao, Q. (1999). The relationship between the Child and Adolescent Functional Assessment Scale (CAFAS) and indicators of functioning. Journal of Child and Family Studies, 8, 109–122.

    Article  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73, 539–548.

    Article  PubMed  Google Scholar 

  • Keyes, C. L. M. (2006). Mental health in adolescence: Is America’s youth flourishing? American Journal of Orthopsychiatry, 76, 395–402.

    Article  PubMed  Google Scholar 

  • Kramer, T. L., Phillips, S. D., Hargis, M. B., Miller, T. L., Burns, B. J., & Robbins, J. M. (2004). Disagreement between parent and adolescent reports of functional impairment. Journal of Child Psychology and Psychiatry, 45, 248–259.

    Article  PubMed  Google Scholar 

  • Little, R. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83, 1198–1202.

    Article  Google Scholar 

  • Love, A. R., Mueller, C. W., Tolman, R. T., & Powell, A. K. (2014). Frequency, level, and rate of improvement for treatment targets in a children’s mental health community-based intensive in-home therapeutic setting. Administration and Policy in Mental Health and Mental Health Services Research, 41, 421–433.

    Article  PubMed  Google Scholar 

  • Muthén, B., & Muthén, L. (2012). Mplus version 7: User’s guide. Los Angeles: Muthén & Muthén.

  • Oakland, T., & Harrison, P. L. (2008). Adaptive Behavior Assessment System-II clinical use and interpretation. Amsterdam; Boston: Elsevier/Academic Press.

  • Ogles, B. M., Melendez, G., Davis, D. C., & Lunnen, K. M. (1999). The Ohio Youth Problem, Functioning, and Satisfaction scales (short form): User’s manual. Athens, OH: Ohio University.

  • Ogles, B. M., Melendez, G., Davis, D. C., & Lunnen, K. M. (2000). The Ohio Youth Problem, Functioning, and Satisfaction scales: Technical manual. Athens, OH: Ohio University.

  • Ogles, B. M., Melendez, G., Davis, D. C., & Lunnen, K. M. (2001). The Ohio scales: Practical outcome assessment. Journal of Child and Family Studies, 10, 199–212.

    Article  Google Scholar 

  • Piacentini, J., Peris, T., Bergman, R., Chang, S., & Jaffer, M. (2007). The Child Obsessive-Compulsive Impact Scale-Revised (COIS-R): Development and psychometric properties. Journal of Clinical Child & Adolescent Psychology, 36, 645–653.

    Article  Google Scholar 

  • Pickles, A. (2001). Child psychiatric symptoms and psychosocial impairment: Relationship and prognostic significance. The British Journal of Psychiatry, 179, 230–235.

    Article  PubMed  Google Scholar 

  • Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56, 345–365.

    Article  PubMed  Google Scholar 

  • Price, C. S., Spence, S. H., Sheffield, J., & Donovan, C. (2002). The development and psychometric properties of a measure of social and adaptive functioning for children and adolescents. Journal of Clinical Child & Adolescent Psychology, 31, 111–122.

    Article  Google Scholar 

  • Price, M., Higa-McMillan, C., Ebesutani, C., Okamura, K., Nakamura, B. J., Chorpita, B. F., & Weisz, J. (2013). Symptom differentiation of anxiety and depression across youth development and clinic-referred/nonreferred samples: An examination of competing factor structures of the Child Behavior Checklist DSM-oriented scales. Development and Psychopathology, 25, 1005–1015.

    Article  PubMed  Google Scholar 

  • Rapee, R. M., Bőgels, S. M., van der Sluis, C. M., Craske, M. G., & Ollendick, T. (2012). Annual research review: Conceptualising functional impairment in children and adolescents. Journal of Child Psychology and Psychiatry, 53, 454–468.

    Article  PubMed  Google Scholar 

  • Reinke, W. M., Eddy, J. M., Dishion, T. J., & Reid, J. B. (2012). Joint trajectories of symptoms of disruptive behavior problems and depressive symptoms during early adolescence and adjustment problems during emerging adulthood. Journal of Abnormal Child Psychology, 40, 1123–1136.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2015). Behavior Assessment System for Children. 3rd ed. Bloomington: NCS Pearson, Inc.

  • Setterberg, S., Bird, H., Gould, M., Shaffer, D., & Fisher, P. (1992). Parent and interviewer version of the Children’s Global Assessment Scale. New York, NY: Columbia University.

    Google Scholar 

  • Singer, J. B., Eack, S. M., & Greeno, C. M. (2011). The Columbia Impairment Scale: Factor analysis using a community mental health sample. Research on Social Work Practice, 21, 458–468.

    Article  Google Scholar 

  • Smith, G. N., Ehmann, T. S., Flynn, S. W., MacEwan, G. W., Tee, K., Kopala, L. C., & Honer, W. G. (2011). The assessment of symptom severity and functional impairment with DSM-IV Axis V. Psychiatric Services, 62, 411–417.

    Article  PubMed  Google Scholar 

  • Sparrow, S. S., Balla, D. A., Cicchetti, D. V., & Doll, E. A. (2005). Vineland-II: Vineland Adaptive Behavior Scales: Survey forms manual. Circle Pines: AGS Publishing.

  • Texas Department of Mental Health and Mental Retardation (2004). Validation and norms for the Ohio Scales among children served by the Texas Department of Mental Health and Mental Retardation. http://www.dshs.state.tx.us/mhprograms/FinalRprtvalidnormsOhioScales.pdf.

  • Texas Department of State Health Services (2007). User’s manual for the child and adolescent Texas recommended assessment guidelines (CA-TRAG) (No. 3.2). http://www.dshs.state.tx.us/WorkArea/DownloadAsset.aspx?id=9952.

  • Treutler, C. M., & Epkins, C. C. (2003). Are discrepancies among child, mother, and father reports on children’s behavior related to parents’ psychological symptoms and aspects of parent–child relationships? Journal of Abnormal Child Psychology, 31, 13–27.

    Article  PubMed  Google Scholar 

  • Turchik, J. A., Karpenko, V., Ogles, B. M., Demireva, P., & Probst, D. R. (2010). Parent and adolescent satisfaction with mental health services: Does it relate to youth diagnosis, age, gender, or treatment outcome? Community Mental Health Journal, 46, 282–288.

    Article  PubMed  Google Scholar 

  • University of Oklahoma E-TEAM (2015). Oklahoma healthy transitions initiative study. Oklahoma Department of Mental Health and Substance Abuse Services. docs.cmhnetwork.org/download.php?id=949.

  • Üstun, B., & Kennedy, C. (2009). What is “functional impairment”? Disentangling disability from clinical significance. World Psychiatry, 8, 82–85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weisz, J. R., Jensen-Doss, A., & Hawley, K. M. (2006). Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychologist, 61, 671–689.

    Article  PubMed  Google Scholar 

  • Youngstrom, E. A., Loeber, R., & Stouthamer-Loeber, M. (2000). Patterns and correlates of agreement between parent, teacher, and male adolescent ratings of externalizing and internalizing problems. Journal of Consulting and Clinical Psychology, 68, 1038–1050.

    Article  PubMed  Google Scholar 

Download references

Author Contributions

S.C.: designed and executed the study, analyzed the data, and wrote the paper. F.T.B.: assisted with the data analyses and writing and editing of final manuscript. C.J.T.: collaborated with the design and writing of the study.

Author information

Authors and Affiliations

  1. Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA

    Sindhia Colburn, F. Tony Bonadio & Carolyn J. Tompsett

Authors
  1. Sindhia Colburn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Tony Bonadio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carolyn J. Tompsett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sindhia Colburn.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Colburn, S., Bonadio, F.T. & Tompsett, C.J. Factor Structure of Parent- and Adolescent-Perceived Functional Impairment. J Child Fam Stud 27, 2811–2823 (2018). https://doi.org/10.1007/s10826-018-1145-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-018-1145-x

Keywords

Search

Navigation