Psychologists face challenges on a daily basis. Among the challenges they face are making diagnostic decisions. Recently, bipolar disorder has shown an increase in diagnosis in children and adolescents. Once felt to be an adult disorder, journals are describing the use of the diagnosis with children and adolescents. While the diagnosis has been considered as relevant, no psychological measures have been developed to make an accurate diagnosis. Developing a new psychological measure for bipolar disorder in children is critical. Due to the lack of data on what constitutes normal behavior as well as the absence of an accurate measurement of early-onset bipolar disorder, it is necessary to develop such a measure. The purpose of this study was to evaluate a newly developed measure based on the literature on bipolar disorder in children. The measure was developed through a review of the current literature, DSMIV-TR criteria for bipolar disorder, and ideas developed within a bipolar disorder research team at Texas A&M University. Because of the item content, the new measure is entitled the Mania Assessment Scale for Children (MASC). The first steps in understanding a new measure for early-onset bipolar disorder is to determine the factor structure of the scale as well as the reliability and validity. Results indicated that the MASC is best understood as a measure with a single score, or factor. Once the underlying structure of the MASC was determined, the study evaluated which behaviors of typically developing children may be misconstrued as indicative of bipolar disorder. Group differences on the measure are also evaluated. Results from statistical analysis showed that there were significant group differences between age groups, but not gender and ethnic groups. In addition, there was a statistically significant difference between clinical and non-clinical groups. To conclude, a discussion of the findings and recommendations for future research is presented. Overall, it is hoped that the study will help psychologists better understand the complexity of behaviors associated with the diagnosis of bipolar disorder in children and adolescents.

Background: For optimizing the validity of diagnoses of mental disorders, several sources of information should be used to assess psychopathological symptoms. Among these are relatives of patients with mental illness. The very low number of empirical studies examining the assessment of psychopathology by relatives of adult, nondemented mentally ill patients stands in significant contrast to the clinical importance of this source of information, however. Sampling and Methods: Using the Positive and Negative Syndrome Scale (PANSS), researchers asked 163 relatives of patients with the main clinical ICD-10 diagnosis of schizophrenic, recurrent depressive or bipolar disorders to rate the current symptoms of the patients at the time of outpatient community-oriented treatment. Results: On average, severity of symptoms was rated as absent or minimal, although anxiety, depression and passive/apathetic social as well as emotional withdrawal, motor retardation, poor attention, and disturbance of volition were clearly rated above the PANSS mean total score for all patients. A six-factor structure identified by factor analysis better illustrates the significant differences in the assessments of the three main diagnostic groups than the three established PANSS scales. With the exception of ‘problematic social behavior’, differences among the diagnostic groups appeared in all factors and were particularly pronounced for ‘delusional beliefs’ and ‘motor impairments’. Conclusions: The results of this study showed that the use of standardized instruments such as PANSS for the assessment of psychopathology by relatives is not only practical, but produces adequately reliable results. The use of PANSS for this purpose, however, requires interviewing of relatives by trained experts able to explain technical terms. Because this study did not sufficiently explore the validity of this approach, further research on this specific issue is urgently needed and should, for example, assess the concordance of ratings between professionals and relatives as well as correlation with suitable external criteria. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.