Predictors of treatment outcome in a child and adolescent psychiatry clinic: A naturalistic exploration

We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed.     

Temporal stability of entries and predictors for entry into out-of-home care before the third birthday: A Danish population-based study of entries from 1981 to 2008

Objective

Placing a child in out-of-home care is one of the most radical measures a child protection system can decide to take. There is an essential interest in understanding the probability of entering care and what circumstances are related to the decision to place a child in out-of-home care. This study investigates the temporal stability of rates and predictors for entry into care.

Method

Data were obtained by linking several registration systems. The study population was defined as all children entering care before their third birthday from birth cohorts 1981–2008 (N = 11,034). Furthermore, a control population consisting of a randomly assigned quarter of the Danish child population from the same birth cohorts was used (N = 515,773). Rates of entry and Cox regression models from six periods from 1981 to 2008 were used to model co-variates associated with entry into out-of-home care.

Results

The overall likelihood for entering care is found to be decreasing over time. Furthermore, results reveal two trends: relative rates of entry are significantly decreasing for children whose mother has a psychiatric history prior to the child's birth; relative rates are significantly increasing for children whose mother or father was unemployed in the year prior to the child's birth.     

Selection of Predictors in Distance-Based Regression

Distance-based regression is a prediction method consisting of two steps: from distances between observations we obtain latent variables which, in turn, are the regressors in an ordinary least squares linear model. Distances are computed from actually observed predictors by means of a suitable dissimilarity function. Being generally nonlinearly related with the response, their selection by the usual F tests is unavailable. In this article, we propose a solution to this predictor selection problem by defining generalized test statistics and adapting a nonparametric bootstrap method to estimate their p-values. We include a numerical example with automobile insurance data.     

The predictive role of support in the birth experience: A longitudinal cohort study

Background

Several risk factors for negative birth experience have been identified, but little is known regarding the influence of social and midwifery support on the birth experience over time.

Risk and protective factors for child neglect during early childhood: A cross-study comparison

The present analysis relies upon data from three separate longitudinal studies to identify risk and protective factors associated with subsequent neglect during early childhood. All three studies (Fragile Families and Child Wellbeing [FFCW]; Healthy Families New York [HFNY]; Illinois Families Study-Child Wellbeing [IFS]) involve probabilistic samples or subsamples of low-income families with young children. Multivariate logistic regressions predicting official reports of investigated neglect allegations and a dichotomous indicator of neglect from the Parent-child Conflict Tactics Scale (CTS-PC) were conducted separately for each study, using common sets of predictors derived from baseline or initial survey waves. Across the three studies, consistencies emerged with respect to the predictors of both neglect outcomes. Specifically, consistencies emerged related to indicators of economic resources and hardships, parent well-being, and parenting. Understanding the predictors of child neglect is of critical importance to the development of child maltreatment prevention strategies since a clearer understanding of the risk and protective factors associated with neglect would enable more effectively targeted and tailored interventions.     

Predictors of women’s positive childbirth pain experience: Findings from an Icelandic national study

Background

Pain in childbirth has been identified as one of the major components in the childbirth experience and an important topic that needs to be addressed during pregnancy, birth and the after-birth period.