Entwicklungsstörungen: Evaluation verschiedener Messinstrumente zur Erfassung von Symptomatik und bedeutenden Kontextvariablen

Developmental disorders include a variety of disorders that can impair personal, social, academic, or occupational functioning. The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) contains the category of neurodevelopmental disorders that can reach from very specific areas like learning and executive functions to more general areas like social or intellectual abilities. Part of the neurodevelopmental disorders is the Attention deficit/hyperactivity disorder (ADHD) that is characterized by problems regarding attention, activity, and impulsivity. Manifestation, course, and family burden of developmental disabilities depend on individual risk and protective factors. Therefore, it is important to consider them in the context of prevention and intervention. For example, children and adolescents with developmental disabilities have an approximately three to four times elevated risk of presenting with emotional and behavioral problems (Einfeld & Tonge, 1996) which do not only have a negative impact on the psychopathology of the children themselves (Emerson, 2003) but also on parental stress and the parents’ mental health (Baker et al., 2002; Emerson, Robertson, & Wood, 2004; Hastings, 2002) as well as quality of life (Schei, Jozefiak, Novik, Lydersen, & Indredavik, 2016). Thus, study 1 evaluated and developed further the Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD; Mazzucchelli, Sanders, & Morawska, 2011), a questionnaire assessing emotional and behavioral problems of children and adolescents with developmental disabilities as well as parental self-efficacy in handling these problems. Several factor analyses supported a three factor structure of the frequency scale (emotional problems, behavioral problems, prosocial behavior) and a one factor structure of the self-efficacy scale that turned out to be reliable and valid (concurrent and predictive validity). The CAPES-DD thus not only assesses problems but also strengths. With the direct link of the reported difficulties and the parents’ beliefs about being able to handle them it combines two constructs in one measure and diminishes the assessment burden of the already stressed families. Studies 2 and 3 focus more specifically on ADHD. Study 2 investigated the differential contributions of various diagnostic instruments for ADHD (subjective ratings, objective tests) by determining their prognostic accuracy regarding an ADHD diagnosis. As subjective measures always incorporate the risk of informant bias and previous research showed that both methods seem to assess partly different constructs, it was of special interest to determine whether a reliable prediction is possible based on objective measures only free of subjective influences. A relatively high accuracy of 79 % (adults) and 78 % (children) was obtained for the objective measures. The combination of both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5 %) and children (86.7 %), with the subjective variables proving to be the most relevant. Study 3 evaluated the German version of the Child and Adolescent Social Support Scale (CASSS; Malecki, Demaray, & Elliott, 2000), an instrument assessing perceived social support of children and youths, and compared a group of children with ADHD with one of healthy controls regarding their perception of social support. A four factor structure according to the four sources of social support (parents, teacher, classmates, close friend) was supported that proofed reliable. Further validity analyses regarding concurrent, discriminant and predictive validity are necessary. Multivariate analyses of variance and subsequent univariate analyses showed children with ADHD to perceive less social support in total and by every individual source. In conclusion, with the CAPES-DD there is an instrument that assesses emotional and behavioral problems as well as prosocial behavior of children and adolescents with developmental disabilities and parental self-efficacy in a reliable and valid way. Also, the German version of the CASSS turned out to be a reliable instrument, and its construct validity could be confirmed. Further validity analyses of the measure will be necessary. The relevance of social support especially in the context of ADHD was confirmed by showing children with ADHD to perceive less social support. Objective tests were highly accurate in predicting ADHD diagnosis highlighting their diagnostic value. A combination of subjective and objective measures is recommended.