Syndromes of Preschool Psychopathology Reported by Teachers and Caregivers in 14 Societies Using the Caregiver-Teacher Report Form (C-TRF)

It is now widely recognized that very young children can experience significant emotional and behavioral problems, and that these problems should not be ignored. A recent editorial in a leading child and adolescent psychiatry journal proclaimed that the field of preschool mental health "has arrived--on a global scale" (Carter, 2010, p. 1181). Reliable and valid assessment instruments are needed to aid in the identification and treatment of psychopathology in young children. Most mental health instruments designed for the assessment of preschoolers use parents' reports. However, in the United States (U.S.), the majority of preschoolers spend a significant amount of time in the care of persons other than their parents. The U.S. Census Bureau estimates that over 60% of U.S. children between the ages of zero and six receive regular childcare from persons other than their parents (Federal Interagency Forum on Child and Family Statistics, 2010). This percentage would be substantially higher if the age range excluded infancy. As more women enter the workforce in response to economic globalization and recession, non-parental childcare arrangements will become more prevalent around the globe. Consequently, reliable and valid assessment instruments using non-parental caregiver (e.g., daycare providers, nannies) and teacher reports will be increasingly important for the assessment of preschoolers. Several standardized instruments that use caregiver or teacher reports are available for assessing the emotional, behavioral, and social functioning of preschoolers. These include the Conners' Teacher Rating Scale (CTRS; Conners, 1997); Childcare Provider Form of the Infant Toddler Social Emotional Assessment (ITSEA; Carter & Briggs-Gowan, 2006), Preschool Behavior Questionnaire (PBQ; Behar & Stringfield, 1974), Social Competence and Behavior Evaluation Inventory (SCBE-30; LaFreniere & Dumas, 1996), Strengths and Difficulties Questionnaire for Educators of 3- and 4-Year-Old Children (SDQ T/3-4; Goodman, 1997; Koglen, Barquero, Mayer, Scheithaur, & Petermann, 2007), and the Caregiver-Teacher Report Form (C-TRF; Achenbach & Rescorla, 2000). All six of these instruments are paper-and-pencil questionnaires. Because world communities are becoming more and more diverse, caregivers and teachers are dealing with more cultural and ethnic differences among the children they serve. Consequently, instruments are needed for assessing preschoolers from diverse societies. However, a crucial question is whether an instrument measures the same constructs in different societies. If an instrument is applied to general population samples in different societies, multivariate statistical analyses could be used to determine whether similar patterns of problems are found in the different societies. Statistically-derived patterns of co-occurring problems can be viewed as "syndromes. " Such syndromes are often derived via factor analytic methods, which can be broadly grouped into exploratory and confirmatory factor analysis (EFA and CFA, respectively). EFA identifies syndromes of co-occurring problems, while CFA tests how well particular hypothesized syndromes fit the data. By testing syndromes in different societies, we can determine whether the same syndrome constructs apply in the different societies. The C-TRF obtains ratings of 99 emotional, behavioral, and social problems (plus one open-ended item) from caregivers and teachers of 18- through 71-monthold children. Achenbach and Rescorla (2000) derived six syndromes from C-TRF ratings of 1,113 mostly U.S. preschoolers. The six syndromes are designated as Emotionally Reactive, Anxious/Depressed, Somatic Complaints, Withdrawn, Attention Problems, and Aggressive Behavior. Second-order factor analyses showed that the first four and the last two syndromes form superordinate groupings labeled Internalizing and Externalizing, respectively. Identification of syndromes that are common across societies can facilitate international collaboration among educators, clinicians, and researchers working with preschoolers. …