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Cited by 16Psychosomatic Disorders and Their TreatmentsChild and Adolescent Psychosocial and Emotional DevelopmentPsychoanalysis and Psychopathology Research

The Utility (or Not) of Self-Report Instruments in Family Assessment for Child and Adolescent Conversion Disorders?

Kozlowska, Kasia, Cruz, Catherine, Davies, Fiona, Brown, Kerri J., Palmer, Donna M., McLean, Loyola, Scher, Stephen, Williams, Leanne M.·2016·Australian and New Zealand Journal of Family Therapy
DOI 10.1002/anzf.1187
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Abstract

Children and adolescents with conversion disorders and their families are challenging to understand and challenging to treat. This study examined whether self‐report instruments are a useful adjunct to family and individual assessment. A total of 57 children and adolescents diagnosed with conversion disorders and 57 sex‐ aged‐matched controls, along with their parents, completed the Strength and Difficulties Questionnaire, Child Behaviour Checklist, Depression Anxiety and Stress Scales, Somatic and Psychological Health Report (SPHERE), Brief Risk‐Resilience Index for Screening, and the NEO–Five‐Factor Inventory. The conversion disorder and control groups were compared on each questionnaire, and classified participants as ‘cases’ or not according to established clinical thresholds for each questionnaire. A discriminant analysis was used to examine which components of the SDQ, CBCL, DASS, SPHERE, BRISC, and NEO‐FFI emerged as most useful in identifying the clinical characteristics of children with conversion disorders. The role of attachment strategy with regards to the utility of self‐report measures was also examined. The SPHERE was the only self‐report that our patient cohort were able to utilise to communicate their somatic and emotional discomfort and distress. Our results suggest that children and adolescents presenting with functional somatic symptoms represent a distinctive clinical population for which the ‘psychological’ focus of most currently available questionnaires is not useful for identifying the presence of somatic illness or of comorbid anxiety and depression, and that these measures – with the exception of the SPHERE – are not a useful adjunct to a family‐based assessment. Therapeutic conversations that utilise language that asks about the state of the body – the body's response to stress, illness, pain, and injury – facilitate engagement and serve as the cornerstone of treatment.

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Crossref · 10.1002/anzf.1187

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  • The diagnosis of comorbid mental health concerns in children with FND is much more likely to be accurate when it is based on clinical interview rather than self-report measures using psychological constructs.

    “The implication is that the diagnosis of comorbid mental health concerns in children with FND is much more likely to be accurate when it is based on clinical interview rather than self-report measures using psychological constructs [32,65].”

    From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [65]

  • One study found that even in children with FND (n = 57) who were admitted to hospital with mixed somatic and psychological symptoms and high levels of functional disability, self-report measures commonly used by mental health clinicians did not identify these children as distressed and as requiring clinical intervention.

    “One study found that even in children with FND (n = 57) who were admitted to hospital with mixed somatic and psychological symptoms and high levels of functional disability, self-report measures commonly used by mental health clinicians did not identify these children as distressed and as requiring clinical intervention [65].”

    From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [65]

  • In our experience, the necessary information about psychological processes tends to emerge slowly during the therapeutic process, and it is unusual to be able to access information about inner thoughts and feelings via brief evaluation processes (including questionnaires).

    “In our experience, however, the necessary information about psychological processes tends to emerge slowly during the therapeutic process, and it is unusual to be able to access information about inner thoughts and feelings via brief evaluation processes (including questionnaires) [65].”

    From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [65]

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Authors
Kozlowska, K., Cruz, C., Davies, F., Brown, K. J., Palmer, D. M., McLean, L., Scher, S., & Williams, L. M.
Affiliations
  • The University of Sydney (AU)
  • Children's Hospital at Westmead (AU)
  • Royal Australasian College of Physicians (AU)
Corresponding author
Kozlowska, Kasia
ORCID
Venue
Australian and New Zealand Journal of Family Therapy
Publisher
Wiley
Published
2016-12
Volume
37
Issue
4
Pages
480-499
ISSN
  • 0814-723X (ISSN-L)
  • 1467-8438
DOI
10.1002/anzf.1187
OpenAlex
W2564055792
Cited by
16
References
43
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1
FWCI
1.48
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 19 d)
Locations
Australian and New Zealand Journal of Family Therapy (publishedVersion)
Funders
  • The Children's Hospital at Westmead
  • The Brain Dynamics Centre
  • Westmead Millenium Institute for Medical Research
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
conversion disorder, functional somatic symptoms, self-report questionnaire, family assessment, children and adolescents, Strengths and Difficulties Questionnaire, Child Behavior Checklist, DASS, NEO-FFI, attachment strategies, comorbid depression and anxiety, family-based treatment, therapeutic language

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