Page 67 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

To determine clinically significant change, the Reliable Change Index was used
on the GSI. Clinically significant change has been defined as “the extent to which
therapy moves someone outside the range of the dysfunctional population or within
the range of the functional population” (Jacobson & Truax, 1991, p. 12). The improved
index for individual reliable change (RCINDIV) introduced by Hageman and Arrindell
(1999) was used. The retest reliability of the norm group’s scores (Boon & De Boer, 4 2007) was used to calculate the standard error of measurement (SE) and the cut-off
point type C. Patients with RCINDIV < -1.65 were considered “improved” and those
with RCINDIV > +1.65 were considered “deteriorated”. Patients with a RCINDIV between -1.65 and +1.65 were categorized as “no reliable change.” Patients with a
reliable change (RCINDIV < -1.65) whose scores were above the cutoff point at T1 and
below this point at T2, were considered “recovered”. All other patients were classified
as showing “no clinically significant change”.
To control for possible differences in population and treatment over the course of 14 years (i.e., the natural design in which patients enrolled in the treatment program at different times), the sample was divided in three cohorts of patients admitted during 1995-1998 (n=44), 1999-2002 (n=47) and 2003-2008 (n=54). To check for changes over time, an ANOVA was performed on the following variables: age at admission, number of previous admissions, length of treatment, GSI at admission.
Results
All 234 inpatients admitted in the residential facility between 1995 and 2009 were approached to participate in the research, 145 of whom participated at both initial assessment and follow-up. For 211 (90.2%), the age of onset of disruptive behavior was determined; 203 (96.2%) completed the SCL-90-R at admission and 145 patients (145/211 = 68.7%) at discharge.
Nonresponse at admission (n=8) was mainly caused by patients who were unable to fill in the questionnaire, e.g., because of active psychotic symptoms. Nonresponse at discharge (n=66) was mainly due to drop out (patients who ran away and could not be traced) or refusal. Two patients committed suicide during treatment. No significant differences were found between the nonresponders and the final sample on sex, age, duration of treatment, and SCL-90-R score at admission. Table 1
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