Identifying Risk for Social/Emotional Difficulty in Adolescents with Sickle Cell Disease Using the Pediatric-Symptom-Checklists

Abstract

The Pediatric Symptom Checklist (PSC) is used to screen for social/emotional difficulty in youth. It is completed by either a parent (PSC) or patient (Y-PSC). The Achenbach Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) are parent- and self-completed social/emotional assessment tools that are well validated, but the less validated PSC and Y-PSC’s availability, convenience, and cost are advantageous for busy clinics. Objective: We examined the appropriateness of using the PSC and Y-PSC to screen adolescents with sickle cell disease for social/ emotional difficulty. Method: Patients with sickle cell disease (n=14; 7 female; mean age ± SD= 4.1 ± 1.8) completed the Y-PSC and YSR, while their parents completed the PSC and CBCL. Rates of risk for social/emotional difficulty were compared between parent-completed forms (PSC versus CBCL), and between patient-completed forms (YPSC and YSR). Agreement in the presence or absence of risk was explored as well. Results: Six youth had total scores exceed cutoffs for a positive screen. Parent-completed questionnaires each identified 4 youth; the YSR and Y-PSC identified 4 and 2 respectively. However, no 2 tools identified the exact same combination of youth and no single informant or tool captured all youth with risk for social/emotional difficulty. Conclusion: Our results, though preliminary, indicate that no single informant or screening tool sufficiently captures risk for social/emotional difficulty in the adolescent sickle cell population. Instead, a multi-informant, multi-method approach to screening for social/ emotional difficulty in adolescents with sickle cell disease is encouraged until additional research can illuminate an alternative.