Preschool Psychopathology Reported by Parents in 23 Societies: Testing the Seven-Syndrome Model of the Child Behavior Checklist for Ages 1.5–5

doi:10.1016/j.jaac.2010.08.019

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 49, Issue 12, December 2010, Pages 1215-1224

, , , , , , , , , , , , , , , , , , , …

https://doi.org/10.1016/j.jaac.2010.08.019 Get rights and content

Objective

To test the fit of a seven-syndrome model to ratings of preschoolers' problems by parents in very diverse societies.

Method

Parents of 19,106 children 18 to 71 months of age from 23 societies in Asia, Australasia, Europe, the Middle East, and South America completed the Child Behavior Checklist for Ages 1.5–5 (CBCL/1.5–5). Confirmatory factor analyses were used to test the seven-syndrome model separately for each society.

Results

The primary model fit index, the root mean square error of approximation (RMSEA), indicated acceptable to good fit for each society. Although a six-syndrome model combining the Emotionally Reactive and Anxious/Depressed syndromes also fit the data for nine societies, it fit less well than the seven-syndrome model for seven of the nine societies. Other fit indices yielded less consistent results than the RMSEA.

Conclusions

The seven-syndrome model provides one way to capture patterns of children's problems that are manifested in ratings by parents from many societies. Clinicians working with preschoolers from these societies can thus assess and describe parents' ratings of behavioral, emotional, and social problems in terms of the seven syndromes. The results illustrate possibilities for culture–general taxonomic constructs of preschool psychopathology. Problems not captured by the CBCL/1.5–5 may form additional syndromes, and other syndrome models may also fit the data.

Section snippets

Previous EFA and CFA Studies of the Preschool CBCL

Konold et al.⁶ tested the CBCL/1.5–5 syndrome model using CBCL data obtained in the National Institute of Child Health and Development Study of Early Child Care (NICHD SECC). Mothers of 1,097 children completed an early version of the CBCL/1.5–5, namely the CBCL for Ages 2–3⁷, when the children were 24 months old. The study tested whether the CBCL/1.5–5 syndrome model was invariant across gender, ethnic groups (African American vs. white), and socioeconomic status (SES; low vs. high). First,

Study Purpose

The purpose of this study was to test the configural invariance of the correlated seven-syndrome model of the CBCL/1.5–5⁴ in 23 societies. We believe this study to be the first multicultural test of taxonomic constructs of preschool psychopathology. It differs from other studies of preschool psychopathology by using uniform CFA procedures to test the same syndrome model in 23 societies. If a syndrome model is supported in many societies, it can provide a taxonomy for assessing psychopathology

Samples

We analyzed data for 19,106 children 1.5 to 5 years old from the 23 epidemiological samples listed in Table 1. We included children who were referred for mental health services. The English language CBCL/1.5–5 was translated for use in all societies except in Australia. Independent back-translations established that translations captured the original meanings. Consent requirements for each investigator's institution were fulfilled. All samples were approximately 50% male. In a companion paper

Results

The model converged for all samples. As presented in Table 1, RMSEAs ranged from 0.036 to 0.059, indicating acceptable to good fit for all societies (25^th percentile = 0.043, 50^th = 0.045, and 75^th = 0.048). CFIs ranged from 0.789 to 0.952, indicating acceptable to good fit for all societies except Iran and Italy (25^th percentile = 0.847, 50^th = 0.878, and 75^th = 0.904). TLIs ranged from 0.824 to 0.972 (25^th percentile = 0.901, 50^th = 0.920, and 75^th = 0.933), indicating acceptable to good fit

Discussion

We found that the seven-syndrome model fit the data for all 23 societies. Our primary fit index, the RMSEA, indicated acceptable to good fit in all societies, although the CFI and TLI were more variable. Of the 5,267 estimated parameters, the two (0.04%) that were outside the allowable parameter space possibly reflected sampling error, according to Van Driel.²¹ Across societies, the median loading of items on their respective factors was high (0.61).

The findings supported the configural

References (32)

H.L. Egger
Psychiatric assessment in young children
Child Adolesc Psychiatr Clin North Am
(2009)
H.L. Egger et al.
Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology
J Child Psychol Psychiatry
(2006)
C. Postert et al.
Five systems of psychiatric classification for preschool children: Do differences in validity, usefulness, and reliability make for competitive or complimentary constellations?
Child Psychiatry Hum Dev
(2009)
T.M. Achenbach et al.
Manual for the ASEBA Preschool Forms & Profiles
(2000)
R.J. Vandenberg et al.
A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research
Organ Res Methods
(2000)
T.R. Konold et al.
Measuring problem behaviors in young children
Behav Disord
(2003)
T.M. Achenbach
Manual for the Child Behavior Checklist/2-3 and 1992 Profile
(1992)
T.X. Tan et al.
Factor structure and clinical implications of Child Behavior Checklist/1.5–5 ratings in a sample of girls adopted from China
J Pediatr Psychol
(2007)
H.M. Koot et al.
Behavioral and emotional problems in young preschoolers: Cross-cultural testing of the validity of the Child Behavior Checklist/2-3
J Abnorm Child Psychol
(1997)
J. Graham
Missing data analysis: Making it work in the real world
Annu Rev Psychol
(2009)

Stata Statistical Software: Release 10

(2007)

T.E. Raghunathan et al.

Multivariate technique for multiply imputing missing values using a sequence of regression models

Surv Methodol

(2001)

S. Van Buuren et al.

Fully conditional specification in multivariate imputation

J Stat Comput Simulation

(2006)

L.K. Muthén et al.

Mplus User's guide

(2007)

C.Y. Yu et al.

Evaluation of Model Fit Indices for Latent Variable Models with Categorical and Continuous Outcomes (Technical Report)

(2002)

M.W. Browne et al.

Alternative ways of assessing model fit

Cited by (220)

Prenatal exposure to per- and polyfluoroalkyl substances and child behavioral problems
2024, Environmental Research
Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may adversely affect child behaviors; however, findings of epidemiologic studies are inconsistent. We examined prenatal PFAS exposure in association with child behavioral problems.
Participants were 177 mother–child pairs from MARBLES (Markers of Autism Risk in Babies – Learning Early Signs), a cohort with elevated familial likelihood of autism spectrum disorder (ASD). We quantified nine PFAS in maternal serum (1–3 samples per mother) collected from the 1st to 3rd trimesters of pregnancy. Child behavioral problems were assessed at 3 years of age using the Child Behavior Checklist (CBCL), developed to test for various behavioral problems of children. We examined associations of the CBCL scores with individual PFAS concentrations and with their mixture using negative binomial regression and weighted quantile sum regression models.
Higher prenatal perfluorononanoate (PFNA) concentrations were associated with higher scores of externalizing problems [β = 0.16, 95% CI (0.01, 0.32)] and aggressive behavior [β = 0.17 (0.01, 0.32)]. Higher PFNA, perfluorooctane sulfonate (PFOS), and perfluorodecanoate (PFDA) were associated with higher scores of sleep problems [β = 0.34 (0.15, 0.54) for PFNA, β = 0.20 (0.02, 0.37) for PFOS, and β = 0.19 (0.00, 0.37) for PFDA]. No significant associations observed for typically developing children, whereas PFOS, PFNA, and PFDA were associated with several behavioral problems among children diagnosed with ASD or other neurodevelopmental concerns. Exposure to a mixture of PFAS was associated with higher scores of sleep problems and aggressive behavior, mostly contributed by PFNA and PFDA.
Our study showed that prenatal exposure to some PFAS could increase child behavioral problems at 3 years of age. However, our results should be interpreted with caution because we relied on data from a cohort with increased familial likelihood of ASD and thereby had more behavioral problems.
A non-randomized controlled study to assess the impact of the “Appui Parental”, an early and intensive support programme for vulnerable families: Study protocol
2024, Encephale
Early home visit programmes have been developed to help parents build an adequate relationship with their baby and to prevent child developmental delays and affective disorders. The “Appui Parental” programme is an intervention carried out by nursery nurses to provide intensive parental support to vulnerable families. Before extending this programme, it seemed necessary to evaluate its impact objectively.
The main aim is to determine the impact of the “Appui Parental” programme on the change in the child's symptoms. The secondary objectives are to evaluate its effects on mother-child interactions, self-assessed parental competence, perception of social support, primary caregiver's anxiety-depression symptoms, alliance with the nursery nurse, frequency of out-of-home placements, and nursery nurses’ stress.
This non-randomized prospective multicentre study would include 44 families who receive the “Appui Parental” intervention for a one to 20-month-old child (intervention group) and 44 families with the same vulnerability criteria who receive care as usual by the maternal and child protection services (control group). The child, parents, mother-child interaction, nursery nurse-mother alliance, and nursery nurse's stress will be assessed at month one and month 18 after inclusion. Comparisons between groups will be performed.
This study should provide the public authorities with objective data on this programme's impact and allow them to pursue its generalization. For professionals, the study should confirm the interest in close early parental support through home visits or should lead to rethinking some aspects of the programme.
Afin de prévenir les troubles psychoaffectifs, les retards de développement et les troubles somatiques associés, plusieurs programmes de soutien parental précoce sous forme de visites à domicile ont été élaborés, notamment pour les familles dites à risque multiple. Ils ont pour objectif de soutenir la mise en place d’un environnement familial et de relations parent-enfant adaptés. En France, ce soutien parental précoce est pratiqué essentiellement par les services territorialisés de protection maternelle et infantile (STPMI). On observe cependant peu de programmes structurés ou d’interventions thérapeutiques à domicile spécifiques, et peu d’études ayant évalué leur efficacité. L’Appui Parental, action de soutien parental renforcé réalisée par des puéricultrices dans des familles vulnérables avec un enfant de moins de 3 ans, vise à soutenir de façon intense et prolongée les compétences parentales et la mise en place d’une relation d’attachement sécure. Après environ quinze ans d’existence, et avant d’étendre cette action à d’autres territoires, une évaluation objective de son impact a été décidée.
L’objectif principal est de déterminer l’impact de l’Appui Parental sur la symptomatologie de l’enfant 18 mois après le début de l’intervention. Les objectifs secondaires sont d’évaluer les effets de l’intervention sur le développement de l’enfant, les interactions mère-enfant, le sentiment de compétence parentale, la perception du soutien social, l’état anxiodépressif de la mère ou du soignant principal, l’alliance entre la mère et la puéricultrice, la fréquence de la judiciarisation des situations et enfin sur le stress des puéricultrices.
Cette étude prospective multicentrique inclut 44 familles bénéficiant d’un appui parental pour un enfant âgé de 1 à 20 mois (groupe intervention) et 44 familles répondant à des critères de vulnérabilité équivalents et qui bénéficient de la prise en charge habituelle proposée par le STPMI (groupe contrôle). Une évaluation du développement de l’enfant, de l’état psychologique des parents, de l’interaction mère-enfant, de l’alliance puéricultrice-mère et du stress du professionnel a lieu dans le mois suivant l’inclusion et 18 mois plus tard, à l’aide de questionnaires et d’un enregistrement vidéo d’un épisode de jeu mère-enfant. Les résultats à 18 mois seront comparés dans les deux groupes après ajustement sur l’état initial à l’aide d’une régression linéaire incluant tous les facteurs de confusion identifiés dans les analyses univariées comparant les deux groupes.
Nous formulons l’hypothèse que les symptômes de l’enfant après 18 mois de suivi seront significativement moins importants chez les sujets ayant bénéficié de l’Appui parental (groupe intervention) en comparaison des sujets avec une prise en charge classique (groupe contrôle). De même, il est attendu que les autres tests aient des meilleurs résultats dans le groupe intervention que dans le groupe contrôle. Cette étude devrait apporter aux pouvoirs publics une meilleure visibilité sur les résultats que l’on peut attendre de ce dispositif et le cas échéant, en poursuivre la généralisation. Aux professionnels, l’étude devrait confirmer l’intérêt d’un soutien rapproché à domicile ou conduire à repenser certains aspects du dispositif.
Association between maternal labour epidural analgesia and autistic traits in offspring
2023, Journal of Clinical Anesthesia
Studies investigating associations between maternal epidural analgesia (MEA) and autism spectrum disorder (ASD) in the offspring are conflicting and lack prospective neurobehavioral follow-up assessments for autistic traits. We aim to prospectively investigate associations between MEA and autistic traits in the offspring.
Prospective neurobehavioral observational cohort study.
Singaporean tertiary healthcare institutions.
Participants recruited were singleton non-IVF children, >36 weeks gestation, delivered via normal vaginal delivery by mothers >18 years of age, delivered in Singapore from June 2009–September 2010 and followed up over 7 years.
Exposure to maternal epidural analgesia during delivery.
The primary outcome is an abnormal Social Responsiveness Scale (SRS) T score at 7 years (≥60 points). Secondary outcomes include the diagnosis of ASD and abnormal scores for autistic traits assessed via a neurobehavioral battery comprising: CBCL (child behavioural checklist), Q-CHAT (Quantitative Checklist for Autism in Toddlers), and Bayley-III. Multivariable analyses adjusting for maternal and offspring characteristics were performed.
704 out of 769 mother-child dyads recruited fulfilled the criteria for analysis. 365/704 mothers received MEA.
The incidence of an abnormal SRS score at 7 years in offspring exposed to MEA was 19.9%, and 26.1% in non-exposed offspring (p = 0.154). Multivariable analysis did not demonstrate a significant association between MEA and abnormal SRS scores at 7 years (O.R.0.726, 95% C·I. 0.394–1.34, p = 0.305). After adjustment for maternal and fetal demographics, exposure to MEA was not significantly associated with an abnormal screen in all other tests for autistic traits.
The clinical incidence of ASD was 1.76% in children without exposure to MEA, and 2.32% in children with MEA exposure (p = 0.506).
MEA is not significantly associated with the development of ASD and autistic traits in offspring, assessed over 7 years. Results should be taken into perspective given our wide confidence intervals and small cohort size.
Intergenerational and early life associations of the gut microbiome and stress-related symptomatology among Black American mothers and children
2023, Brain, Behavior, and Immunity - Health
Recent evidence suggests that maternal childhood adversity may have an intergenerational impact, with children of adversity-exposed mothers exhibiting elevated symptoms of psychopathology. At the same time, many children demonstrate resilience to these intergenerational effects. Among the variety of factors that likely contribute to resilience, the composition of the gut microbiome may play a role in buffering the negative impacts of trauma and stress. The current prospective cohort study tested the novel hypothesis that offspring gut microbiome composition is a potential moderator in the relationship between maternal exposure to childhood adversity and offspring symptomatology (i.e., internalizing, externalizing, and posttraumatic stress symptoms). Maternal childhood adversity was self-reported during pregnancy via the Childhood Trauma Questionnaire and Adverse Childhood Experiences (ACEs) survey, and offspring symptomatology was assessed with the Child Behavior Checklist/1.5–5 when offspring were 2–4 years old. Offspring fecal samples were collected between these timepoints (i.e., during 6- to 24-month follow-up visits) for microbiome sequencing. Results indicated that maternal ACEs and the relative abundances of Bifidobacterium, Lactobacillus, and Prevotella were associated with offspring symptomatology. However, there was little evidence that microbial abundance moderated the association between maternal adversity and offspring symptoms. Overall, these findings further our understanding of how the gut microbiome associates with psychopathology, and informs future studies aimed at targeting modifiable factors that may buffer the intergenerational effects of childhood adversity.
Predictive factors for the outcome of emotional and/or behavioural disorders in 18- to 48-month-old children after parent-child psychotherapy: Protocol of a European prospective cohort study
2023, Encephale
Several studies have shown that in young children, behavioural and/or emotional disorders are more difficult to manage than regulatory disorders. Moreover, data are lacking on outcome predictive factors. This article presents a short synthesis of previous research about outcome predictive factors in child psychiatry. It also describes the protocol of a longitudinal observational European multicentre study the main objective of which was to identify predictive factors of behavioural and emotional disorder outcome in toddlers after parent-child psychotherapy. The secondary objectives were to study predictive factors of the outcome in parents (anxiety/depression symptoms) and parent-child relationship.
In order to highlight medium-effect size, 255 toddlers (age: 18 to 48 months) needed to be included. Outcomes will be assessed by comparing the pre- and post-therapy scores of a battery of questionnaires that assess the child's symptoms, the parents’ anxiety/depression, and the parent-child relationship. Multivariate linear regression analysis will be used to identify predictive factors of the outcome among the studied variables (child age and sex, socio-economic status, life events, disorder type, intensity and duration, social support, parents’ psychopathology, parents’ attachment, parent-child relationships, therapy length and frequency, father's involvement in the therapy, and therapeutic alliance).
This study should allow identifying some of the factors that contribute to the outcome of externalizing and internalizing disorders, and distinguishing between pre-existing and treatment-related variables. It should also help to identify children at higher risk of poor outcome who require special vigilance on the part of the therapist. It should confirm the importance of therapeutic alliance.
ID-RCB 2008-A01088-47.
Les troubles du comportement et les troubles émotionnels représentent des motifs de consultation fréquents chez le jeune enfant. Plusieurs études ont montré une plus grande difficulté de traitement de ces troubles comparés aux troubles fonctionnels, mais il existe peu de données sur les facteurs prédictifs de leur évolution après leur prise en charge. Les études sur le sujet dans le champ de la psychiatrie de l’enfant sont souvent contradictoires et peu nombreuses dans les populations d’enfants de moins de cinq ans. Chez les enfants et les adolescents, les facteurs associés à une moins bonne évolution de l’enfant le plus souvent retrouvés sont l’intensité des troubles de l’enfant, la présence d’une psychopathologie parentale, des événements de vie négatifs et une alliance thérapeutique défavorable. Dans les populations de jeunes enfants, d’autres études sont nécessaires pour mieux appréhender les facteurs impliqués dans l’échec ou le succès des thérapies, déterminer si ce sont les mêmes facteurs que chez les enfants plus âgés, cibler les populations à risques d’échec et au-delà, déterminer quels types d’interventions proposer selon les caractéristiques de chaque famille. L’étude que nous proposons se centre sur les premiers points. L’objectif principal de l’étude présentée est d’étudier les facteurs prédictifs de l’évolution de l’enfant après une prise en charge thérapeutique parent-enfant dans une population de jeunes enfants présentant des troubles du comportement ou des troubles émotionnels. Les objectifs secondaires sont d’étudier les facteurs prédictifs du devenir des parents (symptômes anxieux et dépressifs) et du devenir de la relation parent-enfant.
L’étude est conduite auprès d’une population de 255 enfants âgés de 18 à 48 mois, consultant pour la première fois en psychiatrie de l’enfant et bénéficiant d’une prise en charge ambulatoire habituelle de type consultations thérapeutique parent-enfant. Les jeunes enfants bénéficient d’une batterie de tests permettant d’évaluer: l’évolution de chaque cas, par une comparaison avant et à la fin de la thérapie et/ou à 18 mois, des troubles de l’enfant (Child Behavior Child List, CBCL), des relations parents-enfant (Parent-Infant Relationship Global Assessment Scale, PIRGAS) et des symptômes anxieux et dépressifs des parents (State-Trait Anxiety Inventory, STAI et Center for Epidemiological Studies Depression, CESD); les facteurs prédictifs de l’évolution comprenant, d’une part des caractéristiques de l’enfant et de sa famille: sexe et âge de l’enfant, statut socio-économique, évènements de vie, intensité, type et durée des symptômes de l’enfant, support social, psychopathologie des parents, état d’esprit quant à l’attachement des parents, relation parent-enfant, et d’autre part, des caractéristiques de la prise en charge : durée et fréquence de la thérapie, engagement du père dans la thérapie et alliance therapeutique. Pour investiguer les facteurs pouvant influencer la modification du score du CBCL avant et après la thérapie, des modèles linéaires ajustés sur la ligne de base du score du CBCL seront réalisés pour chaque facteur étudié. Une analyse de régression linéaire multivariée sera alors effectuée. La même méthode sera utilisée pour étudier les facteurs associés à l’évolution du PIR-GAS, du STAI et du CESD.
Cette recherche doit permettre d’identifier les facteurs qui contribuent à l’évolution des troubles du comportement et des troubles émotionnels du jeune enfant, et faire la part des variables préexistantes au traitement et des variables liées au traitement. Elle doit en outre permettre de mieux repérer les enfants les plus à risque d’une évolution défavorable après prise en charge, nécessitant une vigilance particulière du thérapeute. Elle devrait également confirmer l’importance de l’alliance thérapeutique.
Evidence map of Spanish language parent- and self-report screening and diagnostic tools for autism spectrum disorder
2023, Research in Autism Spectrum Disorders
With increasing interests in identification and diagnosis of autism spectrum disorder (ASD) across the world, a number of screening and diagnostic tools have been developed and translated from one language to another in varying qualities. In particular, many tools have been made available in Spanish to meet the needs of the world’s large Spanish-speaking populations. Critical examination of such Spanish language tools, in the areas of development and translation as well as empirical testing, is necessary to determine the quality of these tools, including their validity and reliability in the target population. The aim of the present review is to provide a comprehensive evidence map of screening and diagnostic tools for ASD in Spanish, especially with regards to the aspects of development/translation and empirical testing.
A total of 48 Spanish versions of 21 instruments met study criteria for analysis after conducting multiple searches through nine key databases, grey literature, and by contacting authors, translators, and publishers.
Results showed that a significant number of translations lacked translational process details in published locations and a majority of the studies used a traditional forward-backward approach rather than cultural adaptation procedures. About half of the translations did not provide necessary empirical evidence to support clinical utility of their translated tool.
Future studies are recommended to take more rigorous, culturally adaptive translational approach and test instruments in local populations to ensure their psychometric validities.

View all citing articles on Scopus

: This article is discussed in an editorial by Dr. Alice Carter on page 1181.

: Disclosure: Dr. Ivanova receives research and salary support from the Research Center for Children, Youth, and Families, which publishes the Child Behavior Checklist (CBCL). Dr. Achenbach is President of the Research Center for Children, Youth, and Families, and receives remuneration. Dr. Rescorla receives remuneration from the Research Center for Children, Youth, and Families. Dr. Harder previously held a University of Vermont Postdoctoral Fellowship funding by the Research Center for Children, Youth, and Families. Drs. Bjarnadottir, Gudmundsson, Leung, Verhulst, and Mr. Gudmundsson, receive research support from the sale of the CBCL. Dr. Bilenberg has received honoraria from Eli Lilly and Co., Novartis, Neuroscience, and Janseen Cilag. He has received research support from the Danish Research Foundation, the Lundbeck Foundation, Hermansens Mindelegat, and Mads Clausen Fond. Dr. Eapen has received research support from the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences. Dr. Jusiene has received research support from the Lithuanian Science and Studies Foundation. Drs. Ang, Capron, Dias, Dobrean, Doepfner, Duyme, Erol, Esmaeili, Ezpeleta, Frigerio, Gonçalves, Jeng, Kim, Liu, Oh, Plueck, Pomalima, Shahini, Silva, Simsek, Sourander, Valverde, Van Leeuwen, and Zubrick, Ms. De Pauw, Ms. Kristensen, Mr. Lecannelier, Ms. Montirosso, Ms. Jetishi, Ms. Woo, and Ms. Wu report no biomedical financial interests or potential conflicts of interest.

View full text

New researchPreschool Psychopathology Reported by Parents in 23 Societies: Testing the Seven-Syndrome Model of the Child Behavior Checklist for Ages 1.5–5

Objective

Method

Results

Conclusions

Section snippets

Previous EFA and CFA Studies of the Preschool CBCL

Study Purpose

Samples

Results

Discussion

Child Adolesc Psychiatr Clin North Am

Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology

J Child Psychol Psychiatry

Five systems of psychiatric classification for preschool children: Do differences in validity, usefulness, and reliability make for competitive or complimentary constellations?

Child Psychiatry Hum Dev

Manual for the ASEBA Preschool Forms & Profiles

A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research

Organ Res Methods

Measuring problem behaviors in young children

Behav Disord

Manual for the Child Behavior Checklist/2-3 and 1992 Profile

Factor structure and clinical implications of Child Behavior Checklist/1.5–5 ratings in a sample of girls adopted from China

J Pediatr Psychol

Behavioral and emotional problems in young preschoolers: Cross-cultural testing of the validity of the Child Behavior Checklist/2-3

J Abnorm Child Psychol

Missing data analysis: Making it work in the real world

Annu Rev Psychol

Stata Statistical Software: Release 10

Multivariate technique for multiply imputing missing values using a sequence of regression models

Surv Methodol

Fully conditional specification in multivariate imputation

J Stat Comput Simulation

Mplus User's guide

Evaluation of Model Fit Indices for Latent Variable Models with Categorical and Continuous Outcomes (Technical Report)

Alternative ways of assessing model fit

New research
Preschool Psychopathology Reported by Parents in 23 Societies: Testing the Seven-Syndrome Model of the Child Behavior Checklist for Ages 1.5–5