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Loneliness is a major risk factor for both psychological disturbance and poor health outcomes in adults. This study aimed to assess whether loneliness is associated with a long-term disruption in mental health that extends into adulthood. This study is based on the longitudinal, community-representative Great Smoky Mountains Study of 1420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9-16; 6674 observations; 1993-2000) for childhood loneliness, associated psychiatric comorbidities and childhood adversities. Participants were followed up four times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1334 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric anxiety, depression, and substance use outcomes. Both self and parent-reported childhood loneliness were associated with adult self-reported anxiety and depressive outcomes. The associations remained significant when childhood adversities and psychiatric comorbidities were accounted for. There was no evidence for an association of childhood loneliness with adult substance use disorders. More associations were found between childhood loneliness and adult psychiatric symptoms than with adult diagnostic status. Childhood loneliness is associated with anxiety and depressive disorders in young adults, suggesting that loneliness - even in childhood - might have long-term costs in terms of mental health. This study underscores the importance of intervening early to prevent loneliness and its sequelae over time.

Originating in the 1960s, the Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of instruments for assessing problems and strengths for ages 1½–90+ years. To provide an overview of the ASEBA, related research, and future directions for empirically based assessment and taxonomy. Standardized, multi-informant ratings of transdiagnostic dimensions of behavioral, emotional, social, and thought problems are hierarchically scored on narrow-spectrum syndrome scales, broad-spectrum internalizing and externalizing scales, and a total problems (general psychopathology) scale. DSM-oriented and strengths scales are also scored. The instruments and scales have been iteratively developed from assessments of clinical and population samples of hundreds of thousands of individuals. Items, instruments, scales, and norms are tailored to different kinds of informants for ages 1½–5, 6–18, 18–59, and 60–90+ years. To take account of differences between informants' ratings, parallel instruments are completed by parents, teachers, youths, adult probands, and adult collaterals. Syndromes and Internalizing/Externalizing scales derived from factor analyses of each instrument capture variations in patterns of problems that reflect different informants' perspectives. Confirmatory factor analyses have supported the syndrome structures in dozens of societies. Software displays scale scores in relation to user-selected multicultural norms for the age and gender of the person being assessed, according to ratings by each type of informant. Multicultural norms are derived from population samples in 57 societies on every inhabited continent. Ongoing and future research includes multicultural assessment of elders; advancing transdiagnostic progress and outcomes assessment; and testing higher order structures of psychopathology.

As summarized in this commentary, the first generation of cross-informant agreement research focused on perceptions of child and adolescent mental health. Contributions of this research include demonstrating that modest cross-informant agreement is a very robust phenomenon, utilizing numerous statistical approaches to measure degree of agreement, and identifying many factors that moderate agreement. An important focus of this work has been using multi-society international comparisons to examine cross-cultural similarities and differences in cross-informant agreement. The articles in this Special Issue represent a significant paradigm shift in which cross-informant agreement is examined as an independent variable predicting a wide variety of outcomes. Furthermore, moving beyond perceptions of adolescent mental health, these articles compare parent and adolescent perceptions of diverse aspects of family functioning (e.g., family conflict, parent–adolescent communication, family relationships, parental authority). Additionally, the research presented in this Special Issue employs innovative and sophisticated statistical techniques. Although the Special Issue represents some first steps toward considering cross-cultural aspects of perceptions of family functioning, much work still needs to be done in this area. Some suggestions for future research strategies to accomplish this goal conclude this commentary.

To advance international mental health assessment, instruments that have been internationally validated are needed. To this end, we analyzed ratings from 14 societies on the Adult Behavior Checklist (ABCL), a collateral-report form parallel to the Adult Self-Report (ASR; Achenbach and Rescorla 2003 ) for ages 18 to 59. Both the ABCL and the ASR assess problems, personal strengths, and adaptive functioning. For a sample of 8322 see note below collaterals, we found strong consistency across societies regarding which ABCL problem items tended to obtain relatively low, medium, or high ratings. Most societal effect sizes (ESs) for problem scale scores were small to medium (< 13.9 %), but the ES for the ABCL Personal Strengths scale was 25 %. For most of the same participants ( N  = 8,302), we analyzed cross-informant agreement between self-reports on the ASR and collateral reports on the ABCL. Cross-informant correlations for problem scale scores averaged .47, with considerable societal variation. Problem score means were higher on the ASR than the ABCL in every society, but the size of the difference varied across societies. Mean item ratings on the ABCL and ASR were highly correlated within every society (mean r  = .92), but within-dyad item rating agreement varied widely in every society (mean r  = .39). In all societies, non-corroboration of self-reported deviance and of collateral-reported deviance was common. Overall findings indicated considerable similarity but also some important differences in collateral-reported problems and adaptive functioning across 14 societies.

To improve international needs assessment for child mental health services, it is necessary to employ standardized assessment methods that can be easily administered and scored, can be interpreted by practitioners and researchers with various kinds of training, and that perform similarly across many societies. To this end, we tested the effects of both society and culture on parents’ ratings of children’s problems. We used hierarchical linear modeling as well as analyses of variance to analyze parents’ Child Behavior Checklist ratings of 72,493 6- to 16-year-olds from 45 societies. The 45 societies were nested within 10 culture clusters based on the Global Leadership and Organizational Behavior Effectiveness (GLOBE) taxonomy. Societal differences accounted for 3.8–10.7% of variance in various kinds of problems, while differences between culture clusters (e.g., Anglo vs. Confucian) accounted for 0.1–10.0%. By contrast, differences associated with parents’ ratings of individual children accounted for 85.5–93.3% of variance. Averaged across 17 problem scales, society plus culture cluster accounted for about 10% of the variance in parents’ ratings of children’s problems, whereas individual differences and other possible variables accounted for about 90%. These findings indicate that parents’ standardized ratings can be used to assess effects associated with individual differences in child and adolescent psychopathology, over and above differences associated with societies and culture clusters.

This study examined the criterion validity of the Child Behavior Checklist (CBCL) and Teacher’s Report Form (TRF) problem scales and items in demographically-matched Singapore samples of referred and non-referred children (840 in each sample for the CBCL and 447 in each sample for the TRF). Internal consistency estimates for both the CBCL and TRF scales were good. Almost all CBCL and TRF problem scales and items significantly discriminated between referred and non-referred children, with referred children scoring higher, as expected. The largest referral status effects were on attention problems scales and their associated items, with the TRF having larger effects than the CBCL. Effect sizes for demographic variables such as age, gender, ethnicity and SES were much smaller than effect sizes for referral status, across both the CBCL and TRF forms and at both the scale and item levels. These findings suggest that teachers can be effective partners in identifying children who need mental health services and those who do not.

We analyzed CBCL/1½-5 Pervasive Developmental Problems (DSM-PDP) scores in 3- to 5-year-olds from the Study to Explore Early Development (SEED), a multi-site case control study, with the objective to discriminate children with ASD (N = 656) from children with Developmental Delay (DD) (N = 646), children with Developmental Delay (DD) plus ASD features (DD-AF) (N = 284), and population controls (POP) (N = 827). ASD diagnosis was confirmed with the ADOS and ADI-R. With a cut-point of T ≥ 65, sensitivity was 80% for ASD, with specificity varying across groups: POP (0.93), DD-noAF (0.85), and DD-AF (0.50). One-way ANOVA yielded a large group effect (η 2  = 0.50). Our results support the CBCL/1½-5’s as a time-efficient ASD screener for identifying preschoolers needing further evaluation.

Standardized assessment instruments developed in one society are often used in other societies. However, it is important to determine empirically how assessment instruments developed in one society function in others. The present study tested the fit of the Teacher's Report Form syndrome structures in 20 diverse societies using data for 30,030 6- to 15-year-old students from Asia; Australia; the Caribbean; eastern, western, southern, and northern Europe; and the Middle East. A correlated seven-syndrome model and a hierarchical Attention Problems model were tested separately in each of the 20 societies via confirmatory factor analyses. The results supported the fit of the models in the tested societies.

This study compared teachers' ratings of behavioral and emotional problems on the Teacher's Report Form for general population samples in 21 countries (N = 30,957). Correlations between internal consistency coefficients in different countries averaged .90. Effects of country on scale scores ranged from 3% to 13%. Gender effects ranged from <1% to 5%, and age effects were all <1%. With great consistency across countries, scores were higher for boys than for girls on eight scales: Total Problems; Externalizing; the Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior syndromes; and Diagnostic and Statistical Manual (DSM)-oriented Attention Deficit Hyperactivity Problems, Oppositional Defiant Problems, and Conduct Problems. Correlations between mean item ratings in different countries averaged .74. Teacher's Report Form results were thus similar across 21 very diverse countries, despite differences across these countries in school systems, models of pedagogy, and curricula.

This study investigated vocabulary size and vocabulary composition in Greek children aged 1 ; 6 to 2 ; 11 using a Greek adaptation of Rescorla's Language Development Survey (LDS; Rescorla, 1989). Participants were 273 toddlers coming from monolingual Greek-speaking families. Greek LDS data were compared with US LDS data obtained from the instrument's normative sample (Achenbach & Rescorla, 2000). Vocabulary size increased markedly with age, but Greek toddlers appeared to get off to a slower start in early word learning than US children. The correlation between percentage word use scores in Greek and US samples was moderate in size, indicating considerable overlap but some differences. Common nouns were the largest category among the fifty most frequent words in both samples. Numbers of adjectives and verbs were comparable across languages, but people and closed-class words were more numerous in the Greek sample. Finally, Greek late talkers showed similar patterns of vocabulary composition to those observed in typically developing Greek children.