Akademik Veri Yönetim Sistemi
14th International Congress on Psychopharmacology, Antalya, Türkiye, 22 - 25 Ekim 2023, ss.2-3
Introduction
of Pre-School Age Psychiatric Assessment (PAPA) and Our Clinical Experience
with PAPA
Assoc. Prof. Dr.
Esra Yürümez
In our country, due to
the lack of a reliable and valid structured interview tool to conduct
psychiatric evaluations of preschool children, the parameters of preschool
psychopathology is mostly unknown. The Preschool Age Psychiatric Assessment
(PAPA) is a comprehensive and reliable diagnostic tool mentioned in literature
to assess psychopathologies of preschoolers Edger et al., 2004). In aim to introduce
such a diagnostic tool into our language, we carried out the validity and
reliability study by adapting PAPA to the Turkish society and evaluate the
psychometric properties of Turkish version.
PAPA, which is a
structured and parent-based interview method was started to be developed in
1999. It evaluates the symptoms in four main areas: (1) diagnostic criteria of
all diagnoses in DSM-V ve ICD-11, which are related to the considered age
group, so conditions such as substance-related disorders or sexual disorders
have been removed; 2) all of the Research Diagnostic Criteria-Preschool Age
(RDC-PA) items; 3) all of the Diagnostic Classification of Mental Health and
Developmental Disorders of Infancy and Early Childhood 5 (DC: 0-5); 4)
potential behaviors and symptoms which are not merely diagnostic criteria like
sleeping rituals and peer relationship. Family environment and relationships,
family psychosocial problems, and functional impairments resulting from life events
and addresses not only diseases or problematic areas but also all areas that
play a role in the mental well-being of young children were also evaluated. In
addition, evaluating the relational context of preschool behavior is one of the
most important features of PAPA. It is regularly updated to reflect changes in
diagnostic systems. The latest available version assesses the following areas:
family structure and function, brief developmental assessment, child care, play
and peer relationships, somatization, food preferences and appetite,
elimination behaviors, sleep behaviors, separation anxiety, worries, anxious
affect, rituals and repetitions,stereotypes, tics and trichotillomania,
reactive attachment disorder, regulation, psychosis, hypomania and mania,
depression, conduct problems, hyperactivity, post-traumatic stress disorder
(PTSD), life events, incapacity, impact assessment and ending the interview.
According to the
reliability study of PAPA (Egger et al., 1999), no significant difference was
found according to age, gender, and race. The interview has been shown to be
valid even for the assessment of children as young as two years of age.
In our outpatient
clinic, all patients aged 2-6 years who applied were evaluated in terms of
inclusion/exclusion criteria, and written and verbal consent was obtained from
the parents who agreed to participate in the study. After that, a child psychiatrist
interviewed the children and conducted psychiatric examinations of the
children. After the psychiatric examination and evaluation of the patients, the
PAPA interview was implemented with the parents. The sociodemographic data form
and the PAPA short forms were filled out by the clinician conducting the
interview.
The data of more than
300 children were collected and following a detailed and meticulous statistical
study process, the psychometric features of Turkish version of PAPA were found
to be adequately reliable and strongly consistent with both DC: 0-5 and DSM-5
symptoms and disorders in preschoolers.
References
1.
Egger, HL, Angold, A, Small, B, Copeland, W.
The preschool age psychiatric assessment. In The Oxford Handbook of
Infant, Toddler, and Preschool Mental Health Assessment. Oxford
University Press: 1999; 227-243.
2.
Egger, HL, & Angold, A. The Preschool Age
Psychiatric Assessment (PAPA): A Structured Parent Interview for Diagnosing
Psychiatric Disorders in Preschool Children. In R. DelCarmen-Wiggins & A.
Carter (Eds.), Handbook of infant,
toddler, and preschool mental health assessment. Oxford University
Press: 2004; 223-243.